Substance Abuse and PTSD – by Dr. Keerthy Sunder

Portrait of American Soldier looking down

Post Traumatic Stress Disorder, or PTSD, can happen to anyone that experiences or witnesses a traumatic event. It causes severe anxiety that can be debilitating and make taking care of daily responsibilities impossible for some sufferers. Unfortunately, many of those with PTSD turn to substances like drugs and alcohol to help alleviate symptoms and to deal with their anxiety. As with other dual diagnoses, it is important to get treatment for both disorders in order to see significant improvement in either.

Many individuals with PTSD will turn to drugs or alcohol as a way to numb their pain or to gain some measure of control in their lives. Chronic substance abuse creates a complicated Dual Diagnosis, or the co-existence of a serious psychiatric disorder and an addictive disorder. Recovering from this Dual Diagnosis requires a careful exploration of the causes of PTSD, combined with treatment for drug or alcohol addiction.

What Is Post-Traumatic Stress Disorder?

PTSD is a condition in which an individual experiences tremendous stress or anxiety after witnessing or being engaged in a traumatic event. Any physical or psychological trauma that leaves the individual feeling powerless and out of control may lead to PTSD. Some of the most common causes of the condition include:

  • PTSD symptoms - step 12 magazine - Substance AbuseMilitary combat
  • Violent assault
  • Natural disasters
  • Sexual assault
  • Childhood abuse

The nightmares and flashbacks of PTSD typically involve crises that have never been fully resolved in the individual’s psyche. For instance, a soldier who was taken prisoner in a battle and couldn’t fight his captors might have flashbacks to the incident as a way to work through unresolved anger and fear. A child who felt powerless when she was sexually abused by an older relative might grow up living with intrusive feelings of helplessness and revenge.

In women, sexual abuse is one of the most common causes of PTSD and addiction, according to the National Center for PTSD at the U.S. Department of Veterans Affairs. Combat is another common reason for PTSD, especially in men. In Vietnam veterans seeking treatment for PTSD, between 60 and 80 percent also require treatment for substance abuse.

Symptoms of PTSD include nightmares, flashbacks, avoidance of things related to the event, severe anxiety, sleeplessness, aggressive behavior and angry outbursts. These symptoms can strike the individual at any time, most commonly when he or she is reminded of the events in question.

The symptoms of PTSD can be divided into three general categories: 1) re-experiencing the traumatic incident, 2) avoiding experiences that evoke memories of the incident, and 3) symptoms of hyper-arousal, such as irritability, anger or extreme anxiety. People who experience these symptoms for at least one month may be diagnosed with PTSD. Alcoholism and drug abuse fall into the category of avoidance symptoms, as the individual may use these chemicals to avoid memories or to numb fear.

When alcohol or drugs are used to manage PTSD symptoms, the symptoms of the disorder only become more severe. As a central nervous system depressant, alcohol can worsen depression and anxiety and interfere with normal sleep patterns. Under the influence of alcohol, someone with PTSD is more likely to engage in risk-taking behavior, such as driving under the influence, or to engage in an altercation with someone else.

For this reason, PTSD and substance abuse often lead to legal problems, incarceration, poverty, broken homes and chronic unemployment. Getting the right treatment for this Dual Diagnosis may make the difference between whether or not an individual is able to lead a satisfying, healthy life.

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