While post-traumatic stress disorder (PTSD) can happen for many reasons, we have seen an increasing number of people with the condition in our population. Many soldiers who return from active duty overseas report struggling with PTSD.
As many as 11 percent of those returning from Afghanistan report symptoms of PTSD, and 31 percent report experiencing symptoms that served in the Vietnam War. So what is post-traumatic stress disorder exactly?
The National Institute of Mental Health (NIH) defines PTSD as a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. Soldiers are not limited to the disorder. It can affect those who have experienced a traumatic event, such as a shooting, violence, or car accident, or even a near-death experience.
It’s a natural reaction to feel afraid during and after a traumatic situation. Fear triggers several split-second changes that help the body to avoid danger or how to defend against it. This is called our fight-or-flight response, and it is a standard reaction to protect us from harm. It is common for any single person to experience various responses to a significant event, but most people will recover from their initial symptoms without any aid.
Someone who continues to experience problems after an event that takes place could be diagnosed with PTSD. Those with the disorder can feel stressed and frightened even when no danger is present. It is a common yet complex disorder that researchers are still trying to understand.
Not everyone who experiences a bout of trauma is going to develop an ongoing or even short-term episode of PTSD. As mentioned above, soldiers are not limited to the sphere of PTSD, but people who lose loved ones and any traumatic event can spur the development of the disorder. Symptoms begin early on, but can also start years afterward.
The signs must last more than a month to be severe enough and interfere with relationships or standard obligations to be considered PTSD. Symptoms can range from re-experiencing the event through flashbacks, bad dreams, or intrusively frightening thoughts. When someone re-experiences the trauma, it can interfere with everyday thoughts and feelings. Those who avoid the symptoms will stay away from places or events and cause changes in the daily routine.
So how does all of this tie into substance abuse? Statistics show that upward of 55 percent of those dealing with PTSD also battle with substance addiction. Those with PTSD are two to four times more likely to battle addiction than their peers. Seven out of eight people will deal with it in their lifetime. So how is substance abuse relevant?
Substance Abuse And PTSD
A complex relationship surrounds post-traumatic stress disorder and substance abuse, and people who use addictive substances to mask their pain. This presents a more difficult challenge to overcome during treatment.
High levels of stress make it more likely that someone will turn to drugs or alcohol to escape. If someone is feeling down and a substance can take away the pain, help them feel normal in society, and resume daily activities, it seems like a no-brainer that they will consume drugs. Substance use also increases pleasure, decreases anxiety, and serves as a distraction from these emotions.
When stress levels increase, levels of the naturally occurring chemicals called GABA (gamma-Aminobutyric acid) decrease and adrenaline increases. GABA is the chemical used to help us sleep, ease anxiety, and keep us calm in times of need, but drugs like benzodiazepines and alcohol also stimulate GABA.
When drugs increase the presence of dopamine in the brain, it will tell those chemical messengers to feel happy. When the substances begin to wear off, the mood will start to drop. When our brain stops producing the chemicals on its own because it depends on the drugs, the person using will need the drugs to feel normal. This is the beginning of a substance use disorder called chemical dependency.
Disorders like PTSD, in which stress is a side effect, can interfere with someone’s impulse control, learning, and memory functions. When drug use is presented into the equation, it can become a coping mechanism known as self-medication for negative symptoms. Anytime the person feels stress or anxiety; their initial instinct will be to grab a pill to counteract their negative thoughts.
Some symptoms can help you understand if either you or someone you love is battling with post-traumatic stress disorder. They include:
- Changes in appetite or sleep habits
- Decreased interest in hobbies, spending more time alone to consume a substance
- Extreme mood swings
- Relationship issues
- Drinking or using more of a drug than intended or desired
Only a mental health professional can diagnose PTSD and a substance use disorder which is known as a dual diagnosis.
Most Commonly Abused Drugs With PTSD
People who have PTSD are most likely to use drugs that inhibit the brain’s stress control mechanism known as the fight-or-flight response. The system involves stress and anxiety, which is the primary area that is overstimulated with PTSD. Drugs that depress these areas are highly sought out for the reasons mentioned above. With that said, the most commonly abused substances include:
- Anti-anxiety medications (Xanax, Valium)
- Opioid painkillers (Vicodin, OxyContin)
Alcohol is one of the most commonly abused drugs for this with PTSD because of its low cost and availability. Nearly 60 to 80 percent of military veterans who seek help for PTSD have alcohol use disorders.
How To Overcome PTSD And Substance Abuse
To overcome both substance abuse and post-traumatic stress disorder, both conditions must be addressed at the same time. The severity of PTSD symptoms increases the challenges clinicians must address when treating clients with co-occurring disorders. The issues must be addressed simultaneously. Therapy will involve processing traumatic events that led to the development of the disorder as well as addressing the underlying causes that led to substance abuse. It is common that both disorders are the result of the same issues.
There have been promising results for an integrated treatment that provides exposure therapy for PTSD and cognitive behavioral therapy for people who have co-occurring conditions. It is most beneficial when it takes place in a focused, inpatient treatment program by professionals who are experienced in treating these two disorders at the same time. The most beneficial course of care involves:
- Medical detoxification to support withdrawals from the substance of abuse
- Trauma-focused cognitive behavioral therapy that helps the client learn how to manage their symptoms of PTSD and begin the arduous process of avoiding relapse
- Medications may be necessary to manage withdrawal symptoms and avoid relapse
- Addiction affects everyone involved, not just the user, and family therapy is necessary to repair the relationships that were injured from both disorders
- Support, therapy, and reinforcement following treatment are the keys to abstaining from drugs or alcohol, and also practicing the new behaviors. These will help the client manage triggers and challenges presented during recovery from PTSD and substance abuse. With adequate treatment, a long-term and full recovery is a real possibility.