Orlando Shooting May Lead to PTSD and Addiction

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Flowers and other tributes were left in front of the landmark Stonewall Inn in New York City to honor the victims of the mass shooting at Pulse nightclub in Orlando, Fla., in June 2016.

The June 12, 2016, mass shooting at the Pulse gay nightclub in Orlando, Fla., has left thousands of people in shock over the gun violence that claimed the lives of 49 clubgoers and injured 53 others, and a nation reeling in the aftermath of what has been called the most deadly shooting on American soil in recent history.

The effects of what has transpired will be felt for many years to come by those who survived. The wounds of such violence go beyond the flesh, tearing into the spirits of everyone who is trying to make sense of a senseless crime and figure out how to move forwardif they can.

Some survivors of traumatic events will struggle with the guilt that they are among the survivors. Some will feel shame and a grave sense of loss; others will feel angry as they work to regain the sense of safety and freedom they felt before bullets took that away on that fateful night.

An already vulnerable community

The LGBTQ+ community in Orlando and abroad grapple daily with violence, discrimination, bullying, and rejection, which they face over their sexual orientation and identity.

FBI data show that LGBTQ+ people are more likely to be targeted for a hate crime than other minorities, reportsThe New York Times. One statistic reads that people in this community, “are twice as likely to be targeted as African-Americans and the rate of hate crimes against them has surpassed that of crimes against Jews.”

The FBI also reported in 2014 that of the 5,922 single bias incidents reported in 2013, sexual orientation was the second-largest of the top three bias categories at 20.8 percent. Race was No. 1 at 48.5 percent and religion was No. 3 at 17.4 percent.

The National Coalition of Anti-Violence Programs (NCAVP) recently released its National Report on Hate Violence Against Lesbian, Gay, Bisexual, Transgender, Queer and HIV-Affected Hate Violence in 2015, which said there were 24 reported hate violence homicides in 2015, a 20 percent increase from the 20 reported anti-LGBTQ homicides in 2014. Transgender and gender-nonconforming people of color made up the majority of those homicides, according to the report.

“Anti-LGBTQ hate violence can no longer be viewed in isolation from other forms of bias-motivated violence that our community members are experiencing based on their identities,” authors of the report wrote.

The National Alliance on Mental Illness (NAMI) reports that people in the LGBTQ+ population are three times more likely to experience a mental health condition. LGBTQ+ youths are four times more likely to attempt suicide, and questioning youths are three times more likely to attempt suicide than their peers who are straight. “Between 38-65% of transgender individuals experience suicidal ideation,” NAMI reports.

Also, according to the alliance, the LGBTQ+ community reports higher rates of drug, alcohol, and tobacco use than that of straight people. Prejudice, discrimination, lack of cultural competency in the healthcare system, and lack of peer support were cited as major factors as to why.

How this latest wave of violence will affect the mental and emotional health of the LGBTQ+ community in the US and abroad, as well as the larger community, won’t be realized for quite some time. But some observers say the fact that the gunman targeted a club where people in the community felt they were safe to go and be themselves has shattered their sense of security. Some may never feel safe again.

PTSD common after mass shootings, research shows

woman-reflectiveMany of the victims who survived the shooting at Pulse will likely experience mental and emotional distress. This is known as post-traumatic stress disorder, the condition in which a person experiences extreme stress or anxiety after seeing or being a part of a disturbing and traumatic event.

Many of the 300-plus patrons in the Pulse club that night who survived won’t forget the rounds of gunfire, or the chaos and confusion, and loss of life that played out over three hours on that morning.

Clubgoer Norman Casiano, who was shot in the back twice during the ordeal and recently released from the hospital, reported to The New York Times that he could hear gun shells “clattering to the floor” and the gunman reloading the weapon he carried. Casiano also said he’ll never forget that the gunman laughed or the sound of his laugh. Another Pulse club patron, identified in the Orlando shooting, told the newspaper, “People were screaming, begging for their lives.”

These and so many more sights and sounds will be remembered, and any memories or reminders they have could contribute to the post-traumatic stress disorder shooting victims may endure.

According to WebMd, in “1 out of 10 Americans, the traumatic event causes a cascade of psychological and biological changes known as post-traumatic stress disorder.”

“Simply put, PTSD is a state in which you ‘can’t stop remembering,’” WebMd says, which often happens after people experience military combat, violent assaults, natural disasters, car or airplane accidents, sexual assaults, kidnappings, and abusive and threatening situations, among others.

Symptoms are defined and can include having nightmares, flashbacks, jumpiness, emotional detachment or emotional outbursts, and aggressive behavior, among other disturbances. Affected persons may also isolate themselves or suffer from depression. They also may be startled by loud noises or have trouble sleeping or concentrating.

The National Center for Posttraumatic Stress Disorder has studied the effects of mass shootings in the US, concluding that “the psychological consequences of directly experiencing or witnessing a mass shooting are often serious.” The study also found that of the shootings examined, “prevalence of postdisaster diagnoses (predominantly PTSD) in these studies ranged from 10 percent to 36 percent.”

Link between PTSD, substance abuse

When violence strikes, the questions that come to mind are, “What happens to people who are left behind in its wake? How do they move forward?”

Unfortunately, some survivors with PTSD turn to substance use to manage their condition.

Sadly, as people attempt to put their lives back together, some will seek out to abuse substances, a common scenario for people affected by PTSD. Drinking alcohol or doing drugs may be the only way some people know how to cope with their illness.

Alcohol and drug use does not always lead to substance abuse. But WebMd says there are red flags that signal there is a problem with alcohol and/or drugs. Problematic substance use can lead to addiction.

The VA reports that drinking a lot of alcohol makes one more susceptible to having PTSD, along with multiple other factors. Drinking large amounts of alcohol can lead to chemical dependence that leads to substance abuse or an alcohol use disorder.

A person may be developing an Alcohol Use disorder when they are:

  • Unable to control their temper after drinking
  • Feeling guilty about drinking or using drugs
  • Avoiding personal responsibilities, obligations to themselves and others
  • Drinking to numb their feelings or deal with stress
  • Trying unsuccessfully to quit drinking, doing drugs
  • Engaging in risky behavior, such as driving under the influence or operating machinery
  • Spending a great deal of time trying to obtain illicit substances

If you, or someone you know, are exhibiting signs of an alcohol use disorder, and have experienced trauma in the recent, or not-so-recent past, that person may be suffering from post-traumatic stress disorder and needs to seek help as soon as possible.


Post-traumatic stress disorder sufferers can undergo treatment that helps them regain control over their lives, says the Mayo Clinic. The primary treatment is psychotherapy, which teaches sufferers how to address their symptoms and helps them learn healthy ways to cope with their symptoms should they arise again. Medication is also prescribed for affected individuals, though the biological, psychological, and social determinants of each person must be considered before it is.

Psychotherapy, also known as talk therapy, may include:

*Cognitive therapy. In this method of therapy, clients recognize and identify negative and inaccurate thinking patterns in normal, everyday situations that might keep them stuck. The Mayo Clinic says this type of therapy may also be used along with exposure therapy.

*Exposure therapy. This behavioral therapy method allows individuals to face their fears so they can cope with them effectively. Individuals may participate in “virtual reality” programs in which they re-enter the setting in which they experienced trauma to help them manage or overcome their reactions to it.

*Eye movement desensitization and reprocessing. Known as EMDR, this therapy method uses exposure therapy along with guided eye movements to help the individual process traumatic experiences and change their reaction to those events.

PTSD treatment may also include antidepressants, which can help improve concentration and sleep, and medicines that treat anxiety.

We are here to help

If you, or someone you know, are struggling with post-traumatic stress disorder with a co-occurring substance use disorder, or if you suspect you have symptoms of the condition, please call Palm Beach Institute at 855-534-3574. There is no better time than now to take your first step toward gaining control of your life. Our specialists are available anytime, day or night, and waiting for your call. Begin your journey to lasting health, happiness, and sobriety today.

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