PTSD and Addiction: A Cycle of Trauma and Self-Medication
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PTSD and Addiction: A Cycle of Trauma and Self-Medication

It’s no secret that America is currently in the grips of an opioid epidemic so widespread and deadly that the president in 2017 declared it a public health emergency. One of the ways that people can work to fight against the rising tide of fatal drug overdoses is by understanding and addressing what drives an individual to start using drugs in the first place.

Substance use disorders rarely, if ever, have a single cause. There are often many elements and contributors behind why one person may be more vulnerable to addiction than another. These factors also explain why they might be driven to start using drugs or alcohol until they become dependent on them, including family history, mental health issues, genetic predispositions, and past trauma.

Post-traumatic stress disorder (PTSD) is defined as protracted symptoms associated with a traumatic situation or experience. An estimated eight million adults age 18 and older in the United States currently suffer from PTSD and are between two and four times more likely to struggle with substance abuse than those without PTSD. In fact, more than 50 percent of those who seek treatment for a substance abuse disorder meet the criteria for PTSD.

PTSD and addiction are both complex and chronic problems, but what exactly is it about Post-traumatic stress disorder that makes those living with it more susceptible to using and eventually abusing drugs or alcohol? And why doesn’t solving one of these issues help the other?

What Are the Causes and Symptoms of PTSD?

To properly understand the link between PTSD and addiction, one needs to understand PTSD and how it affects those afflicted with it. While PTSD is often discussed in the context of military veterans, PTSD can also be caused by living through or witnessing traumatic events such as:

  • Accidents
  • Natural disasters (earthquakes, hurricanes, etc.)
  • Physical, emotional, or sexual abuse
  • Sexual assault
  • Terrorist attacks

This is just a short list of situations and experiences that can cause someone to develop PTSD. Family members of trauma victims have also been known to suffer from the disorder through what is known as “vicarious trauma.” It can occur at any age, affects both men and women, and research has shown that it may even run in families, appearing in descendants with no exposure to trauma.

Some common symptoms of PTSD include:

  • Feeling as if the trauma is happening all over again, also known as flashbacks
  • Nightmares and difficulty sleeping
  • Depression
  • Anxiety and panic attacks
  • Intense emotional outbursts
  • Feelings of numbness or detachment
  • Dissociation or depersonalization from one’s thoughts or feelings
  • Hypervigilance
  • Difficulty concentrating

The symptoms usually begin within a few months of the traumatic incident, but it can sometimes take years for them to appear. Some people recover from PTSD in six months or a year, while for others it can become a chronic condition.

Self-Medicating Through Substance Abuse

With such debilitating symptoms, it becomes clear why so many people living with PTSD might seek solace in drugs or alcohol. But why choose them over therapy or treatment?

There are many reasons that someone with PTSD might forgo treatment and instead turn to substance abuse:

  • They don’t think or realize that what they have is PTSD, perhaps because they only see the symptoms and not the bigger picture, or lack the mental health knowledge necessary to recognize it.
  • They lack the resources, such as time, money, and access to medical professionals that are trained to handle PTSD, or they don’t know where to start.
  • They are too ashamed or scared to get help due to the stigma of mental illness that still very much exists today. This is especially true of veterans, many of whom view admitting to suffering from the symptoms associated with PTSD as a sign of weakness.

And so, instead, people turn to the temporary relief that drugs and alcohol can provide, numbing feelings of anxiety or hypervigilance, inducing sleep, and disconnecting from negative memories.

No one who begins drinking or using drugs sets out to become addicted, but unfortunately, using drugs and alcohol to manage PTSD will lead not only substance abuse but also a worsening of symptoms over time.

This is in part because your body and brain become chemically dependent on drugs or alcohol. The symptoms of PTSD will come back stronger as the “high” wears off and they will now be coupled with withdrawal symptoms and drug cravings. Also, becoming lost in drugs and alcohol only serves to continue the cycle of avoidance instead of confronting the issues at the root of your mental condition and can actually make your symptoms last longer than they otherwise would.

The most dangerous aspect to self-medicating with drugs and alcohol is even more sinister. Once you have reached the point where you need these substances to function and you have regularly been using for a long period of time, your body builds up a tolerance and requires more of the substance to achieve the desired effects. As the dosage gets higher and higher, the odds of an overdose increase exponentially and, depending on the substance, can be potentially fatal.

Breaking the Cycle

An incorrect but unfortunately common belief about co-occurring disorders (simultaneously suffering from both mental illness and a substance use disorder) is that treating one issue will fix the other. However, this is simply not the case.

Attempting to treat only the PTSD will not be enough to stop someone’s substance abuse issues. This is because, once it has progressed enough to be considered an addiction, the individual will have developed a tolerance and will become physically and psychologically dependent, having had their reward system effectively hijacked.

Treating the cause behind PTSD will not have any effect on physical symptoms such as drug cravings or withdrawal. The addiction will likely undermine most aspects of the PTSD treatment, as the person’s judgment, perception, and understanding will be impaired.

On that same note, focusing solely on an individual’s substance use disorder is a case of just treating the symptoms and the not the disease. Treating the issues that have manifested as a result of PTSD—such as addiction, eating disorders, or self-harm, for example—fails to address the root of the problem and will most likely allow the symptoms to continue to manifest, even if someone can manage them for a brief period. This is partly why many people with PTSD give up on seeking treatment or find it ineffective.

When someone is battling both PTSD and addiction, these disorders must be treated concurrently. This is typically done in an addiction recovery setting, as the majority of addiction centers offer dual diagnosis treatment. This form of integrated treatment means that someone in an addiction rehabilitation program will be able to get expert and professional help recovering from addiction as well as understanding and addressing the factors behind it such as Post-Traumatic Stress Disorder.

Ending Stigmas and Saving Lives

Misconceptions about both substance abuse and mental illnesses like PTSD make people struggling with either one less likely to seek out professional help.

Ending the stigma surrounding mental health issues through education and open dialogue has the potential to save lives and make sure that the people in need of treatment receive it instead of self-medicating with drugs and alcohol.

Learning more about addiction and mental health and understanding how they work and affect each other in a person is one way that we can work together to help positively impact the country’s tragically high overdose rates. Call the Palm Beach Institute 855-534-3574 now to speak with an addiction specialist to learn about treatment methods tailored for you. Help may just be one phone call away.

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