Some Pulse Survivors Grapple with PTSD Years After Shooting

Many lives have not been the same since June 12, 2016.

In the wee hours of that morning, bullets tore through Pulse, a gay nightclub in Orlando, Fla., claiming the lives of 49 people and injuring 53 others.

While today marks three years since the mass shooting happened, the wounds of such violence are fresh for many of the survivors. Many have not regained the sense of security they had before their haven of safety was taken under siege. Countless people in the LGBTQ+ community live in fear that they will be targeted next.

Trying to make sense of a senseless crime and figuring out how to move forward has not been easy, and while time has passed, many psychological wounds have not healed.

“They warned us that years three, four and five will be very different. They are,” Pulse club owner Barbara Poma told the Tampa Bay Times for its report marking the three-year anniversary. Poma is also the executive director of the onePulse Foundation.

“I don’t know how to explain it, but it really is a different feeling,” she said. “It’s hard to really wrap your brain around.”

At least 300 patrons, if not more, were at the Pulse club on the morning of June 12. They endured rounds of gunfire, chaos and confusion, and the loss of life during the three-hour ordeal.

Clubgoer Norman Casiano, who was shot in the back twice during the attack, told The New York Times shortly after it happened 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.”

Survivors and the LGBTQ+ community in Orlando and abroad have no doubt tried to move on from the tragic turn of events. But some have found that hard to do, especially as they struggle with post-traumatic stress disorder or PTSD.

PTSD Common After Mass Shootings, Research Shows

PTSD is the condition in which a person experiences extreme stress or anxiety after seeing or being a part of a disturbing and traumatic event. It is common for people who have gone through trying circumstances to experience this for weeks, months, or even years.

Many of the patrons who were at Pulse at that time won’t ever forget the rounds of gunfire, or the chaos and confusion, and loss of life that played out over three hours on that morning.

Pulse survivor Orlando Torres, who drives an Uber and Lyft, recently reflected on the three-year anniversary to the Tampa Bay Times, saying he had to change jobs because he could no longer work in an office with a shared restroom. He was once a promoter for the nightclub and a bus driver.

Torres was one of the people who were trapped inside a restroom stall as the gunman started shooting on the club’s dance floor. He heard screams and the sound of bullets flying. He recalled playing dead when the shooter poked him after Torres’ cell phone rang.

According to the Tampa Bay Times’ article, Torres has PTSD. He wants to start therapy again once he can find the time and money, he told the newspaper.

“I just need something to correct me or put me in a straight line or put my mind or heart at ease,” he said.

Other Pulse survivors told the newspaper that recent mass tragedies have triggered them, such as the mass shootings at a high school in Parkland, Fla., and at a music festival in Las Vegas.

“This isn’t something that’s going to heal itself,” Brian Reagan told the newspaper. “We’re at three years and people still feel like it happened just yesterday.”

PTSD Happens When People ‘Can’t Stop Remembering’

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 writes.

The disorder 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

While some like Torres will seek therapy to help them cope, others may seek solace in addictive substances, such as drugs and alcohol, to manage their PTSD. This is a common scenario among 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 red flags can signal there is a problem with alcohol and/or drug use. Problematic substance use can lead to addiction.

The U.S. Department of Veterans Affairs (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 use disorder or alcohol use disorder. lists the following symptoms of substance use disorders:

Behavioral changes, such as:

  • Drop in attendance and performance at work or school
  • Frequently getting into trouble (fights, accidents, illegal activities)
  • Using substances in physically hazardous situations such as while driving or operating a machine
  • Engaging in secretive or suspicious behaviors
  • Changes in appetite or sleep patterns
  • Unexplained change in personality or attitude
  • Sudden mood swings, irritability, or angry outbursts
  • Periods of unusual hyperactivity, agitation, or giddiness
  • Lacking of motivation
  • Appearing fearful, anxious, or paranoid, with no reason

Physical changes, such as:

  • Bloodshot eyes and abnormally sized pupils
  • Sudden weight loss or weight gain
  • Deterioration of physical appearance
  • Unusual smells on breath, body, or clothing
  • Tremors, slurred speech, or impaired coordination

Social changes, such as:

  • Sudden change in friends, favorite hangouts, and hobbies
  • Legal problems related to substance use
  • Unexplained need for money or financial problems
  • Using substances even though it causes problems in relationships


If you, or someone you know, are exhibiting signs of substance 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.

An Already Vulnerable Community

Members of the LGBTQ+ community across the globe grapple daily with violence, discrimination, bullying, and rejection, which they face over their sexual orientation and identity.

Hate crime data released from the Federal Bureau of Investigation (FBI) show that in 2017, of the 7,175 hate crime incidents reported, 1,130 of them were based on sexual orientation and 119 on gender identity bias.

According to a report from the Human Rights Campaign, which reviewed the FBI’s data, “These numbers reflect a 5 percent increase in reporting of hate crimes motivated by sexual orientation bias, and a 4 percent decrease in reporting of hate crimes motivated by gender identity bias.

“However, of incidents reported that were motivated by gender identity bias, 106 targeted transgender people, representing a 1 percent increase from 2016. 

“The overall decrease in reported hate crimes motivated by gender identity bias in 2017 is largely due to a 31 percent decrease in incidents targeting gender non-conforming people.”

From the FBI’s data:

Of the 1,338 victims targeted because of  sexual-orientation bias:

  • 57.8 percent were victims of crimes motivated by their offenders’ anti-gay (male) bias.
  • 24.9 percent were victims of anti-lesbian, gay, bisexual, or transgender (mixed group) bias.
  • 12.3 percent were victims of anti-lesbian bias.
  • 2.8 percent were victims of anti-heterosexual bias.
  • 2.2 percent were victims of anti-bisexual bias.

And of the 132 victims of gender-identity bias:

  • 119 were victims of anti-transgender bias.
  • 13 were victims of anti-gender non-conforming bias.

LGBTQ+ people are more likely to be targeted for a hate crime than other minorities, reportsThe New York Times.

The Human Rights Campaign goes on to say in its report that, “Despite the slight decrease in reported hate crimes motivated by gender identity bias, anti-transgender violence remains an epidemic.

“In 2017, advocates reported the tragic deaths of 29 transgender individuals across the U.S., the highest number ever recorded in a single year. While it is unclear if all of these were hate crimes, they illustrate the fatal violence that affects transgender people, especially transgender women of color who live at the intersections of racism, sexism and transphobia.”

Mental Health Is Significant Issue in LGBTQ+ Community

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.

Torres and Reagan, according to the Tampa Bay Times, have advocated for access to mental health resources in Florida for the people who need them.


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 855-960-5456. 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.

Addiction & the Military: How PTSD Leads to Addiction

Memorial Day weekend is a time that we as Americans can reflect on the sacrifices our men and women in uniform have made in order for us to continue to experience freedom. Those individuals who have served or actively serve in our military deserve nothing but the utmost in respect for giving their time, energy and lifetime to us as a society. However, there is a growing percentage of returning veterans that are coming back from active duty with significant physical injury as well as mental distress. One of the most common afflictions that returning soldiers can face is post-traumatic stress disorder (PTSD).

PTSD is one of the most emotionally debilitating disorders that one can face, especially for our soldiers. PTSD can cause intense anxiety, intrusive memories and vivid flashbacks that can interfere with daily functioning. In the absence of proper therapy, counseling and other support, a good number of our veterans turn to alcohol and drugs in order to numb the pain or to find some sort of control in their lives. With the presence of substance abuse, this can create a complicated dual diagnosis and become essential to understand the roots of the causes of PTSD along with treatment for alcohol and/or drug addiction.

Statistics: Substance Abuse and PTSD

The statistics concerning substance use and abuse and the prevalence of PTSD among military personnel has become increasingly concerning. For example, it is estimated that up to 75% of combat veterans that have lifetime PTSD also met the criteria for lifetime alcohol and/or drug dependence. Male soldiers are twice as likely to develop substance abuse issues when PTSD is present in comparison to female soldiers. One area of concern is the growing tide of prescription drug abuse. In the period between 2002-2005 prescription drug abuse among the military doubled and in the years 2005-2008 the rate tripled.

Alcohol abuse is the most prevalent problem and one which poses a significant health risk. A study of Army soldiers screened 3 to 4 months after returning from deployment to Iraq showed that 27 percent met criteria for alcohol abuse and were at increased risk for related harmful behaviors. Additionally, there is the specter of mental illness. In another study of returning soldiers, clinicians identified 20 percent of active and 42 percent of reserve component soldiers as requiring mental health treatment. Drug or alcohol use frequently accompanies mental health problems and was involved in 30 percent of the Army’s suicide deaths from 2003 to 2009 and in more than 45 percent of non-fatal suicide attempts from 2005 to 2009.

Why Turn To Drugs and Alcohol?

There are several key reasons regarding why those in the military who suffer from PTSD turn to drugs and alcohol to cope with their disorder. A common reason those in the military turn to drugs—and especially alcohol—is the fact that it is viewed as the best “over the counter” medication available. In the case of alcohol, it is legal and inexpensive and the results of drinking can be seen as predictable in the fact that it can numb and slow things to the point where life is seemingly more manageable.

Secondly, the military’s “zero tolerance” policy can also contribute to the problem of substance abuse among military personnel. While this type of policy does lower the instance of illicit drug use while soldiers on are active duty it does not provide any sort of outlet for help in case someone were to develop a substance dependence issue. Additionally, military medicine follows the concept of “partitioning” where the addiction counselor, the psychiatrist, the neurologist and the doctor work separately rather than in conjunction with one another.

While the wounds and trauma may be healed on those individual levels, substance abuse is a complex issue which has a presence of many levels. In order to effectively treat the substance abuse, the mental and physical pain and trauma must all be acknowledged and accounted for in addition to the substance abuse. The best thing we could do for the thousands of Americans in uniform now, who often return troubled by their experiences, is to apply some common sense to their healing. If you or someone you know is suffering from a drug & alcohol problem call The Palm Beach Institute today at 1-855-470-2050.