How PTSD Can Cause Substance Abuse

11/17/19: Addiction Recovery

Post Traumatic Stress Disorder (PTSD) is an extremely emotionally, mentally, and even physically debilitating disease that can have a profound impact on an individual’s life, and that of their family and close friends as well. Because of how intertwined the symptoms of PTSD can become in a person’s day-to-day activities, the life of someone struggling with this disorder can be very exhausting. It is no wonder, then, that around 50–66 percent of people who suffer from PTSD also have problems with addiction, and vice versa (according to TIME). In addition, according to the journal Clinical Psychology, individuals with PTSD are also between two and four times more likely to have a substance abuse problem than their peers without PTSD. We are going to discuss just how PTSD can lead to substance abuse, and what to do if you believe you or a loved one is experiencing PTSD and/or addiction.

What is Post Traumatic Stress Disorder?

PTSD can be very complex, and often co-occurs with other mental health issues. According to the National Institute of Mental Health (NIMH), it is a disorder that affects around 7–8 out of 100 people in their lifetime. People who experience a traumatic or life-threatening event often come away with PTSD. When an individual perceives a danger to their life, their brain triggers the “fight-or-flight” response, resulting in a spike of adrenaline, heart rate, blood pressure, breathing rate, and body temperature. This causes them to be wide awake, alert, and ready to respond accordingly in a potentially hazardous encounter. This is a very natural response, and we want our bodies to respond in this way because it allows us to think on our feet and do what needs to be done to avoid serious injury or death. This becomes an abnormality when this reaction continues to occur long after the danger has passed, and it is no longer necessary. This is PTSD.

What can cause PTSD?

PTSD is said to be incited from a “traumatic event.” But what counts as a “traumatic event”? It is impossible to say whether or not something is guaranteed to cause PTSD, and sometimes a person can witness something that we would definitely consider to be a severely traumatic occurrence and still come out of it without developing this disorder. However, on the other hand, there is no severity scale out there that dictates what people should and shouldn’t find traumatic. As long as their brains register an occurrence as trauma, the person can develop PTSD from it. That said, the occurrences that most often lead to one developing PTSD include:

• serious accidents
• physical or sexual assault
• abuse, including childhood or domestic abuse
• severe health problems
• childbirth experiences, such as experiencing a miscarriage
• war and combat
• torture

Know, however, that this is not a comprehensive list. Just because you haven’t experienced any of the things listed above, this doesn’t mean that you do not have PTSD. Also know that on the opposite hand, even if you have experienced any or some of the above, it doesn’t mean you automatically struggle with the disorder. In order to determine if you have this disorder or not, you must undergo a psychological evaluation/mental health assessment performed by a mental health professional.

How is PTSD diagnosed?

As mentioned above, PTSD is diagnosed by a psychiatrist or psychologist, or other qualified mental health professional. In order to be diagnosed with PTSD, an adult must experience all of the following for at least 1-month duration: At least:

• One re-experiencing symptom
• One avoidance symptom
• Two arousal and reactivity symptoms
• Two cognition and mood symptoms

What are the symptoms of PTSD?

As you can see above, the symptoms of PTSD are broken down into four categories:

1. Re-experiencing symptoms. These can be referred to as “flashbacks.” They are often triggered by certain words, objects, situations, occurrences, etc. that remind the person of the trauma they experienced upon witnessing the inciting event. They may be “taken back” to that experience, causing them to feel the fear they felt in that moment all over again. Re-experiencing symptoms can be:
   • Flashbacks
   • Bad dreams
   • Frightening thoughts
2. Avoidance symptoms. These occur when a person purposely avoids the things or activities that they know will trigger their PTSD symptoms. For example, if the person developed PTSD from a car accident, they may avoid driving or being near roads or streets. Avoidance symptoms can be:
   • Staying away from people, places, and things that will trigger feelings of discomfort and fear.
   • Avoiding thoughts or feelings about the traumatic event.
3. Arousal and reactivity symptoms. These symptoms remain fairly consistent throughout a person’s day-to-day life. These can be:
   • Feeling “on edge”, easily startled
   • Difficulty sleeping
   • Irritability that may lead to angry outbursts
4. Cognition and mood symptoms. Cognition and mood symptoms affect a person’s mental well-being. They can be:
   • “Blacking out” certain details of the traumatic event
   • Negative thoughts about oneself
   • Apathy/discontent with life
   • Feeling guilt or blame
   • Loss of interest in activities once enjoyed

PTSD and Addiction

Because of how impactful this disorder is on a person’s daily life, the distress and discomfort of the symptoms may lead a person to use substances or harmful activities to numb the pain they feel. In other words, PTSD causes high levels of stress. As we know, stress is one of the biggest contributing factors to developing an addiction. Drugs, alcohol, certain foods, and activities have the same effect of stimulating the brain’s reward center by releasing dopamine, causing us to experience a pleasurable response. The brain remembers the good feeling that the substance or activity caused, and it will instill a desire in you to continue seeking out whatever caused the response. These pleasurable experiences are especially desired when the person is also experiencing stress brought on by PTSD, as the dopamine provides an escape from the negative feelings. Another important factor in whether or not a person develops an addiction due to PTSD is if they have healthy coping skills. A lack of healthy coping skills is a big predictor of someone turning to drugs, alcohol, or other damaging methods of managing painful emotions. Drug withdrawal symptoms can worsen PTSD symptoms, making it extremely difficult to not only stop using the drug but also to heal from the PTSD itself. This is why if you or a loved one are struggling with PTSD and addiction, it is crucial to seek help as quickly as possible so that you can begin the process of healing as soon as possible.

Treatment Options for PTSD & Substance Abuse

When PTSD and addiction co-occur, it is essential to use a holistic approach and treat the two disorders simultaneously. Not only is the interplay between these two disorders complex, but each individual will have different symptoms and experiences which add to the layers of complexity with treatment. If the dependence on the drug is significant, detoxing is usually the first step. Medical detox is the best and most optimal plan of action for kickstarting treatment. During medical detox, an individual is admitted to a specialized addiction treatment facility where they can stay for as long as it takes for them to get the drug out of their system. These facilities have 24/7 access to knowledgeable, trained medical professionals and mental health counselors who are there for you whenever you need them. You will be able to heal in a secure, safe, and comfortable environment. In order to better manage stress, cope with potential triggers, enhance one’s self-esteem, and combat negative thoughts, behavioral therapies such as Cognitive Behavioral Therapy (CBT) may be used. In addition, Exposure Therapy is useful in helping those with PTSD confront their fears and traumas head-on. In addition, medications, when used in conjunction with behavioral therapy techniques, can help manage severe symptoms so that a person can enjoy their daily life.

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