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PTSD and Addiction

Post-Traumatic Stress Disorder (PTSD) is one of the most common disorders in the United States. In fact, 6.8% of the population will have PTSD at some point during their lives. And, about 3.5% have PTSD in any given year. While that means millions of people struggle with panic, stress, and the other symptoms of PTSD, it also means that millions of Americans are at significantly higher risk of developing complications – like addiction. 

How? Of the 18.5 million Americans with substance use disorder in 2019-2020, 38.5% met criteria for PTSD. 

This extremely high overlap between PTSD and addiction is very similar to that between anxiety and addictiondepression and addiction, or bipolar disorder and addiction. A mental illness greatly increases your risks of substance use disorder and of developing symptoms of addiction.

If you or a loved one experiences a traumatic event leading to PTSD, you’re more likely to be vulnerable to addiction. If you have a substance use disorder, you’re also more vulnerable to PTSD. This negative, reinforcing loop means that PTSD may lead to substance use disorder or substance use disorder may lead to PTSD. 

What is PTSD?

photo of mature psychologist and despair soldier with ptsdPost-traumatic stress disorder is a syndrome in which people become locked in a moment of stress, usually a severe loss of control or a life-or-death situation. This mental health disorder results in physical side-effects like increased cortisol production. In fact, the most defining aspect of PTSD is that the body continues to react as though it is in a high stress situation. Common examples include molestation, physical assault, car accidents, natural disaster, presence in a war zone, terrorist act, or spousal abuse.

In fact, the reason why individuals with substance use disorder are more likely to get PTSD is that they are more vulnerable to these types of violent losses of control. Individuals with a substance use disorder are more likely to be exposed to crime, to violent partners, to homelessness, and to road accidents. These all greatly increase the risk of PTSD.

Similarly, many people think of veterans and military service when they think of PTSD. War zones cause significant PTSD. 30% of veterans experience PTSD. That’s a high contrast to the 6.8% of civilians who do. But, the 38.5% of addicts with PTSD is a more significant correlation than either.

What Are the Symptoms of PTSD?

PTSD has a range of symptoms. However, the most common include:

  • Intrusive memories
  • Vivid dreams
  • Flashbacks or repetitive playback of an event
  • Repetitive playback of negative emotions at the slightest trigger
  • Avoiding people or places that could cause trauma or emotion.
  • Using alcohol or drugs to numb emotions caused by those triggers
  • Persistent guilt, apathy, irritability, anger, or withdrawal

It’s normal for someone to experience these kinds of emotions for a week or two after a traumatic event. Recovering from a car accident mentally takes much more effort than recovering physically in most cases. But, when side effects don’t go away and continue to persist, it’s crucial to seek out help. That’s true no matter how bad the event was. It’s also true if you’re not sure if there was an event. If you experience these symptoms, get help.

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How Does PTSD Increase Substance Use?

photo of Psychologist sitting and touching young depressed man's hand with ptsd for encouragement near windowPTSD interacts with substance use disorder in multiple ways. For example, mental health disorders like PTSD increase vulnerabilities to substance use disorder by decreasing mood, by increasing risk-taking, by increasing the likelihood of self-medication, and even by reducing socioeconomic status and support groups.

Reduced Support Groups – Individuals with PTSD are very likely to withdraw, often when they need that support the most. This means they’re less likely to benefit from the social support of friends and family. However, PTSD also increases incidents of antisocial behavior, meaning that some people with undiagnosed PTSD may alienate friends and family as well. This increases withdrawal and isolation, creating a self-defeating loop.

Negative Emotions – PTSD is strongly associated with mood swings and increases in negative emotions. These commonly include fear, repetition of traumatic events, stress, guilt, exhaustion, loneliness, and sadness. They’re also exacerbated by ongoing and rising stress, PTSD interfering with daily life, PTSD causing failure at tasks and commitments, and PTSD causing withdrawal. This results in feeling bad, reacting to that, and then feeling worse as a result. Eventually, individuals with PTSD can experience very severe mood swings where they go from normal to extremely upset with very little buildup needed. 

Increased Risk Taking – Negative emotions and stress always lead to an increase in impulsivity. Eventually, this results in person with PTSD engaging in high risk-taking behaviors. This normally tracks to reduced serotonin and increased cortisol – pushing the individual to seek out happiness. That makes the individual more likely to impulsively drink or take alcohol, more likely to take risks, more likely to drop responsibilities, and more likely to make impulsive purchases and decisions. 

Self-medication – Self-medication is the highest risk activity contributing to addiction. Here, people use drugs or alcohol to numb or reduce the symptoms of PTSD. That can start out as something as simple as having a beer when you get home from work, taking an extra Xanax because you’re having a panic attack, etc. But, it almost always escalates into larger use of symptoms. For example, when most people start to self-medicate, they don’t have a diagnosis. They use whatever they have at hand to numb symptoms. They don’t have a dose, a safe usage schedule, or medical checkups. This puts you at very high risk of chemical dependence, increased tolerance, and, eventually, addiction.

Eventually, all of these reasons overlap to cause a significant increase in drug and alcohol uptake for persons with PTSD. That also means you’re at significant risk of addiction. For example, an estimated 5.6% of PTSD patients are addicted to alcohol after a year with a further 7.7% experiencing chemical dependence but not seeking behavior within that year. The statistics also hold true for veterans. 1 out of 3 with a substance use disorder have PTSD. 20% with PTSD have a substance use disorder.

The overlap between PTSD and substance use disorder is significant. That not only means you’re more likely to be addicted if you have PTSD, but also that you’re more likely to need more specialized treatment to recover.

What is Dual Diagnosis Treatment?

Dual Diagnosis Treatment or Co-occurring treatment is the concept of treating both PTSD and substance use disorder together. That’s important because one often interferes with the other. For example, it’s very difficult to treat someone for PTSD when they have a substance use disorder. On the other hand, the PTSD will constantly undo the work of the substance use treatment – resulting in relapses.

Most dual diagnosis treatment takes a prioritization approach. Patients are treated in a residential facility, away from the ability to access drugs or alcohol. There, the most pressing or life-threatening problems are treated first. Physical substance use disorder, suicidal ideation, etc., are given the highest priority, because they pose a risk to your life and health. From there, motivational and resistance reduction treatment, behavioral therapy like CBT, and skills training to help you recognize and recover from the underlying causes of both PTSD and addiction.

If you or a loved one has a substance use disorder, it’s important to follow through with a full evaluation of mental health and needs. If you have PTSD, it’s important to assess substance use and reliance, to keep in touch with family and friends, and to regularly discuss your health with your doctor. Unfortunately, most people don’t recognize they have PTSD until well after it becomes a problem. That means you may need substance use disorder treatment as part of treating PTSD. If you do, there’s no shame in it. Millions of Americans struggle with substance use disorder. PTSD makes you more vulnerable. Taking time to get help and to recover from your disorders is the best possible thing you can do to get your life back.

If you have any questions about PTSD and Addiction or about drug and alcohol rehab programs, contact us today to speak in complete confidence with one of our experienced and caring addiction treatment team.