ptsd and addiction

What Causes PTSD?

Post Traumatic Stress Disorder (PTSD) can be caused by many things. The first thing that people think of when they hear about PTSD is people who have fought in a war. But, other situations can cause PTSD as well. An alarmingly high percentage of people, including women, men, and children develop PTSD because they were raped, molested, or otherwise sexually assaulted. In fact, sexual violence is one of the top reasons that people develop post-traumatic stress disorder. Here is a more complete list of the top reasons that someone can develop PTSD:

  • Military combat
  • Violent assault
  • Natural disasters
  • Sexual assault
  • Childhood abuse 
  • Serious injury
  • Death or injury of a loved one

Please note that there are many other reasons that someone might develop PTSD, but these are some of the most common reasons. 

7.7 million adults experience PTSD at some time in their lives. 1 out of 3 of these people are seeking help for some form of addiction. That is simply the number of people seeking help, not the number of people who have both PTSD and an addiction. This translates to 65% of people who have PTSD also have a substance use disorder. Unfortunately, 8% of people in the United States have a documented PTSD disorder. 

Why do People with PTSD Develop Addictions?

People who have PTSD often also develop depression and anxiety as well as a substance use disorder. The most common substance abused by people suffering from PTSD is alcohol. 

It is not surprising that many people turn to substances such as alcohol to numb the pain caused by these traumatic events. Some people do not know where to turn to get help. Other people develop denial that they have PTSD. Still more people see getting help for PTSD as a sign of weakness, or they believe that going to treatment will affect their ability to hold their current job.

What Should I Do If I Have PTSD?

There are dual diagnosis centers, like DreamLife Recovery, that can help you with you PTSD and addiction disorders together. You are worthy. Bad things have happened to you and no one has the right to tell you that you are not suffering enough to merit treatment. Rape and childhood abuse are legitimate causes for PTSD. Three quarters of people who survive violent/abusive trauma and/or any form of assault report alcohol abuse disorders. You are not alone. 

PTSD is a mental disorder. Trauma can rewire the brain to cause problems like difficulties telling the difference between long term and short-term memories and present experiences. Post-traumatic stress disorder damages that part of the brain. Some emotional symptoms of PTSD are:

  • Fear
  • Anxiety
  • Stress

It can be hard for people who suffer from PTSD to know when they need to get help. Many people brush off other people’s experiences. Some things that give someone else PTSD will not affect another person the same way. However, other traumatic events might give them PTSD but it might not affect you in the exact same way it affects them. There is no reliable indicator of exactly which experience will give which person PTSD.

What are the Medical Symptoms of PTSD?

Below are the DSM-5 criteria for diagnosing PTSD. 

Criterion A (one required): The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

  • Direct exposure
  • Witnessing the trauma
  • Learning that a relative or close friend was exposed to a trauma
  • Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

Criterion B (one required): The traumatic event is persistently re-experienced, in the following way(s):

  • Unwanted upsetting memories
  • Nightmares
  • Flashbacks
  • Emotional distress after exposure to traumatic reminders
  • Physical reactivity after exposure to traumatic reminders

Criterion C (one required): Avoidance of trauma-related stimuli after the trauma, in the following way(s):

  • Trauma-related thoughts or feelings
  • Trauma-related reminders

Criterion D (two required): Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

  • Inability to recall key features of the trauma
  • Overly negative thoughts and assumptions about oneself or the world
  • Exaggerated blame of self or others for causing the trauma
  • Negative affect
  • Decreased interest in activities
  • Feeling isolated
  • Difficulty experiencing positive affect

Criterion E (two required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

  • Irritability or aggression
  • Risky or destructive behavior
  • Hypervigilance
  • Heightened startle reaction
  • Difficulty concentrating
  • Difficulty sleeping

Criterion F (required): Symptoms last for more than 1 month.

Criterion G (required): Symptoms create distress or functional impairment (e.g., social, occupational).

Criterion H (required): Symptoms are not due to medication, substance use, or other illness.

Two specifications:

  • Dissociative Specification:  In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli.
  • Depersonalization: Experience of being an outside observer of or detached from oneself (e.g., feeling as if “this is not happening to me” or one were in a dream).
  • Derealization: Experience of unreality, distance, or distortion (e.g., “things are not real”).
  • Delayed Specification: Full diagnostic criteria are not met until at least six months after the trauma(s), although the onset of symptoms may occur immediately.

How Do I Use the DSM-5 to Diagnose My PTSD?

The DSM-5 only provides guidelines for doctors and other health professionals. Even with a DSM-5 excerpt like the one above it takes a trained medical professional to fully diagnose someone. While it is important to look for these indicators it is also important not to try to diagnose yourself or your loved ones at home. It takes the help of a qualified health professional to make an accurate diagnosis and to start treatment.

 

How Do I Know If I Will Develop PTSD?

Over 70% of people go through a traumatic event in their lifetime; 8% of these people will develop PTSD. One of the key factors in developing PTSD is a history of trauma before the triggering event, such as abuse during childhood. 

One of the greatest building blocks of PTSD is the feeling of helplessness. The more helpless the person feels during the traumatic process, the more likely they are to develop PTSD. Addictions, like alcohol addiction, often forms as a way for the person to relax from their hypervigilant state, stop intrusive memories, and soothe anxiety.

Are People With PTSD at Risk for Suicide?

Many people who have PTSD are at high risk for suicidal thoughts, attempts, and completed suicidal acts. While some of these suicidal actions are intentional, some come from severely decreased inhibition. The person might know that something is very dangerous but do it anyway because the symptoms of their PTSD and, often, substance use disorder cause them to not care about their own lives.

Every person is different so, depending on the nature of the traumatic event and the nature of the person, someone can spend as little as one month in therapy and move on from their PTSD without developing an addiction. For other people, it is a lifelong struggle in which they may or may not turn to substances to cope with their pain. 

Will Treating My PTSD Get Rid of My Substance Abuse?

It is almost impossible to help someone with the co-occurring disorders of addiction and PTSD unless both conditions are treated simultaneously. Treating the PTSD alone will not cure the addiction. Both the addiction and PTSD are physically separate conditions. If someone who does not get help for their PTSD as well as their addiction disorder, they will relapse no matter how many times they go through treatment.

Do I Need Hospitalization for My PTSD?

Because of the nature of PTSD interacting with the addiction(s) the individual going through detoxication must be in full-time care for at least several days. Medically assisted tapering is also usually required.

What is Medical Tapering?

Medically-assisted tapering is when a person is weaned off of their addictive substance through the use of gradually smaller doses of substitute drugs like methadone. This should only be done under the supervision of medically trained staff and should never be attempted at home. 

What is Talk Therapy?

Both talk therapy and CBT (Cognitive Behavioral Therapy) are used to treat PTSD. Yoga and creative activities such as painting are also shown to help patients with PTSD. It is worth noting that talk therapy and CBT are completely separate treatments. Both talk therapy and CBT are important and they can be implemented at the same time, but someone who needs CBT and talk therapy cannot rely solely on talk therapy and vice versa. 

When Should I Seek Help for my PTSD?

Here at DreamLife Recovery, we urge you to seek help for your PTSD as well as your addiction disorder. You cannot simply “power through it” and an addiction disorder will not heal on its own. You are worth healing. Sometimes the past does not stay in the past and we are here to help put what happened to rest. 

References:

https://www.dualdiagnosis.org/mental-health-and-addiction/post-traumatic-stress-disorder-and-addiction/

https://www.mentalhelp.net/ptsd/and-addiction/

https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp

Article Reviewed by Lidice Morales

Lidice MoralesLidice Morales, an honors graduate from the Kaiser University, has made a name for herself as the Director of Nursing at several behavioral health facilities and as the Director of Operations for Detox MD. Now she is the VP of Operations at DreamLife Recovery. She strives for better patient care through constant self-improvement and furthering her education. Her steadfast work ethic and passion in the field has remained the most important aspect of her professional career; showing dedication to not only the acquisition of new knowledge, but also its mastery. Lidice believes that a professional work atmosphere fosters cohesion and malleability amongst herself and her coworkers; thereby increasing both the level of patient care and quality of life.

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