At first glance, post-traumatic stress disorder (PTSD) and substance abuse seem to have little in common. But people often suffer from these two conditions at the same time. Seventy-five percent of those who struggle with PTSD report having abused alcohol at some point. They’re twice as likely to use nicotine and three times as likely to abuse drugs. When a mental health and substance use disorder occur at the same time, they’re called co-occurring disorders, or a dual diagnosis. One of the disorders generally causes the other. Either addiction develops as a way to cope with the intense anxiety of PTSD, or addiction places a person in unsafe situations that make traumatic events more likely to occur. No matter which comes first, it’s always best to treat these disorders at the same time.
What Is PTSD?
When terrifying events are experienced, the resulting feelings are intense fear, anxiety, and stress. When feelings this strong surpass your ability to cope, post-traumatic stress develops. PTSD causes you to feel that you’re stuck in these emotions, as if you are continuously re-living the traumatic situation. You may feel you’re in serious danger even when you aren’t. Triggering events that can cause PTSD include:
- A serious accident
- Sexual assault
- Natural disaster
Symptoms of PTSD are broken into four categories:
- Intrusive memories
- Changes in physical and emotional reactions
- Negative changes in thinking and mood
Here are a few examples of common PTSD symptoms:
- Flashbacks, or reliving the traumatic event
- Nightmares about the event
- Avoiding people, places, or activities that bring back unwanted memories
- Negative beliefs about oneself or the world
- Being easily startled
- Difficulty concentrating
- Difficulty sleeping
- Irritability or aggression
- Overwhelming feelings of guilt or shame
- Severe anxiety
- An exaggerated fight-or-flight response
Substance Abuse as a Coping Mechanism
The symptoms of PTSD make everyday life very difficult. Flashbacks and anxiety can make it hard to focus at work and and in school. Lack of sleep leads to exhaustion and difficulty performing well. Guilt and self-blame cause problems in relationships. It might seem harmless to have a drink to help you get to sleep or take a Xanax before work to calm your nerves. Substance use causes feelings of numbness and detachment, creating a diversion from emotional pain. The problem is, using drugs or alcohol as a way of coping is habit-forming. Once you start depending on these drugs to get through your day, you’ve begun to form a dangerous addiction. You may need more and more of them over time to get the same effects. Substance use may temporarily help you cope with your PTSD, but it does nothing to heal your trauma. Addiction can even make PTSD worse. This is because using alcohol or drugs to cope doesn’t make the underlying emotions/stressors go away. They’re only temporarily numbed. Once the drugs wear off, your pain will come rushing back, creating a need to use again. Due to tolerance, this often means taking more of the drug over time. It becomes a cycle of using drugs and alcohol to cope that leads to a strong and difficult-to-break dependency.
Treating Addiction and PTSD as a Whole
If you’ve developed a habit of using drugs to cope with your PTSD, both disorders are severe enough to make professional addiction treatment and treatment of PTSD necessary for you to fully recover and heal. To give you the best possible chance at lasting sobriety, both disorders should be treated at the same time. It was once believed that co-occurring disorders should be treated separately, with one viewed as more severe and taking priority. But if addiction is treated first, unresolved PTSD symptoms make it much easier to relapse. And treating PTSD while you are still using alcohol or drugs is not feasible, since you won’t be able to fully process your trauma if you’re still numbing your emotions. Dual diagnosis treatment, in which both disorders are treated at the same time, is the preferred method of treatment among doctors and clinicians. PTSD and addiction, like any dual diagnosis, combine to form a unique set of signs and symptoms. Symptoms resulting from co-occurring disorders can be different from person to person. Therefore, treatment should revolve around you, your situation, and what you need from a treatment program. Washburn House is a co-occurring capable treatment center. This means that if you have a primary diagnosis of a substance use disorder and a secondary mental illness diagnosis, we can help. Pre-screening during our admissions process is the first step in establishing whether you need co-occurring disorder treatment. Following admissions at any rehab facility, you may need to detox. In medically monitored detox, you’ll be cared for my medical professionals as you go through any withdrawal symptoms. This will give you a good foundation on which to build your addiction recovery and mental health treatment. You’ll then move to inpatient care, an intensive outpatient program, or a day program. Any of these programs can help you navigate and unpack your trauma and how it led to your use. The admissions process, when you meet with experienced addiction and healthcare professionals, will determine which track is right for you. You’ll leave substance abuse treatment with a toolbox of coping skills to help you manage your traumatic stress in a healthy and sober way. Examples of types of therapy that are effective for co-occurring disorders, and which are offered in treatment at Washburn House, are:
- Cognitive behavioral therapy
- Group therapy
- 12-step meetings like Alcoholics Anonymous® and Narcotics Anonymous®
- Elective activities like yoga and music therapy
- Psychiatric care and medication management
Being stuck in the midst of PTSD and addiction can be exhausting, not to mention dangerous. While the idea of facing your trauma without alcohol or drugs may be scary, it’s the only way to lessen the grip your PTSD has over you. Don’t do it without help. Let our empathetic, trauma-informed clinicians guide you through this process with treatment options in the home-like setting of Washburn House. Reach out to us today to take the first step toward true healing.