The Diagnostic and Statistical Manual of Mental Disorders defines trauma as
“Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: directly experiencing the traumatic event(s); witnessing, in person, the traumatic event(s) as it occurred to others; learning that the traumatic event(s) occurred to a close family member or close friend; Experiencing repeated or extreme exposure to aversive details of the traumatic event(s).”
Examples of traumas may include surviving a natural disaster, being in a major accident, stalking, online bullying, physical or sexual abuse, death of a loved one, or being involved in war combat. There are hundreds of trauma types that can be applied to the definition.
Perception also plays a role. What one person may perceive as traumatic, another may not. One person may experience trauma-related mental health issues, and another may not. The after-effects can be overwhelming for those who are traumatized, and they may find it difficult to cope.
Post-Traumatic Stress Disorder
Following a trauma, someone may experience signs of post-traumatic stress disorder(PTSD). One in eleven Americans, or 3.5%, are diagnosed with PTSD at some point in their lifetime. Unfortunately, many people experience multiple traumas. Research shows that those who experience four or more traumas are five times more likely to develop an alcohol use disorder and up to 46 times more likely to become an IV drug user.
Symptoms of PTSD fall into four categories: intrusion, avoidance, alterations in cognition and mood, and alterations in arousal and reactivity.
Intrusion symptoms refer to not being able to stop thinking about the event because memories of it return often. You may have flashbacks or nightmares about the traumatic event, feel distressed because you encounter internal or external cues that remind you of the event or have physical reactions, like being easily startled when something reminds you of the trauma.
Alterations in your thinking patterns, moods, arousal, and reactivity produce symptoms like dissociation or the inability to remember the event. You may blame yourself, detach emotionally, participate in risky or reckless behavior, and have sleep disturbances.
Avoidance symptoms refer to the actions you take to avoid all the above symptoms. You find ways to stop the memories, thoughts, conversations, and anything else that reminds you of the traumatic event.
A common method many choose is drug or alcohol use.
Self-Medication to Cope with Trauma
Substances like alcohol, opioids, benzodiazepines, stimulants, or a combination of these provide a numbing effect when consumed. They give you a false feeling of happiness. This happens because when drugs and alcohol enter the brain, they signal the release of a neurotransmitter called dopamine. Many refer to it as the “feel good” chemical.
It floods the reward center of the brain with much more dopamine than the brain can produce naturally. It takes away the symptoms of PTSD temporarily. Continued use leads to dependence on the substance and, eventually, addiction.
It’s easy to get caught in the cycle of using substances to self-medicate and avoid the symptoms of both trauma and withdrawal. PTSD is no longer the only disorder that needs treatment. You now may also have a substance use disorder.
Co-Occurring Substance Use Disorder and PTSD
Having a substance use disorder is another form of trauma. Drug and alcohol use not only worsens PTSD but also sets you up to experience additional traumas when you put yourself in risky situations. The combination can also create new psychological symptoms, including severe anxiety and depression.
You may experience relationship, legal, and medical problems.
When you have both a mental health and substance use disorder, you have a co-occurring disorder. The PTSD Alliance reports fifty percent of people with PTSD also misuse alcohol.
The National Center for PTSD reports it is common for veterans to have co-occurring disorders with post-trauma and substance abuse.
The good news is that you can get help for co-occurring disorders at the same time. It is recommended they happen simultaneously. There are many treatment options available.
Treatment for PTSD and Addiction
The first step in any treatment process is to be evaluated by a licensed mental health and substance abuse specialist. They will assess your drug use history, mental health symptoms, family history, medical history, and more to determine which level of care is needed to help you safely withdraw from substances and begin working through PTSD issues.
Treatment options are discussed below:
Medication-Assisted Detox
For some, withdrawal symptoms can be severe and make it hard to focus on learning recovery skills. To alleviate the symptoms, many people relapse. Treatment centers recognize this problem and provide medications to reduce withdrawal symptoms, including cravings so that you can participate in therapeutic activities.
Inpatient Rehab
After detox, it is recommended to transition to an inpatient program to continue medication management and begin working on early recovery and relapse prevention skills necessary to stay sober long-term.
Individual and group counseling, support groups, and educational classes are offered in this setting.
Step-Down Treatment Options
When inpatient rehab is complete, you can transition to a lower level of care program, like partial hospitalization, if you still need the structure of inpatient during the day. You may also choose a sober living facility where you get to practice the skills you have learned in a real-world setting before you return to your home environment.
Intensive outpatient allows you to attend individual and group therapies for nine or more hours a week. When not in treatment, you can work and take care of personal or social responsibilities.
Outpatient counseling allows you to work one-on-one with a licensed therapist who can provide continued support and education. You will learn coping skills and improve communication, conflict resolution, and interpersonal relationships.
Because PTSD and addiction affect the entire family and friends, you can participate in family therapy or couples counseling to ensure the whole family learns boundaries and experiences healing.
You can begin the treatment process today by calling a local, licensed therapist who specializes in PTSD and addiction.