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PTSD, Complex PTSD, and Addiction

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Post-traumatic stress disorder, or PTSD, is a condition that can develop after experiencing or witnessing a severely traumatic event. It could be a murder, rape, terrorist act, natural disaster, battle, or any other event capable of resulting in significant injury or death.


PTSD is quite common, and not just among people fighting in wars. The U.S. Department of Veterans Affairs reports that roughly 60% of men and 50% of women experience at least one traumatic event during their lifetimes, and about 6% of the population will develop PTSD at some point. The types of traumatic experiences among genders tend to differ, as well. Males are more likely to experience trauma through physical assault, an accident, war, witnessing a death, or significant injury. Females are more likely to experience trauma through rape or child sexual abuse.


If you or a loved one has PTSD, there is nothing to be ashamed of. The National Institute of Mental Health says that while PTSD can occur in anyone who has experienced trauma, not everyone who has PTSD has experienced a dangerous event. Certain factors influence a person’s chances of developing PTSD, including the number of traumatic incidents endured and how related to the incident a person is. For example, someone injured during a horrific car crash is much more likely to develop PTSD than a bystander who only saw such an accident.


When a person has PTSD, they tend to relive the traumatic event either through flashbacks or nightmares. During these experiences, those who have PTSD usually endure a tremendous sense of sadness along with fear or anger. It’s also not uncommon for them to feel detached from their loved ones and friends. As a result, these people need to do their best to avoid any situation that could trigger a PTSD episode.


What Is Complex PTSD?

According to the National Foundation to End Child Abuse and Neglect, Complex PTSD, or CPTSD, is caused by chronic, long-lasting, or repeated traumatic events. For example, childhood trauma, such as physical, emotional, and sexual abuse and neglect, can all lead to CPTSD.


CPTSD usually results in a person experiencing more frequent and extreme PTSD symptoms. According to the National Library of Medicine along with the National Center for Biotechnology Information, some of the most common symptoms experienced by those with complex PTSD include:


  • Inability to control your emotions
  • Inability to trust others
  • Continual feelings of hopelessness
  • Feeling as if no one understands you
  • Difficulty in forming relationships
  • Dissociative symptoms like depersonalization
  • Headaches
  • Dizziness
  • Chest pains
  • Suicidal ideation


These symptoms can occur at any point in a person’s life after exposure to trauma. They can also occur in many different ways. Medical practitioners typically consider them to be free-standing conditions when first diagnosed. It is not until later in life that a healthcare professional pinpoints the trauma causing the conditions and diagnoses the person with complex PTSD.


Another type of trauma, called institutional or sanctuary trauma, can occur when organizations whose purpose is to intervene and offer support do not do so in a beneficial way and may even worsen the issues. This additional trauma can result in a deep mistrust of others and an inability to identify potentially harmful individuals or situations, a condition known as betrayal blindness. This dynamic seems to relate to the fact that complex trauma is linked to higher vulnerability to revictimization and re-traumatization throughout an individual’s lifespan, especially with those who experienced childhood trauma.


PTSD, Complex PTSD, and Substance Abuse

Those who have complex PTSD or PTSD have a higher risk of developing substance use disorders. Why? Because the aftereffects and symptoms created by the trauma that leads to PTSD often go hand in hand with a person wanting to escape reality, and for many, this comes in the form of abusing legal and illegal substances.


Treating addiction and PTSD at the same time is ideal. Both therapy and medication may be used. Despite its importance, sobriety does not automatically end the trauma. To cope, the addicted trauma survivor requires specialized education and knowledge of emotion management techniques that do not involve using drugs or alcohol.


The course and duration of the therapy can differ significantly from one person to the next, and it may include evidence-based trauma-focused PTSD treatment such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT).


The most crucial thing to understand about receiving therapy for complex trauma, complex PTSD, and addictions is that healthcare facilities offer diverse new and successful methods to treat co-occurring PTSD or C-PTSD and substance use disorders. In the past, your symptoms may have confused you or made you feel hopeless about getting help. However, as a trauma victim, you can get good therapy, recover, and get your life back on track.


Drug and Alcohol Abuse and PTSD

Drug and alcohol abuse causes the brain to produce fewer endorphins, significantly affecting feelings of happiness after a traumatic event. Alcohol and other mood-enhancing substances, which are well-known to raise endorphin levels, may be used by people with PTSD to increase endorphin levels temporarily. However, with continued use, they can become dependent on the substance to eliminate the irritation, anxiety, and depressive symptoms associated with complex PTSD.


Individuals with PTSD or complex PTSD should be conscientious when it comes to using any drug. When going to the doctor for mental or physical health conditions, the treating doctor should always be aware of any existing health conditions, like PTSD or complex PTSD. In knowing this information, the doctor is more likely to prescribe treatment regimens that will help PTSD as well as any new or existing diagnoses being made or treated.


People with PTSD frequently experience a sense of estrangement from their friends and loved ones. For relatives and friends who endure the violent outbursts or anxiety of a loved one with PTSD can be distressing. It’s not uncommon for those who have PTSD to turn to drugs and alcohol as a form of self-medication due to the guilt they feel over these outbursts. Such continued consumption of alcohol or other drugs will often result in addiction.


PTSD affects the areas of the brain connected to memory and emotion. A brain in good health can distinguish between memories from the past and events from the present, but PTSD obstructs this ability. A person with PTSD may retaliate if their current surroundings trigger memories of a traumatic event, putting themselves and others in possible harm’s way. The brain’s reaction induces fear, worry, and tension, making it appear that the individual is still in the past. Some of the most frightening PTSD symptoms include suicidal thoughts. Misusing alcohol or drugs can intensify these emotions, feelings, and thoughts.


The way substance use disorder and PTSD impact memories go hand in hand. Triggers, or locations and individuals connected to drug use, can cause cravings in a brain affected by a substance use disorder. Triggers for PTSD and addiction symptoms might overlap and worsen one another’s effects. This is yet another reason it’s so essential to treat PTSD and substance use disorders simultaneously.


Guide to Withdrawal

If you or someone you know has PTSD or complex PTSD and substance use disorder, there is a period in the treatment process called withdrawal. During the withdrawal phase, a number of symptoms will likely occur, including:


  • Repeated memories of trauma
  • Vivid flashbacks
  • Night terrors
  • Inability to talk about the trauma
  • Avoiding people, places, and things that trigger cravings or flashbacks
  • Emotional numbness
  • Lack of positive emotions
  • Lapses in memory
  • Negative sense of self-worth
  • Extreme irritation
  • Insomnia
  • Overwhelming guilt
  • A desire to engage in self-destructive behavior or commit suicide


Treating withdrawal symptoms is especially important, but identifying co-occurring PTSD and substance use disorder can be challenging. Often those with PTSD try to hide their drug and alcohol use from others out of embarrassment. Fortunately, various treatment options are available to those suffering from a substance use disorder and PTSD or C-PTSD.


Types of Treatment Available for PTSD and Substance Abuse

Treatment and therapy options must be chosen with care because exposing complex trauma clients to their traumatic past too closely might result in retraumatization and functional impairment if they cannot regulate their emotions or feel safe. Therefore, the treatment sequence consists of these main stages:


  • Pre-Treatment
    • Begins with exploring treatment options and developing a treatment plan with the help of a healthcare professional.
  • Early Stage:
    • Includes detoxing and establishing sobriety while helping the patient appropriately deal with flashbacks.
  • Middle Stage:
    • Support for ongoing sobriety and intended exposure to trauma to heal the patient and develop positive emotional processing and resolution.
  • Late Stage:
    • Involves ongoing sobriety and helping the client further develop their self and relational development without being hindered by trauma responses.


Granite Recovery Centers has transformed people’s lives throughout New England and other regions. Our addiction treatment centers offer a unique blend of evidence-based psychotherapies and a comprehensive 12-Step curriculum. In addition, Granite Recovery Centers offer a full continuum of care to our clients. Including medical detox, medication-assisted detox and therapy, residential rehab, after-treatment care, sober living options, and intensive outpatient treatment.


Get the Treatment You Need Today

Standard PTSD therapies might help you, but if you have complex PTSD and a co-occurring SUD, you may require long-term, comprehensive support and treatment to heal. Comprehensive treatment is available, so contact us to find out how we can help you.