Post-traumatic stress disorder, also known as PTSD, is a challenging and relatively common illness that occurs in the aftermath of a traumatic experience. Unfortunately, individuals who suffer from some sort of trauma often turn to addictive substances in order to cope with their experience, resulting in a serious addiction and necessitating treatment. Fortunately, help is available for these people who are suffering so greatly.
What Is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder is what happens to some individuals in the aftermath of a highly traumatic experience such as an accident, an assault, a death, or an incidence of violence. It is more common in some populations, including first responders, active-duty military members, and veterans.
These individuals are more likely to suffer from PTSD because of the significant physical, mental, and psychological strain that comes as part of their jobs. Unfortunately, this often results in exposure to incredibly traumatic events, including assault, death, murder, and more.
PTSD is a crippling anxiety disorder. It can cause incredible discomfort to people who are suffering from it and can cause huge spikes in anxiety, flashbacks, nightmares, and a constant reliving of the traumatic event. While sufferers of PTSD usually endure the pain from one traumatic event, some individuals suffer from complex PTSD, which is a specific type of PTSD that occurs as a result of multiple events. Members of the military and first responders often suffer from this type of PTSD as their jobs repeatedly expose them to highly traumatic events.
It is important to note that although PTSD is more common for certain populations who are engaged in highly risky professions, anyone can experience the disorder. Furthermore, you do not have to have participated in an event in order to suffer from PTSD. Often, witnessing an event is enough, and recent changes to the formal diagnosis process have made it clear that someone needs to only witness a traumatic event in order to be diagnosed with PTSD.
According to available statistics, 3.5% of all adults in the United States actively suffer from some sort of PTSD. An estimated 10% of all adults will have PTSD at some point in their lives. Interestingly, women are twice as likely to be diagnosed with PTSD than men.
Tragically, major events can often result in a diagnosis of PTSD or kick off a series of events that lead to major growth in PTSD. The terrorist attacks of September 11, 2001, are an unfortunate example of this phenomenon.
A study of more than 2,700 people found that 11% developed PTSD as a result of 9/11, even though they were just New York City residents and were not directly involved in the attacks. Furthermore, among first responders, 6.4% of all relief workers developed PTSD as a result of working at Ground Zero.
What Are the Symptoms of PTSD?
Like all mental disorders, there are specific criteria that must be met before a diagnosis of PTSD can be given. According to the current version of the Diagnostic & Statistical Manual of Mental Disorders, there are some very broad symptoms of PTSD.
First, and most obvious, a traumatic event must be involved. This can include experiencing, being threatened with, or witnessing death, assault, violence, or sexual assault.
From there, a person will have to have experienced at least one “intrusion” symptom. These include nightmares, flashbacks, emotional distress after some sort of reminder about the incident, a physical reaction after the reminder, or unwanted/intrusive memories about the incident in question.
A person who suffers from PTSD will also avoid certain situations, feelings, or thoughts associated with the trauma. They will also certainly suffer from any number of negative changes in their mood or thinking, including at least two of the following:
• Difficulty recalling certain aspects of the trauma
• Difficulty experiencing positive emotions
• Negative thoughts about life
• Excessive blame of either themselves or others for the traumatic event
• Negative emotions
• Lowered interest in other activities
Unfortunately, people with PTSD are also more likely to experience a variety of other emotional and physiological changes, including:
• Insomnia or difficulty sleeping
• Heightened aggression or irritability
• Concentration challenges
• Destructive, aggressive, or risky behavior
• An increase startle reaction
Substance Abuse and Co-Occurring PTSD
As noted above, PTSD is a devastating illness. It can lead to major mental health challenges and cause people to aggressively change their behavior. Unfortunately, all too often, this results in a spike in substance use.
According to available statistics, PTSD and substance use disorder (SUD) are commonly co-occurring conditions. For example, per a 2012 study:
• People who suffered from PTSD were anywhere between two and four times more likely to also suffer from SUD than individuals without PTSD.
• The National Comorbidity Survey found that, among people with PTSD, 46.4% of PTSD sufferers also met the criteria for a substance use disorder. Over 22% also met the criteria for substance dependence, which is a more severe form of a substance use disorder in which someone develops withdrawal from stopping substance use as a result of repeated abuse.
• A similar survey in Australia found that one-third of all individuals who suffer from PTSD also suffer from at least one substance use disorder, with alcohol being the most likely substance to be abused.
• Studies from 2003 and 2007 found that patients with PTSD were 14 times more likely than the rest of the population to suffer from a substance use disorder.
As you can see, there are clearly varying potential levels for suffering from PTSD and SUD. However, it is very clear that individuals with PTSD are more likely to then develop a substance use disorder.
As noted by a variety of studies, a dual diagnosis of SUD and PTSD can make treatment more complex and complicated. It can also make symptoms significantly more painful and harder to treat while increasing the odds that an individual with both of these disorders will ultimately relapse.
Many theories exist as to why individuals with PTSD are more likely to abuse certain substances. Tragically, the most prominent one is the “self-medication” theory, which holds that people turn to substances as a way to numb the pain associated with their PTSD condition. At least one study found that individuals with PTSD who also developed SUD were more likely to develop symptoms that included avoidance and hyperarousal symptoms. It was theorized that these individuals turned to substance use as a way to find relief from these symptoms.
What Are the Symptoms of Drug or Alcohol Abuse?
It may seem like it should be obvious, but the simple truth is that it is not always easy to detect a substance use disorder. There are some symptoms that include:
• Changes in behavior, including depression, increased lethargy, engagement in criminal activity, enhanced irritability or aggression, attitude changes, a lack of motivation, personality changes, or significant changes in habits or life priorities
• Physical changes, including sleeping problems, weight changes, appetite changes, bloodshot or glazed eyes, tooth or other dental problems, and skin challenges
It’s important to note that these are not the only potential symptoms of SUD, but they are among the most prominent.
Military Members and Veterans With PTSD
As a result of the high-risk nature of their jobs, some populations are more likely than others to experience PTSD-related symptoms. These include first responders (such as police, firefighters, and EMTs), active-duty military members, and military veterans.
As noted by many studies, PTSD is a particularly acute problem among veterans and active members of the military. Indeed, PTSD has been an ongoing problem within the military but first became evident in the aftermath of the Civil War, which was when modern military techniques and weapons first became widely used. The name changed over the years, morphing from “shell shock” to “battle fatigue,” but it became apparent that many soldiers suffered greatly as a result of their military experiences.
The statistics are quite revealing:
• A major screening of Iraq and Afghanistan war veterans found that 13.5% experienced PTSD.
• Other estimates have found that anywhere between 20% and 30% of returning service members may suffer from PTSD.
• These numbers mean that up to 500,000 U.S. troops have suffered from PTSD over the past 13 years.
Veterans can often experience unique challenges when it comes to getting assistance for PTSD or SUD. The challenges within the Veterans Affairs system when it comes to accessing help are well known and well documented. Furthermore, veterans who receive a dishonorable discharge are often unable to receive medical help from the VA, and many veterans who suffer from PTSD or SUD may engage in behaviors that make them more likely to be dishonorably discharged. Thus, there exists a terrible paradox: Individuals who commit offenses that will get them dishonorably discharged need help the most but have the least access to it. This fuels a bitter spiral as an individual whose mental disorders go untreated becomes less likely to gain steady employment and the access to health care that comes with it.
Lastly, despite intensive efforts to normalize PTSD and help-seeking behaviors, significant social stigma remains when it comes to seeking psychological assistance. According to one review, less than half of all veterans in need are actually receiving mental health services. Stigma creates a significant barrier when it comes to seeking mental health assistance, and this barrier is even more prominent in fields like the military or law enforcement. These fields are usually male-dominated and pervaded by the idea that men must be tough and push through any mental health disorders that they are suffering from.
SUD, PTSD, and Veterans
Unfortunately for these individuals, their PTSD experiences make them more likely to suffer from a wide range of other psychological disorders, including substance use disorder. Again, there is long-standing evidence to demonstrate this correlation. An astonishing 74% of all Vietnam War veterans who had PTSD also developed substance use disorder.
Other studies have found that anywhere between 63% to 76% of all veterans who suffered from PTSD had a co-occurring substance use disorder. This co-occurrence created additional treatment barriers as it often limited treatment options and made them more expensive and complex. Furthermore, this unfortunately made treatment less likely to be effective and made it harder for sufferers to stick to a treatment plan.
Get Help Today
The good news is that many programs have been developed by professionals with a deep understanding of the pain suffered by members of our military as a result of the traumatic experiences they have endured. As noted repeatedly by experts, co-occurring PTSD and SUD require an intensive, specialized treatment program. The need for these programs is even more enhanced when one considers the need to provide treatment options for military members or veterans who have developed co-occurring PTSD and SUD.