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.
Clinical specialists in Post-Traumatic Stress Disorder (PTSD) help clients identify and understand the root of their compulsion to use in relation to their trauma. Only through careful examination of their negative behaviors, compulsion triggers, and also the connection to their trauma, can clients move forward through treatment and into recovery.
Defining Trauma and PTSD
Post-traumatic stress disorder 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 can cause a person crippling anxiety and incredible discomfort. This can be marked by huge spikes in panic/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.
Unfortunately, it is all too common for 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.
Trauma is defined as an event or circumstance that a person experiences as harmful and one that they have difficulty coping with. Oftentimes, trauma with the most lasting adverse effects stem from childhood, but trauma can be experienced at any life stage. For example, forms of trauma include:
- Sexual assault
- Child neglect
- Physical and/or sexual abuse
- Emotional abuse
- Psychological abuse
- Domestic violence
- War violence
- Community violence
- Medical trauma
- Traumatic loss
- Natural disasters
Post-Traumatic Stress Disorder usually follows a traumatic event or period of time. Patients with PTSD present the following characteristics:
- Exposure to actual or threatened death, serious injury or sexual violence
- Intrusive memories, recurring dreams, flashbacks or other troubling reactions to the event
- Avoidance of people, places or things associated with the event (isolation)
- A generally negative change in thoughts or mood following the event(s)
- Excessive blame of themselves or others for the traumatic event(s)
- Difficulty recalling certain aspects of the trauma
- Heightened arousal beginning or worsening after the event(s) (for example: being startled very easily, feeling “on edge,” or having difficulty sleeping).
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
CBT Interventions for Trauma and PTSD
Trauma and PTSD treatment is most commonly approached using Cognitive Behavioral Therapies (CBT), such as:
- Trauma-Focused Cognitive Behavioral Therapy: Talking about and examining thoughts and associations with the trauma, in order to learn how to process them more positively to provoke healthier coping behaviors.
- Psychodynamic Therapy: Talking in a free association manner about the trauma and how it has impacted one’s life. The therapist helps the patient organize these thoughts into a pattern of impactful cognitive meaning, which defines the trauma and resolves the negative feelings and resultant negative behavior patterns.
Trauma and Substance Use Disorders: A Co-Occurring Crisis
The effects of trauma and PTSD compound when substance use is used as a coping strategy. Whether a substance use disorder begins with a trauma or a preexisting substance use disorder is amplified by a trauma, the result is a co-occurring emotional crisis.
Over half of all clients seeking treatment for substance use disorders have experienced trauma which that has contributed to compulsive use of substances. Major trauma — whether repressed or acknowledged – produces feelings of pain, shame, regret, anger, and guilt that, if not processed properly, can catalyze self-destructive behaviors such as alcohol or drug use. When clients seek treatment for a substance use disorder, Granite Recovery Centers’ clinicians and 12-Step facilitators often encounter unprocessed trauma that require clinical intervention. Through Trauma-focused Cognitive Behavioral Therapy, clients can through their trauma and develop more positive ways of coping.
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.
Symptoms of Substance 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.
Treatment for PTSD at Granite Recovery Centers
Granite Recovery Centers treats clients struggling with trauma or PTSD and substance use disorders. We use specialized clinical interventions that integrate seamlessly into our 12-Step curriculum. Trauma therapy helps clients identify, process, and then better cope with trauma. Meanwhile, the 12-Steps wok provides a framework to apply this understanding to the development of a daily design for living going forward.