PTSD – Post Traumatic Stress Disorders

ptsd treatment word cloudWhile post-traumatic stress disorder (PTSD) is often associated with military veterans, this mental health disorder can happen to anyone that has experienced or witnessed a traumatic event include:

  • witnessing death
  • being threatened with death or injury
  • being sexually abused
  • other traumatic events

According to the U.S. Department of Veterans Affairs (VA), approximately 7 to 8% of the U.S. population will have PTSD at some point during their life. Additionally, the VA notes that PTSD and substance abuse disorders (SUD) often occur together. This is known as a co-occurring or dual diagnosis. National studies have found that more than 46% of those with lifetime PTSD also had a SUD.

The most common reason that substance abuse accompanies PTSD is an effort by the individual to self-medicate their PTSD symptoms. Unfortunately, using addictive substances to cope with the symptoms only contributes to increased use of the addictive substances.

Signs and Symptoms of Post-Traumatic Stress Disorder

Common signs of PTSD can first appear as soon as a month after the traumatic event. For some, symptoms may not happen until years later. Signs and symptoms may be stronger during periods of stress or when an individual sees or experiences a trigger related to the trauma. Whenever they occur, the symptoms fall within four categories: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Examples of these types of symptoms include:

Intrusive memories

  • Experiencing unwanted and distressing memories of the traumatic event
  • Flashbacks of the traumatic event
  • Reliving the event through upsetting dreams or nightmares
  • Feeling severe emotional distress or even physical reactions when reminded of the trauma


  • Avoiding thinking or talking about the traumatic event
  • Staying away from places, activities, or people that may serve as reminders of the event

Negative changes in thinking and mood

  • Negative thoughts
  • Hopelessness about the future
  • Memory problems
  • Struggling to maintain close relationships
  • Feeling detached from family and friends
  • Showing a lack of interest in activities
  • Struggling to feel positive emotions
  • Feeling emotionally numb

Changes in physical and emotional reactions

  • Being easily startled or frightened
  • Being on guard for danger always
  • Engaging in self-destructive behavior, such as drinking too much or driving too fast
  • Having trouble sleeping
  • Difficulty concentrating
  • Displaying irritability, angry outbursts, or aggressive behavior
  • Feeling overwhelming guilt or shame

If an individual has lived through a traumatic event and then experiences any of these symptoms for more than three months, they may have PTSD and should consult a professional for help.

Self-Medicating to Cope with PTSD

Individuals struggling with PTSD may develop substance abuse issues stemming from an effort to escape the symptoms they are experiencing. Self-medication can offer some relief initially, but in the long term, drinking or using drugs will only worsen a person’s PTSD symptoms. Trying to deal with the physical and emotional aspects of PTSD with drugs or alcohol can lead to additional problems, as well, including depression and anxiety, relationship challenges, and legal troubles. Other serious outcomes that can result from self-medication of PTSD symptoms include psychiatric hospitalization, overdose, and lasting health consequences.

Researchers are also studying if substance abuse increases a person’s chances of experiencing a traumatic event and developing PTSD. There are also theories that an underlying genetic link may increase a person’s chances of developing both PTSD and a substance use disorder, or SUD. The connection between these two diagnoses is still being explored.

Symptoms of Substance Abuse

Family members and loved ones who suspect that an individual is struggling with addiction may notice problems at school, at work, or at home. Changes in behavior, poor personal hygiene, sudden weight gain or loss, and chronic financial problems all may be signals that an individual’s substance use has become a problem. Other warning signs include:

  • Needing to use the drug regularly
  • Experiencing intense urges for the drug that block out any other thoughts
  • Needing more of the drug to get the same effect (tolerance)
  • Taking larger amounts of the drug over a longer period than desired
  • Making certain to maintain a supply of the drug or alcohol
  • Spending money on drugs or alcohol, even when they can’t afford it
  • Skipping obligations and work responsibilities or cutting back on social or recreational activities because of drug use
  • Continuing to use the substance, even though their drug or alcohol use is causing problems
  • Committing crimes to secure the substance, such as theft
  • Driving or other risky activities when under the influence of the drug
  • Spending significant time finding, using, or recovering from the effects of the drug
  • Failing to get sober
  • Experiencing withdrawal symptoms when trying to stop taking the drug or drink

Treatment for PTSD and Substance Use Disorder

Luckily, behavioral health professionals have developed specialized treatments for individuals living with PTSD and SUD.

Trauma Focused Therapy

The most effective treatments for PTSD are trauma-focused psychotherapies that help the person process the traumatic event in a healthy and supportive way. These include:

  • Cognitive Behavioral Therapy (CBT), a type of talk therapy that shows the connections between an individual’s thoughts, feelings, and behaviors, particularly those related to the trauma
  • Eye Movement Desensitization and Reprocessing (EMDR), which uses side-to-side eye movements and other bilateral sensory input to process difficult memories, thoughts, and emotions in those with PTSD
  • Prolonged Exposure, which guides those with PTSD in approaching their trauma-related feelings and memories in a gradual manner, so that they learn the related cues and triggers aren’t dangerous, and they don’t have to avoid them.

Treating Co-Occurring Substance Use

An integrated treatment that combines trauma-focused PTSD treatment with treatment for SUD is ideal for individuals struggling with both disorders. This approach includes:

  • Relapse Prevention, which equips individuals with the skills they need to notice and avoid common relapse triggers
  • Dialectical Behavior Therapy (DBT), which helps individuals learn to manage disruptive or intense emotional responses that are common in both addiction and traumatic stress
  • Contingency Management, which reinforces, or rewards evidence of positive behavioral change, such as staying sober and attending peer support groups
  • Medication options, which can include medically assisted treatment options for addiction and antidepressants, including SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), for PTSD

Mental health professionals once believed that treating PTSD separately from substance use issues was most effective. Now, we understand that treating both conditions together is the best route.

Treatment for addiction and co-occurring disorders leads to improved physical health, increased enjoyment, and an overall healthier lifestyle.

If you or someone you love is living with PTSD and SUD, contact us about effective, compassionate group treatment. Our mission at Lasting Recovery is to help you manage your mental health for the long term. Let us help you recover.

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