PTSD & Addiction
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Post-traumatic stress disorder can correlate with substance use disorders. In other words, people who have experienced traumatic stress and resulting mental health issues are more likely to struggle with addiction. Trauma is complex and difficult to treat. Psychological wounds often do not heal on their own but need to be properly addressed. When left untreated, the symptoms of PTSD can be a significant risk factor for drug use, and vice versa.
The relationship between trauma and addiction is complicated, as well. There are different ways in which either condition can affect a person’s susceptibility to the other, and there are correlating risk factors, as well as social and societal interplay, especially among survivors of violence or dangerous environments. Properly addressing both PTSD and addiction requires an integrated treatment approach that doesn’t just treat the conditions concurrently but sees them as one larger mental health issue.
What is PTSD? How Does PTSD Develop?
Post-traumatic stress disorder is a mental health condition characterized by certain symptoms experienced after a traumatic event. At its core, PTSD is an anxiety disorder, and it is also the most common condition in the family of trauma-related stress disorders (which include other conditions, such as reactive attachment disorder, adjustment disorder, and acute stress disorder).
Post-traumatic stress disorder is called this because symptoms can develop weeks or months after the traumatic event that triggers them.
Traumatic events that may trigger PTSD include exposure to, or the immediate threat of:
- Death
- Life-changing injury
- Sexual abuse
- Violence towards others
In cases where trauma develops into PTSD, doctors look for signs and symptoms such as:
- Intrusive thoughts and memories (unwanted flashbacks or disturbing thoughts)
- Avoidance symptoms (avoiding places, people, or topics that remind you of your trauma)
- Negative mood (depressive thinking)
- Hyperarousal (changes in physical and emotional reaction)
Anyone can develop PTSD. However, PTSD is most diagnosed in teenaged and middle-aged women. Women are two to three times more likely to develop PTSD over the course of their lives than men. Among military veterans, an estimated 10 percent of men and 19 percent of women received a PTSD diagnosis in 2021 alone.
Other risk factors for PTSD include childhood abuse and exposure to violence. For example, first responders (such as firefighters, paramedics, and police officers) are more likely to be diagnosed with PTSD, as are people who lived in warzones, or experienced natural catastrophes up close.
The Link Between PTSD and Addiction
Researchers have identified different theories on the relationship between PTSD and addiction. The most prominent is the theory of self-medication. This theory hypothesizes that PTSD reinforces addiction because certain PTSD symptoms can be temporarily repressed through drinking or drug use but come back in full force after the temporary high has ended. This creates a cycle where repeated drug use helps soothe symptoms, but not for long.
Other popular theories include susceptibility and risk factor theories. The susceptibility theory believes that chronic drug use can make a person psychologically vulnerable to potentially traumatic events and make the onset of PTSD more likely. The risk factor theory finds that there are correlating genetic and environmental factors between people who have experienced PTSD, substance use disorders, and both conditions.
In many cases, the individual reality might be somewhere in the middle of the triangle. Each theory has supporting evidence, and it’s likely that the relationship between trauma and addiction is defined by shared risk factors, susceptibility fueled by both conditions, and the dangers of self-medication. And in all cases, it’s important to address not just one, or the other, but both conditions within the same integrated treatment plan.
Trauma as a Recurring Stressor
PTSD symptoms may become more or less intense over time. Stress can exacerbate and worsen symptoms. Certain triggers can make them come back stronger. Sounds, smells, and sights can remind people of their trauma. PTSD can become chronic, lasting years or even decades.
Severe stress is one of the biggest risk factors for substance use disorders. Drug use provides a temporary escape from the brunt of PTSD’s most intense symptoms, albeit temporarily. The catch is that drug use tends to worsen PTSD over time, increasing symptoms of anxiety and depression.
Why Treating Trauma Matters
PTSD can contribute to addiction risk, but it also makes substance use disorders harder to treat. The mental and physical burden of drug withdrawal can worsen symptoms of PTSD and other co-occurring mental health issues.
Negative self-talk and intrusive thoughts become stronger and harder to ignore, coupled with the intense cravings that accompany an addiction. Improving mental resilience to stress is an important part of long-term recovery and effective relapse prevention. Addressing an addiction without addressing underlying sources of stress, such as PTSD, can be futile.
Treatment Approaches for PTSD and Addiction at Coastwise
Here at Coastwise, we implement trauma-informed care when planning out an integrative treatment program for clients with PTSD and addiction symptoms. Our programs adhere to the six tenets of trauma informed care:
- Safety
- Trustworthiness & transparency
- Peer support
- Collaboration & mutuality
- Empowerment & choice
- Sensitivity to cultural, historical & gender issues
Integrated treatment sets itself apart from concurrent or adjacent treatment by combining modalities within a single treatment plan, organized by coordinating mental health professionals. Rather than treating both conditions separately through different specialists, an integrated treatment plan views a client’s mental and physical health issues through a holistic lens and formulates a plan that addresses these contributing health conditions altogether.
At Coastwise, we do so by combining different treatments for PTSD and addiction within our partial hospitalization (PHP) and intensive outpatient (IOP) programming, such as:
- Individual Psychotherapy
- Emotional Transformation Therapy (ETT)
- Acceptance and Commitment Therapy (ACT)
- Dialectical Behavioral Therapy (DBT)
- And more.
After our IOP or PHP treatment programs, we work with our clients to ensure that their path to long-term recovery is secured through peer support, recovery sponsors, group support programs such as AA/NA, medication management through a mental health professional, and continued therapy or counseling.
Get Started with Us at Coastwise
Our programs at Coastwise are tailored to each individual client’s needs and circumstances. Rather than focusing on treating separate conditions, we focus on treating our clients as best we can. PTSD can complicate addiction and vice versa – but an integrated treatment plan can help people with traumatic pasts overcome their trauma and build the repertoire they need to manage their addiction. Want to learn more about our programs at Coastwise? Give us a call today.