PTSD and Addiction

Post-traumatic stress disorder (PTSD) is a debilitating mental anxiety disorder that develops after an individual experiences or witnesses a traumatic, tragic, terrifying or life-threatening event. People suffering from PTSD experience flashbacks to the traumatic event and a sensitivity to emotional or mental triggers that remind them of the experience, causing negative changes in their lifestyles and an inability to achieve normal goals or objectives. Events that lead to PTSD include war or military combat, accidents, physical or sexual assault, abuse, natural disasters, terrorist attacks, bombings, and events in which individuals are injured. Among those with PTSD, co-occurring disorders are frequent, as high rates of combinations of depression and other anxiety disorders with substance addiction are usually found in these individuals. Section Menu For people with PTSD, a co-occurring substance use disorder can be extremely harmful. People with PTSD often experience problems with their interpersonal relationships, health and everyday functions. Combine this with a substance use disorder, and these difficulties are only amplified. PTSD sufferers may use substances to “self-medicate” as a way to treat symptoms such as isolation, sleep disturbances and emotional numbness. Unfortunately, using substances to alleviate PTSD symptoms provides only temporary relief while intensifying the negative effects and symptoms that stem from PTSD. Nicholas Stefanovic, a former Marine who completed two tours of duty in Iraq and Afghanistan, began feeling the effects of PTSD when he returned to the United States in 2006. He turned to prescription opioids to deal with his symptoms. “I started using [OxyContin] because it was like a miracle drug for me,” Stefanovic told DrugRehab.com. “[The drugs] immediately fixed my problems.” He knew that misusing opioids could cause another set of problems. He didn’t care. He had no plans for the future anyway, he said. “I was not suicidal, but there were times when I didn’t care if I lived or died,” Stefanovic said. People with PTSD most commonly use alcohol to alleviate their symptoms, with about 52 percent of men and 28 percent of women with PTSD meeting the criteria for alcohol abuse. For people with co-occurring PTSD and substance abuse disorder, recognizing the signs of the disorders is the first step to recovery.

Symptoms of PTSD

While people with PTSD can experience a variety of symptoms related to their condition, these symptoms can be broken down into three types. The first is re-experiencing symptoms. Re-experiencing symptoms include flashbacks where an individual repeatedly relives the trauma that caused their PTSD, has bad or haunting dreams about the trauma and has frightening thoughts or ideas that can be triggered by environmental factors. These symptoms can also cause physical side effects, such as increased heart rate and sweating. These flashbacks, thoughts and dreams can also be extremely debilitating and may prevent people from leading a healthy lifestyle. Individuals with PTSD may also experience avoidance symptoms. Individuals experiencing avoidance symptoms often stay away from people, places or things that may remind them of the traumatic event that caused their PTSD. Individuals with these symptoms can also feel “numb” or lose interest in things that were enjoyable to them in the past, feel a strong sense of guilt, depression and worry, and may have trouble remembering and addressing the past trauma. Avoidance symptoms can cause people to isolate and will often push people with a co-occurring substance use disorder deeper into substance use. “I came home in 2006, but metaphorically I didn’t really come home,” Stefanovic said. “I was lost, and people close to me told me that I was different. I was completely isolated. I didn’t want to be around family, friends. I got an apartment and stuck to my bedroom.” The final group of symptoms is hyperarousal symptoms. Individuals with these symptoms experience anxiety, are easily startled, feel tense or “on edge,” have difficulty sleeping, and may be unable to control their emotions. Stefanovic also experienced some of these effects. “Everyone has their own symptoms, and my symptoms involved nightmares,” said Stefanovic. “I would have panic attacks for no good reason. I couldn’t sleep. I was afraid to sleep.” The most serious side effects associated with PTSD, however, are suicide and suicidal thoughts. Research shows a strong positive correlation between PTSD and a high risk of suicide and suicidal thoughts. Combine this with a substance use disorder, which often leads to decreased inhibitions, and individuals with PTSD become highly susceptible to suicide.

Causes of PTSD

An individual’s development of PTSD is affected by a number of factors that determine the severity of the condition. The root cause for all PTSD is a traumatic event. Trauma affects every person differently, and the majority of individuals who live through traumatic events go through a period of recovery, usually about a month long, before mentally moving on from that event. People who develop PTSD, however, usually experience a trauma so severe that it changes the ability for their brain to properly process the results of the event. In military veterans, for example, live combat involving death or injury can lead to the development of PTSD. For civilians, a car accident, child abuse or neglect, sexual assault or a physical attack may haunt someone long after the event. Stefanovic’s PTSD was caused by the horrors of war. While in Afghanistan, he witnessed an elementary school bombing. Some of his fellow Marines died in battle. He said he went through the worst suffering of his life while overseas, and his return home wasn’t easy. “I was living with a lot of grief and guilt,” Stefanovic said. “I had no closure.” While traumatic events play a significant role in the development of PTSD, genetics also affect the development of the condition. Genes may make certain people more likely to develop PTSD, and people with a family member with PTSD have a higher risk of developing the condition as well. Although research is still being conducted, scientists have theorized that individuals who develop PTSD may lack the genetic proteins needed to form fear memories and the brain chemicals that help with the response to fear. It is generally believed these pre-existing biological factors play a role in an individual’s development of PTSD. In addition to traumatic events and genetic factors, key areas of the brain also have an effect on an individual’s development of PTSD. Two areas of the brain in particular are believed to affect the development of PTSD: the amygdala, the area of the brain responsible for learning about fear, and the hippocampus, the area of the brain responsible for creating memories. Scientific evidence has shown that the amygdala can be hyperactive in people with PTSD. Evidence has also shown a loss of volume in the hippocampus in individuals with PTSD, which may be the cause of memory deficits associated with the disorder. Further research has led scientists to the conclusion that it may be possible to predict PTSD development in individuals based on psychological and neurochemical responses of people who experience a traumatic event.

Civilian PTSD

Although the disorder is frequently associated with military veterans, PTSD among the general public is just as common. Civilian PTSD is caused by noncombat-related trauma that occurs in everyday life, such as car accidents, physical or sexual abuse, natural disasters or other harmful events. The trauma some individuals face can have a strong and lasting impact and potentially lead to PTSD development. In the United States, 61 percent of men and 51 percent of women have experienced at least one traumatic event during their lifetime. Out of those who experience trauma, 8.1 percent of men and 20.4 percent of women develop PTSD. Rates of PTSD are also high among American youth, with a large number experiencing trauma before the age of 16.

Survivors of Sexual Assault

One of the most common traumatic events that cause PTSD is sexual assault, especially rape. Victims of sexual assault may experience PTSD symptoms such as repeated thoughts or memories of the assault, nightmares, avoidance symptoms, negative thoughts or feelings. According to the National Sexual Violence Resource Center, one in five women and one in 71 men will be raped during their lifetime. Female victims, which make up 91 percent of sexual assault victims, are most at risk for developing PTSD after an assault. One study monitored PTSD symptoms among women who were raped for the first two weeks after the rape and found that 94 percent of those women experienced symptoms of PTSD during that time. Additionally, 30 percent of the studied group reported PTSD symptoms nine months later. According to the National Women’s Study, about 33 percent of rape victims develop PTSD at some point during their lifetime and 11 percent of rape victims currently suffer from PTSD. Get a recovery plan that’s made for you. Get Help Now