Why Do People with PTSD Develop Substance Abuse?
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When we encounter a traumatic event, it can be incredibly destabilizing. Whether we witnessed something shocking, or personally experienced a disturbing event, the trauma registers deep in our psyches.
Each of us has a unique capacity to overcome trauma. Many find themselves resorting to drugs or alcohol to help numb the effect of the traumatic memories. In this article we will attempt to answer the question, “Why do people with PTSD develop substance abuse?”
Understanding PTSD
At the root of post-traumatic stress disorder (PTSD) is a traumatizing event. Trauma is defined as an event where there is perceived risk of physical or psychological harm. It can be a witnessed event or something experienced firsthand. Examples of a traumatic event might include:
- Physical assault
- Death of a family member, spouse, or close friend
- Sexual abuse or rape
- Physical injury, such as being in a serious car accident
- Divorce
- Stress related to military combat
- A serious illness
- Abuse, abandonment, or neglect in childhood
- Domestic abuse
- Natural disasters
PTSD is diagnosed when an individual has not been able to overcome the effects of a trauma within a month. PTSD has specific features that are outlined in the DSM-5. These include:
- At least one re-experiencing symptom. These include flashbacks, nightmares, or recurrent frightening thoughts.
- At least one avoidance symptom. These involves avoiding situations, events, places, people, or things that remind the person of the trauma. Avoidance also pertains to blocking thoughts and feelings that are related to the trauma.
- At least two arousal and reactivity symptoms. These include hyper-arousal, such as feeling tense, jumpy, or on edge. Also includes sleep disturbances and angry outbursts.
- At least two cognition and mood symptoms. These include trouble remembering details of the traumatic event, having a negative mindset, and inappropriate feelings of blame or guilt. It also features a loss of interest in activities once enjoyed.
Different Ways People Deal with PTSD
When someone is haunted by a traumatic event, whether it occurred a month or decades prior, they adopt coping methods. These are mechanisms that the person utilizes to manage their emotions on a daily basis.
Some coping methods for dealing with the aftereffects of trauma can be healthy, where others are called maladaptive or unhealthy. Examples of maladaptive coping techniques for PTSD include:
- Substance abuse. Drugs and alcohol provide a temporary escape from the memories and associated psychological distress of a traumatic event.
- Avoidance. To prevent triggers, those with PTSD make a conscious effort to avoid anything that might cause difficult emotions to resurface.
- Detachment. Some with PTSD form a wall around their emotions, becoming detached from others, and from their own feelings.
- Withdrawal. People struggling with PTSD may withdraw from family and friends and avoid social situations altogether.
PTSD and Substance Abuse
When considering, “Why do people with PTSD develop substance abuse?” it helps to understand self-medication of mental health distress. Drugs and alcohol are commonly misused for the purpose of relieving mental health symptoms. This not only applies to those with PTSD, but is also associated with depression, anxiety, bipolar, and other disorders.
Psychoactive substances dull the mind and consciousness, the exact effect someone with PTSD might desire. They want to forget what happened to them, so substance abuse becomes a form of disordered therapy. In fact, studies confirm that a high rate of substance use disorders exist among individuals with PTSD.
Treatment for Co-Occurring PTSD and Substance Use Disorder
When someone with PTSD is ready to approach recovery for a substance use disorder, they will need dual diagnosis treatment. To achieve a successful recovery result, both the PTSD and substance abuse disorder must be treated simultaneously.
This comes back around to the question at hand, “Why do people with PTSD develop substance abuse?” The substance has been used to self-medicate the PTSD, so both the trauma and the addiction must be treated together. If not, the recovery will be short-lived.
An integrated dual diagnosis treatment program involves these elements:
- Medical detox and withdrawal management
- Individual psychotherapy
- Group therapy
- Family therapy
- 12-Step program or similar
- Addiction education
- Holistic activities
Trauma-Informed Therapies
Rehab for PTSD recovery includes a special emphasis on trauma-focused protocols. These are highly focused types of therapy that help the person become less sensitive to the trauma memories and include:
- Trauma-focused cognitive behavioral therapy (TFCBT). TFCBT helps by reshaping the thoughts that have led to the maladaptive coping techniques. This is accomplished by guiding the person to safely express their feelings about the traumatic experience. As they share about their feelings, the therapist shows them how they have led to substance abuse.
- Exposure therapy. This is another behavioral therapy that uses prolonged exposure techniques to help the person become less sensitive to the trauma. The therapist has the person describe the traumatic event while gradually exposing them to triggers within a safe environment.
- Eye movement desensitization reprocessing (EMDR). EMDR is a type of exposure therapy that features an 8-step process. This process also helps to reduce the effects of the trauma. EMDR uses an object or an action such as tapping to distract the person as they discuss the trauma with the therapist.
PTSD Continuing Care
Completing the detox and residential rehab program provides an excellent start on a healthy new life in recovery. Just as important are the aftercare actions you take after rehab that are designed to help you sustain newfound wellness.
To reduce the risk of relapse for either PTSD or substance abuse, or both, you must engage in continuing care efforts. These include:
- Outpatient services, including therapy, support groups, and life skills classes.
- Sober living housing if the home environment is not supportive of recovery efforts.
- Joining a local A.A., N.A., or SMART Recovery group for social support.
- Forming healthy habits, like regular exercise, a healthy diet, and good sleep quality.
- Making new sober friends through sober groups, a sober gym, or through recovery meetings.
Annandale Behavioral Health Provides Dual Diagnosis Treatment for PTSD and Addiction
Annandale Behavioral Health is a residential dual diagnosis treatment center that specializes in co-occurring PTSD and addiction. If you have been wondering, “Why do people with PTSD develop substance abuse?” we can provide the answers. Please reach out to our friendly team today at (855) 778-8668.
