PTSD and Addiction: Healing the Wounds

Last Updated on October 25, 2023

The National Center for PTSD reports about seven or eight of every 100 people will suffer from PTSD at some point in their lives.¹ People with PTSD are also three times more likely to abuse drugs than those without it. Additionally, 50 percent of people who have PTSD also abuse alcohol.²

While the relationship between PTSD and addiction is very clear, the solution is not always as obvious. If you or a loved one is suffering, it’s important to understand why the two disorders often occur simultaneously and what kind of treatment is most effective for overcoming both.

What is PTSD?

PTSD stands for posttraumatic stress disorder and is defined by the American Psychiatric Association as “a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event.”³

Although PTSD is often associated with combat veterans or people who have experienced the turmoils of war, PTSD can affect anyone who has experienced something traumatic such as a natural disaster, physical or sexual assault, or a serious accident. Much like addiction, the PTSD does not discriminate based on age, sex, race, or cultural background.

Just because a person suffers from PTSD does not mean he or she is mentally weak. There are several different factors that can increase a person’ risk for developing PTSD, such as:

• Experiences of previous trauma
• History of physical, emotional, or sexual abuse
• History of substance abuse
• Lack of coping skills
• Lack of social support
• Death/unexpected loss of a loved one
• Extreme or ongoing stress⁴

While these factors may influence whether or not a person develops PTSD, not everyone who faces these things will develop the disorder. This often depends on a person’s genetics, social experiences, personality traits, and how their brain typically responds to stress.⁵

Signs and Symptoms of PTSD

The signs and symptoms of PTSD can often be very confusing because they don’t occur until several weeks following a traumatic event. Symptoms can also range in severity and duration depending on the person.

According to the PTSD Alliance, there are three main clusters of PTSD symptoms that include:

1. Recreating the traumatic event over and over (flashbacks)
2. Avoiding people, places, or things that trigger memories of the traumatic event
3. Always being alert, on-edge, and cautious of danger⁶

In addition to these, people with PTSD may also experience the following symptoms:

• Reduced ability to feel pleasure (anhedonia)
• Detachment from family and friends
• Reckless and self-destructive behavior
• Low self-worth
• Depression/feeling numb
• Inability to remember or talk about the traumatic event(s)
• Irrational anger
• Inability to focus on daily tasks
• Anxiety
• Chronic pain
• Chronic fatigue
• Heart problems
• Eating disorders
• Headaches
• Digestion problems
• Racing heart or chills when memories of the traumatic event arise⁶

If PTSD is left untreated, these symptoms can be severely debilitating and additional self-destructive behaviors can occur, like suicidal behaviors or severe substance abuse.

PTSD and Addiction

People with PTSD often turn to drugs and alcohol to cope with their symptoms. The effects of certain drugs and alcohol can serve as a distraction from complex emotions and drown out the physical and emotional pain associated with PTSD. For many people, self-medicating with drugs and alcohol seems like an effective solution that makes them feel happier, at least for a short time.

People who are living with undiagnosed PTSD may not even know there are other ways to deal with their symptoms, often leaving them feeling hopeless, depressed, and isolated amid their substance abuse.

Repeated drug use will affect the brain’s ability to regulate normal amounts of hormones like dopamine, causing additional symptoms like drug cravings, withdrawal, insomnia, and anxiety, among others. As the person’s physical dependence grows, they can easily lose control of the drug use and become addicted. Drug withdrawal symptoms can also exacerbate the symptoms of PTSD, which can cause further deterioration of physical, emotional, and mental health.

As a result, co-occurring PTSD and addiction can cause a revolving cycle of drug abuse and emotional distress that is never resolved or reduced. Instead, both issues will continue to increase and worsen with time without treatment.

Effective Therapies and Treatment for PTSD and Addiction

Since addiction and PTSD have many overlapping symptoms, it is best to treat both disorders simultaneously.⁷ That way, a person can address negative emotions and triggers associated with their drug use. In the long run, this will help the person maintain their sobriety and establish a strong foundation in sobriety because it does more than just treat the symptoms of addiction; it addresses the causes too.

Medications like Lexapro, Zoloft, and Prozac are often used in conjunction with behavioral therapy to treat both PTSD and addiction. However, if a person has a history of addiction involving antidepressants or benzodiazepines, medication may not be the best treatment option.

Therapies that have been shown to be effective for treating PTSD and addiction include cognitive behavioral therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and Seeking Safety.

Cognitive Behavioral Therapy for Treating PTSD and Addiction

Cognitive behavioral therapy is used to prevent relapse by teaching people how to evaluate their thought patterns and attitudes that contribute to substance abuse. The purpose of CBT is to eliminate negative behaviors and thoughts and give people the coping skills and strategies they need to implement positive behaviors in their lives that will combat drug and alcohol addiction.

Cognitive behavioral therapy has many benefits for people with PTSD and addiction.⁸ For example, it can help them:

• Prevent relapse
• Deal with relapse in a productive, healthy way
• Identify high-risk situations and avoid them
• Deal with negative emotions like anger
• Cope with cravings, trauma, loss, and grief without the use of drugs or alcohol
• Improve relationships and build healthy new ones

EMDR Therapy for Treating PTSD and Addiction

EMDR therapy stands for Eye Movement Desensitization and Reprocessing, which is a type of behavioral therapy that helps people process and resolve traumatic memories and emotions. In working with a therapist throughout an addiction treatment program, EMDR therapy can help clients gain closure from traumatic life events and move forward without the crutch of drugs and alcohol.⁹

The primary method used in EMDR therapy allows clients to reframe certain memories and traumatic experiences in a more positive way. So instead of being horrified, frightened, or angry about an event, the client can learn to associate that event with something more positive, such as the realization that they are strong, courageous, and capable because they survived it.

EMDR therapy is an effective way to provide addiction treatment through a trauma-informed lens. This means therapists provide appropriate recovery-focused treatment while also creating a safe and supportive environment for clients of all backgrounds and life experiences. When it is facilitated properly, EMDR can provide a wealth of benefits for people with PTSD and addiction, such as:

• Resolving past and current trauma
• Processing traumatic events and life experiences
• Improving self-esteem and self-efficacy
• Reducing physical or psychological symptoms of trauma and PTSD

Seeking Safety for Treating PTSD and Addiction

Seeking Safety is another therapeutic method for treating PTSD and addiction. This type of therapy is designed to help people establish a sense of safety by reducing risky behaviors, setting healthy boundaries in life, and learning how to cope with triggers.¹⁰

The Seeking Safety approach is evidence-based, trauma-focused, and extremely flexible to provide effective treatment for people who are suffering from both PTSD and addiction simultaneously.

Types of Addiction Treatment Programs that Address PTSD and Addiction

A person with PTSD and addiction can choose from a variety of addiction treatment program types based on their needs and personal circumstances. Although a residential 90-day addiction treatment program will provide the most thorough treatment with the highest level of structure, not every person will need that much structure or will be able to commit to a 90-day inpatient program. Fortunately, there are other options such as:

• Medical drug and alcohol detox – A medically-assisted detox program will provide proper treatment for severe withdrawal symptoms, which is common in people with PTSD. Medical detox provides 24/7 medical assistance, nutritious meals to repair nutritional deficiencies, group or individual counseling, and personal recommendations for ongoing treatment. Some detox centers also offer executive detox programs for business professionals or H&I speakers to introduce clients to the 12-Step Program early in treatment.
• Residential inpatient treatment – A residential program requires that clients live in gender-specific quarters at a drug rehab center for the duration of their treatment. They adhere to a structured daily schedule that consists of group and individual counseling, 12-Step meetings, meal times, exercise times, personal time, and specialized therapies like CBT, EMDR, music therapy, or animal-assisted therapy.
• Intensive Outpatient Treatment (IOP) – Clients meet three times each week in a clinical outpatient setting. Treatment is facilitated by a professional drug therapist and clients have the flexibility to attend work, school, or continue caring for their children while they are enrolled in IOP.

Clients can also continue their addiction treatment with a sober living program, aftercare, or personal monitoring, which all provide recovery support services for people who are recovering from PTSD and addiction.

If you or a loved one is struggling with PTSD and addiction, the addiction treatment professionals at Nova can provide a flexible treatment program and continuum of care that will address symptoms of both disorders and provide the most effective route for your own personal recovery.

Call Nova Recovery Center to speak with an admissions representative about treatment options today.

References:

1. https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml
2. http://www.ptsdalliance.org/ptsd-and-addiction/
3. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
4. https://hcahealthcare.com/hl/?/20074/Risk-Factors-for-Post-traumatic-Stress-Disorder–PTSD-
5. https://www.everydayhealth.com/ptsd/causes-risk-factors-when-seek-help/
6. http://www.ptsdalliance.org/symptoms/
7. https://www.psychguides.com/guides/ptsd-and-addiction/
8. https://health.usnews.com/health-news/patient-advice/articles/2016-07-18/self-medicating-to-cope-with-trauma-how-emdr-therapy-can-help-in-substance-abuse-treatment
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466083/