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PTSD and Addiction – What Is the Connection?
Author: Phil Kosanovich
Published: December 21, 2021

Post-traumatic stress disorder (PTSD) is a mental health disorder that individuals may experience after living through a traumatic event like war, violence, or natural disaster. People living with PTSD may have been involved in the event itself, witnesses to it, or traumatized by hearing another’s story – a condition known as secondary trauma.

Those living with PTSD may experience a range of symptoms, including flashbacks, depression, disassociation, and anxiety, that significantly impact their daily lives. Without treatment, these symptoms can persist for years.

In the absence of adequate care and support, some people turn to alcohol and drugs as a coping mechanism. Though substances may offer an escape from negative thoughts, emotions, and reality, with repeated use, this coping method can develop into substance use disorders and addiction.

In the long term, however, substance abuse only exacerbates the symptoms of PTSD and intensifies symptoms like anxiety and depression. The good news is that there are effective and accessible treatments for both PTSD and addiction.

Dual diagnosis programs that treat co-occurring disorders like PTSD alongside addiction target the underlying causes of the addictive behavior to help individuals stay away from substance use in the long term. They offer holistic healing that supports overall mental wellness so that PTSD and SUD sufferers can overcome their symptoms and live fulfilling and productive lives.

Why Does PTSD Develop?

PTSD can develop after a very frightening or stressful event or after a prolonged period of emotional distress – a condition called complex PTSD. It can develop from many kinds of traumatic experience, including:

  • Car accidents
  • War and conflict
  • Torture
  • Physical or sexual violence
  • Domestic or childhood abuse
  • Childbirth experiences
  • Severe health problems
  • Distressing experiences at work

About one-third of people who experience a traumatic event will have PTSD. Scientists do not know exactly why some people develop the condition, but factors like genetics and receiving care and support after the event may play a role.

While we still don’t have a clear picture of the mechanisms underlying the development of PTSD, scientists have suggested a few possible explanations. Some of these are:

  • A survival mechanism – Some scientists suggest that experiencing flashbacks after a traumatic event could help us prepare for the event next time by going over the sequence of events in detail. In reality, however, these flashbacks are unhelpful as they prevent an individual from processing and moving on from the incident.
  • High adrenaline levels – Studies have shown that people living with PTSD have unusually high levels of stress hormones. Our bodies usually produce these hormones when we feel under threat to trigger a flight or fight response that can get us out of danger. However, the persistence of these hormones leads to symptoms like anxiety that can disrupt our everyday lives.
  • Physical brain changes – In people with PTSD, the area of the brain called the hippocampus appears smaller in size. This area of brain cells is responsible for managing our memory and emotions. Changes in the hippocampus may relate to symptoms of anxiety, depression, memory problems, and flashbacks that are associated with PTSD.

What Is the Connection Between PTSD and Addiction?

PTSD and trauma can be driving factors behind drug and alcohol abuse. Sometimes, substances can offer a way to cope with symptoms of PTSD. In other cases, the experience of trauma leads to both PTSD symptoms and substance abuse.

Some individuals with PTSD may develop depression, anxiety, or feel detached from friends and loved ones. They may turn to drugs and alcohol to improve their mood, experience strong feelings of pleasure, or relieve worry and stress. Over time, they can become dependent on substances as a coping mechanism for emotional and mental pain.

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PTSD affects the parts of our brain that relate to memory and emotions. It interferes with our ability to distinguish between past and present experiences, causing people to experience intense flashbacks and triggers in the environment that remind them of past events.

Addiction also affects our memory and pathways in our brains. Repeated drug use creates strong connections between the reward of a substance high and cues in the environment that you associate with that substance. Certain triggers – like places or people – can produce strong urges to re-use the substance, even after years of abstinence.

When someone is in recovery, avoiding or coping with these triggers is crucial for maintaining sobriety. However, PTSD can complicate this process. A study by Drug and Alcohol Dependence found that PTSD symptoms lead to a greater risk of relapse in intrapersonal and negative physiological contexts. It also increases symptoms of anxiety and depression before and after relapse.

What Are Effective Treatments for PTSD and Addiction?

In The Principles of Effective Treatment, the National Institute on Drug Abuse explains that effective addiction treatment must target the underlying causes of addiction, treating co-occurring disorders alongside addiction. Only by overcoming the source of addictive behavior can people achieve long-term recovery.

Scientists have uncovered a range of evidence-based treatments that can effectively treat sufferers of PTSD and addiction. These include:

  • Cognitive-behavioral therapy
  • Eye movement desensitization and reprocessing (EMDR) therapy
  • Support groups

To Conclude

Traumatic events can have a significant impact on our lives – leading to PTSD symptoms and, in some cases, substance abuse. However, with effective treatment, care, and support, individuals can process trauma, recover from addiction, and live fulfilling and joy-filled lives.