Many people first learn about post-traumatic stress disorder (PTSD) in relation to Vietnam veterans. In fact, the term “post-traumatic stress disorder” first came to use in the 1970s, when many Vietnam vets were presenting with symptoms that up until then were referred to as “shell shock” or “combat neurosis.”
In 1980, PTSD was included as a mental health disorder in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-3). In recent years, PTSD has gained attention for occurring following traumas other than war, such as rape and other sexual assault, childhood abuse, and mass shootings. Prolonged interpersonal abuse and intergenerational trauma can also lead to the development of a type of PTSD called complex post-traumatic stress disorder.
Self-medication with drugs or alcohol of negative emotional states, like the persistent stress and anxiety associated with PTSD, can lead to addiction. This creates an especially vicious circle for people with PTSD because side effects of alcohol abuse can include anxiety, agitation, and aggression — often the very symptoms the person is trying to control.
PTSD and Alcohol Abuse: Co-Occurring Disorders
Post-traumatic stress disorder and alcohol use disorder are co-occurring disorders. This means that having one of the disorders makes it more likely that a person will also have the other. It also means that when symptoms of one of the disorders worsen or improve, so too will those of the other.
Knowing that these two disorders tend to occur together makes dual diagnosis more likely. This is very helpful in treatment and recovery, because treating both disorders at the same time provides the best results.
If someone is showing signs of alcohol abuse, for example, healthcare providers increasingly are aware of the importance of checking for symptoms of other mental health disorders that can co-occur.
PTSD aside, living through a traumatic experience has been shown to lead to alcohol misuse. In fact, nearly 40 percent of people who experienced childhood trauma have an alcohol addiction, according to a recent study out of the Emory University School of Medicine.
Symptoms of Co-Occurring PTSD and Alcohol Use Disorder
With co-occurring disorders, it’s difficult to know which disorder came first. Did a person have a high level of anxiety, which led to drug abuse? Or did they start abusing drugs and then develop anxiety?
What’s more important is knowing that they occur together, so that treatment can be improved. With PTSD and alcohol abuse, symptoms associated with PTSD might lead a person to turn to alcohol for self-medication. For example, stress and anxiety might seem to be alleviated by the use of alcohol, a central nervous system depressant.
However, the use of alcohol typically worsens symptoms of PTSD. Stress and memories of trauma will perpetuate, essentially extending the length of time required to heal and complicating the healing process.
PTSD symptoms that can worsen with alcohol use include the following:
- being unaware of emotions (feeling “numb”)
- isolating from others
- feeling depressed, irritable, or angry
- always being on high alert
- sleeping poorly, including having nightmares
Furthermore, people who abuse alcohol are more likely than people who don’t to find themselves in situations that could be traumatic, such as being involved in a car accident or physical altercation.
You might be abusing alcohol if you regularly:
- crave drinking it
- drink more than you planned to
- find that you have to drink more to get the same effects that you initially did
- keep drinking despite any negative effects
- experience withdrawal symptoms when you try to stop drinking
Getting Help for Alcohol Addiction and PTSD
It can be empowering for people with PTSD and alcohol use disorder to learn that their alcohol use is likely worsening their PTSD symptoms. The lonely place where many survivors of trauma find themselves, living with stress, anxiety, or anger that they’ve tried to “cure” with alcohol, is just as good a starting place as any to get to the root of the problem and begin the path to healing.
The use of medication to treat both PTSD and alcohol addiction is underexplored. However, cognitive-behavioral therapies (CBT), including the following three specific types, get very good results.
Exposure-based therapies: The gold standard for the treatment of PTSD, exposure-based therapies involve exposing people to safe, anxiety-provoking situations and revisiting memories of trauma. Over time, their anxiety is diminished.
Cognition-focused therapies: In this type of therapy, the meaning that people give to their traumatic experience is explored and, through exposure via discussing memories with the therapist, new ways of looking at related themes like power, safety, and trust are adopted.
Anxiety/stress-management therapies: These types of therapy aim to provide people with healthy coping mechanisms for dealing with anxiety and stress. This might involve assertiveness training, breath control, anger management, and other techniques.
There is significant scientific evidence that when CBT is used to treat people with both PTSD and alcohol use disorder, both conditions are improved, leading health professionals to believe that healing past trauma can make it easier to stop abusing alcohol.
Living with PTSD and alcohol addiction can be a vicious circle, with symptoms of one disorder feeding into the other. However, treatment is available that can help people with this dual diagnosis live a sober, healthy life. Addiction treatment centers provide an environment conducive to healing, offering a variety of treatment therapies and other evidence-based care.