PTSD and substance use

We briefly discussed PTSD in the post "Getting Over Past Traumas" Click Here, but we’ll take a closer look at it now because of its high association with alcoholism and addiction. We must keep in mind that although PTSD has garnered a lot of attention in recent times, many people who do not develop full-on PTSD are also often anguished by past calamity, and struggle with life and alcoholism-addiction as a result.

People with PTSD have witnessed or been through a traumatic event, but sometimes just hearing about a traumatic event is enough to bring on the symptoms. Until recently PTSD was unrecognized, and its victims were labelled as “cowards” or “whiners.” Its first recognition, albeit in an embryonic way, came in the form of extreme examples of it being labelled by the term “Shell-shock” during and after the First World War, and “Combat Fatigue” during the Second World War and Vietnam War. Even these people were frequently branded as cowards. Victims of debilitating mental symptoms following other traumas – such as rape, assault, fire, natural disaster, witnessing an injury or fatality, or other tragedies – were not given the same acknowledgement.

Symptoms

People with PTSD continue to suffer from the psychological impact of the traumatic event long after it happens. They suffer intrusive thoughts, which can include vivid nightmares, persistent memories, and flashbacks where they re-live the experience. These intrusive thoughts renew the terror and pain of the experience over and over again.

PTSD sufferers avoid situations, objects, or people that remind them of the event. They often have over-the-top reactions to a sudden unexpected stimulus such as a loud noise or a tap on the shoulder. They are frequently irritable and avoid contact with others, especially when memories of the offending ordeal are strong.

People suffering PTSD have a tendency to internalize their feelings. They don’t want to talk about the horrible event nor their feelings around it, and can become violently defensive when asked to do so. They live with a great deal of fear and mistrust. They understandably view the world as a scary, dangerous place. They often blame themselves for their feelings, and may become very down on themselves. Symptoms of depression and anxiety assault their already wounded hearts.

Symptoms usually develop within days of the traumatic event but may appear months later. These persist for months and sometimes many years. For some people the symptoms of PTSD improve or disappear over time. For others it is an ongoing plague on their life.

Treatment

There is treatment available for PTSD, although it is difficult to treat. There is no “magic bullet” for it, so prevention is key. Post-trauma counselling is a key aspect of prevention. I was exposed to an event that shocked me deeply when I was an intern working in the ER. The hospital funnelled me right away into post-traumatic counselling, and I am today very thankful for that. Although I still get occasional clusters of flashbacks, they are only when I see something that reminds me of the event and they are very manageable. I have no doubt that the counselling I received after the event prevented much suffering on my part.

Other than a focus on prevention, treatment involves medications together with psychotherapy, especially Cognitive Behavior Therapy (CBT). The goal is to reduce symptoms until the condition burns itself out. The great danger lies in the PTSD victim seeking relief from their symptoms from “self-medication” with alcohol, drugs, or addictive behaviors. Ultimately, suicide risk is worrisome. PTSD is a very serious illness.

Ties to alcoholism / addiction

We discussed in the post "Getting Over Past Traumas" Click Here the psychology, ties to substance abuse and other dysfunctional coping mechanisms, and an approach to "dealing with" past trauma.

If they come to us for help with their substance use, we must give these unfortunates their space as they work through their issues with professional therapists and their doctor. It is my opinion that the Twelve Step process affords an excellent framework for coming to terms with past events, but those with PTSD will require patience when it comes to discussing these, as will many others with a tormented history. In the meantime, finding sobriety will help the rest of the process along immeasurably.



To learn more about the science and psychology of addiction and recovery, and to understand why alcoholics and addicts behave the way they do, see the author's book The Alcoholic / Addict Within.

Available for sample or purchase in paperback and ebook editions at amazon.com (Click Here).