Understanding Co-Occurring Disorders: PTSD and Alcohol Use Disorder

ptsd and alcoholism

Post Traumatic Stress Disorder, commonly referred to as PTSD, is a common psychological disorder. Debilitating and emotionally intense, PTSD can stem from repeated negative emotions regarding specific events in one’s life. PTSD can create many difficult side effects that make everyday life hard to cope with. Many people turn to alcohol to cope with their PTSD, as drinking can temporarily reduce symptoms and emotional stress. Drinking with PTSD can lead to co-occurring alcohol use disorder, which is a dangerous combination that needs proper dual diagnosis treatment. 

Understanding Post-Traumatic Stress Disorder

PTSD is a mental health condition that is characterized by repeated flashbacks or anxiety surrounding specific negative events in one’s life. Some things you may experience if you suffer from PTSD include: 

Behavioral Changes: agitation, irritability, hostility, hypervigilance, self-destructive behavior, or social isolation

Psychological Stress: flashbacks, fear, severe anxiety, or mistrust

Mood Changes: loss of interest or pleasure in activities, guilt, or loneliness

Sleep troubles: insomnia or nightmares

Also common: emotional detachment or unwanted thoughts

There is no limit to what experiences have the potential to cause PTSD. Any event or experience that caused a traumatic or negative reaction can lead to this disorder. Exactly what events have the potential to cause this condition are individualized and based on their own brain chemistry, childhood, and life experiences.

In most cases, the individual knows what experiences in their life are causing the symptoms of PTSD, but there are cases where the individual is unaware. In these instances, a licensed professional would be able to help unfold the emotional and physical past. Some common causes of this dual diagnosis of PTSD and alcohol dependence include: 

  • Military combat
  • Physical and sexual assault
  • Childhood abuse
  • Natural disasters
  • Loss of loved ones
  • Witnessing a violent or severe event (i.e. car accident, death, etc.)

PTSD is like reliving past trauma over and over again. It can be so severe that the individual may experience the actual physical pain of the event, even if it’s not happening in real-time. The stress can take over every aspect of your life, and many people turn to drugs or alcohol to numb the pain. Over time, an occasional drink to de-stress will lead to full-blown alcoholism if the individual is emotionally unhealthy.  

About Alcoholism: What is It and How Does It Affect People?

Alcoholism is a serious and life-threatening addiction characterized by frequent periods of heavy drinking. Over time the body becomes dependent on alcohol for normal function. While under the influence of alcohol, all bodily functions (both physical and emotional) are suppressed. Some side effects of alcohol use include:

  • Slurred speech
  • Drowsiness
  • Vomiting 
  • Diarrhea
  • Upset stomach
  • Headaches
  • Breathing difficulties 
  • Distorted vision and hearing 
  • Impaired judgment 
  • Decreased perception and coordination 
  • Unconsciousness 
  • Anemia (loss of red blood cells) 
  • Coma
  • Blackouts (memory lapses, where the drinker cannot remember events that occurred while under the influence)

Once you become dependent on alcohol, your body will need it to function. Attempting to stop drinking will lead to withdrawal, which can be life-threatening in some cases. The combination of impaired function from alcohol with the side effects of PTSD makes for complex co-occurring conditions that require a professional dual diagnosis and treatment plan. 

Heavy drinking can also lead to life-threatening conditions such as alcohol poisoning, coma, and even death. If you have PTSD episodes that leave you unable to control your emotions or behavior, you may be at a higher risk of drinking to a fatal amount. 

The Effects of Co-Occurring Disorders

Post-traumatic stress disorder and substance use often go hand in hand. More than 50% of people suffering from PTSD have reported using alcohol or another substance to cope with their emotional stress. This method of coping is actually another way of avoiding what’s really going on.

PTSD and alcohol use may be two separate conditions, but when they co-occur, they intensify the symptoms of one another. This can make it difficult to tell which condition is causing which symptom and will make treatment more complex. The combination can also lead to the development of further psychological concerns. Some potential side effects of co-occurring PTSD and alcohol dependence include:

  • Anxiety
  • Depression
  • Weakened immune system
  • Bipolar disorder
  • Social anxiety
  • Impaired brain function
  • Insomnia

The patterns and behaviors of PTSD act as a form of mental addiction in themselves. The brain functions in an endless cycle of repeated negative behaviors, thought patterns, lifestyle habits, and poor coping practices. Introducing alcohol to an already unhealthy emotional state makes it more difficult to unlearn these patterns.

Treatment for PTSD and Alcohol 

A dual diagnosis of PTSD and alcoholism can be overwhelming and scary. Trauma survivors don’t need to remain in this negative cycle. There are plenty of treatment options that will address both conditions at the same time and bring you back to a healthy state of being. 

Treatment for dual diagnosis of PTSD and alcohol use should have a combination of professional services directed at addressing both the mental and physical effects of both conditions. Most treatment plans will include:

  • Detox: For the cleaning of the body from alcohol and any other harmful substances
  • Depression/Anxiety medications: This helps stabilize a person’s mental health
  • Talk Therapy (CBT, ACT therapy): To verbally work through struggles, any past traumas, emotional wounds, and current recovery issues
  • Dialectical Behavioral Therapy (DBT): This helps individuals develop mindfulness, tolerance, social skills, and emotional regulation
  • Eye Movement Desensitization: This therapy retrains eye movement to respond to trauma and fear in a healthier way  
  • Nutritional therapy: To help rebuild the immune system and improve overall organ function
  • Meditation and yoga: This incorporates mindfulness, exercise, and relaxation techniques
  • Relapse prevention: To help an individual recognize triggers and ensure relapse prevention 

Detox is the first and most crucial part of treatment for anyone suffering from these co-occurring conditions. If alcohol use is not terminated and properly detoxed from the body, symptoms will remain. 

More on Treatment: Withdrawal Symptoms, Detoxification, and Therapy

Since alcohol withdrawal can have life-threatening side effects, detox should be done in a professional setting under the supervision of a medically licensed staff. Detox programs last up to 7 days and will be the foundation of individuals’ sobriety. Some common side effects of alcohol withdrawal include:

  • Agitation
  • Nausea
  • Anxiety
  • Tremor
  • Mood swings
  • Hot flashes
  • Digestive issues
  • Hallucinations
  • Disorientation

During the initial phase of detox, PTSD symptoms may increase as the mind adjusts to functioning and coping without alcohol. Medication is commonly used to address various aspects of PTSD but will be monitored and prescribed, only if it will not feed into any pre-existing addictions. Licensed professionals will be able to modify doses and types of medication to meet the individual needs of patients. 

Talk therapy is a crucial aspect of treatment for co-occurring PTSD and alcohol use. Working with a therapist or psychologist is the best way to address the root causes of both PTSD and alcohol dependence. Understanding the development of these co-occurring conditions will help you overcome them. 

Holistic healing modalities should always be added to every treatment program. Services like meditation, yoga, acupuncture, and herbal therapy can improve mindfulness and reduce stress. This inner strength will aid patients in overcoming recovery and mental health challenges.

Long-Term Care for PTSD and Alcohol Dependence

Detox and treatment are just the first steps in a treatment program. Once the physical side of the dual diagnosis (addiction) is under control, the stress of PTSD is given long term attention and tools for healthy coping. Anyone with past PTSD or alcohol use will face triggers and moments of weakness in their lives. Successful treatment will give them the tools to allow individuals to handle triggers in a healthy way.

Additionally, treatment programs offer extended outpatient treatment and long term tools such as:

  • Therapy
  • Meetup groups
  • Reintegration programs 

Treatment at Sana Lake Recovery 

A dual diagnosis of PTSD and alcohol dependence can be intimidating, but seeking professional help is the best thing you can do for your future. These conditions should be treated at the same time to address the patient as a whole. Sana Lake Recovery offers the highest quality treatment programs and services to ensure our clients are given the best chance for a full recovery. If you or a loved one is suffering from PTSD and alcohol use disorder, contact us today to find out more information about our treatment programs. 

References:

https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

https://pubs.niaaa.nih.gov/publications/arh23-4/256-262.pdf

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.