The existence of both PTSD and an alcohol use disorder in an individual makes both problems worse, alcohol use problems often must be addressed in PTSD treatment…

June is Post-Traumatic Stress Disorder Awareness Month in the United States. It is an important opportunity to learn more about mental ill-health in general and post-traumatic stress disorder (PTSD) in particular, especially concerning the links to alcohol. PTSD is a mental health condition that will affect approximately 7.8% of Americans at some point in their lives.

Usually PTSD is diagnosed when a person experiences three types of symptoms for the duration of month (approximately):

Other symptoms that PTSD sufferers may experience are:

  • Nightmares,
  • Depression,
  • Detachment, and
  • Emotional numbness.

One common denominator for people suffering from PTSD is that they had to go through a traumatic event. The good news is that PTSD can be treated, typically through a combination of psychotherapy, medication, and the support of the social network around the PTSD sufferer.

In reading and educating myself more about PTSD, I came across this list of important things to bear in mind:

1. PTSD Has Multiple Causes

PTSD was first brought to public awareness after doctors observed some of the symptoms exhibited by war veterans who returned from Vietnam. The American Psychiatric Association added PTSD to The Diagnostic and Statistical Manual of Mental Disorders in 1980. The illness can be caused by a wide range of events such as:

  • sexual assault,
  • physical abuse,
  • domestic violence,
  • natural disasters, and
  • car accidents.

Witnessing a violent act can also cause PTSD — for example, if a child witnesses their parent being abused. Typically, a PTSD sufferer continues to live in a state of psychological shock and is unable to process the associated emotions of fear and helplessness, long after the event that triggered their state has passed.

2. PTSD Sufferers Are More Likely To Develop Other Illnesses

It’s common for individuals suffering from PTSD to develop other health conditions — most commonly depression, anxiety, and substance abuse, like alcohol use disorder. Nearly 50% of people suffering from PTSD also exhibit symptoms of depression. 50% of PTSD sufferers develop a dependence on alcohol and 30% develop addiction to other drugs. Evidence from the American Academy of Experts on Traumatic Stress (AAETS) shows that:

  • 25 to  to 75% of those who have survived abusive or violent trauma also report problems with alcohol use.
  • 10 to 33% of survivors of accidental, illness, or disaster trauma report problematic alcohol use, especially if they are troubled by persistent health problems or pain.
  • 60 to 88% of Vietnam veterans seeking PTSD treatment have alcohol use disorders.
  • Veterans over the age of 65 with PTSD are at increased risk for attempted suicide if they also experience problematic alcohol use or depression. War veterans diagnosed with PTSD and alcohol use tend to be binge alcohol users.

The AAETS writes that people with a combination of PTSD and alcohol use problems often have additional mental or physical health problems. As many as 10 to 50% of adults with alcohol use disorders and PTSD also have one or more of the following serious disorders:

  • Anxiety disorders (such as panic attacks, phobias, incapacitating worry, or compulsions)
  • Mood disorders (such as major depression or a dysthymic disorder)
  • Disruptive behavior disorders (such as attention deficit or antisocial personality disorder)
  • Addictive disorders (such as addiction to or abuse of street or prescription drugs)
  • Chronic physical illness (such as diabetes, heart disease, or liver disease)
  • Chronic physical pain due to physical injury/illness or due to no clear physical cause

The existence of both PTSD and an alcohol use disorder in an individual makes both problems worse, alcohol use problems often must be addressed in PTSD treatment.

3. Women Are More Likely Than Men To Develop PTSD

Although women are slightly less likely to experience a traumatic event than men, females are twice as likely to develop PTSD. This is because the traumas most commonly experienced by women  — specifically, sexual assault, domestic violence, and other physical abuse — are more intimate and personal, and thus, more likely to lead to post-traumatic stress. Another dimension to why women are more likely to develop PTSD, compared to men is that women also more likely to blame themselves for their traumatic experience – which is largely due to factors like cultural conditioning.

Women who go through trauma have a higher risk for developing alcohol problems. They are at risk for alcohol use disorder even if they do not have PTSD. Women with alcohol problems are more likely than other women to have been sexually abused at some time in their lives.

4. PTSD Often Is Obstacle To Lead Usual Life

PTSD can make it extremely difficult to function on a day-to-day basis, and PTSD sufferers are more likely to have problems in the workplace and school, and to struggle with trust and interpersonal relationships.It’s hard to develop trusting relationships with PTSD, and even the most stable existing relationships can be negatively impacted. Survivors may feel numb and detached from their loved ones, even when friends and family are supportive. Since one of PTSD’s prime symptoms is avoidance and loss of interest in activities, sufferers may choose to isolate themselves and prefer to be on their own. If the trauma involved someone the victim trusted (such as acquaintance rape or partner violence), it can be extremely difficult to continue trusting others close to them.

5. Getting Help Is Key To Recovery

There are a number of effective treatment techniques for PTSD (including EMDR, cognitive behavior therapy, and group therapy).

Because the existence of both PTSD and an alcohol use disorder in an individual makes both problems worse, alcohol use problems often must be addressed in PTSD treatment. When alcohol use is (or has been) a problem in addition to PTSD, it is best to seek treatment from a PTSD specialist who also has expertise in treating alcohol (addictive) disorders. In any PTSD treatment, several precautions related to alcohol use and alcohol disorders are advised:

  • The initial interview and questionnaire assessment should include questions that sensitively and thoroughly identify patterns of past and current alcohol and drug use.
  • Treatment planning should include a discussion between the professional and the client about the possible effects of alcohol use problems on PTSD, sleep, anger and irritability, anxiety, depression, and work or relationship difficulties.
  • Treatment should include education, therapy, and support groups that help the client address alcohol use problems in a manner acceptable to the client.
  • Treatment for PTSD and alcohol use problems should be designed as a single consistent plan that addresses both sources of difficulty together. Although there may be separate meetings or clinicians devoted primarily to PTSD or to alcohol problems, PTSD issues should be included in alcohol treatment, and alcohol use (“addiction” or “sobriety”) issues should be included in PTSD treatment.
  • Relapse prevention must prepare the newly sober individual to cope with PTSD symptoms, which often seem to worsen or become more pronounced with abstinence.

In addition, initiatives like HelpGuide offer comprehensive information about understanding and helping a loved one with PTSD.

6. Recovery Is Possible (And It’s Worth The Effort)

Approximately 80% of PTSD sufferers will recover. Thus, the diagnosis of PTSD does not mean a life of chronic flashbacks, fear, and unhappiness.

For further reading:

The American Academy of Experts on Traumatic Stress: “PTSD and Problems with Alcohol Use – A National Center for PTSD Fact Sheet

Anxiety and Depression Association of America: Substance Abuse

Caitlin Flynn on