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The Connection Between PTSD and SUD

Updated: Jun 19



The relationship between Post-Traumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) is a complex issue, deeply rooted in biological, psychological, and social factors.


June 27th is National PTSD Awareness Day. Trauma in childhood and at the hands of my therapist in my 40s I feel are tied into one of the reasons I pickced up the bottle. PTSD, depression, anxiety, sleep disorders and my lack of life/coping skills paved the path towards alcoholism for me. PTSD Traumatic experiences can significantly impact an individual's mental health, often leading to the development of PTSD, a condition characterized by the severe anxiety, flashbacks, and intrusive thoughts related to the trauma that I suffered with for years - with and without the bottle. In an attempt to manage these distressing symptoms, many individuals turn to alcohol, which can temporarily alleviate their anxiety and emotional pain but ultimately leads to a cycle of dependence and worsening mental health.


The Role of Trauma in Developing PTSD


Traumatic experiences, such as military combat, sexual assault, severe accidents, or the sudden loss of a loved one, can overwhelm an individual's ability to cope, leading to the development of PTSD. According to the National Institute of Mental Health, about 8% of people who experience trauma will develop PTSD at some point in their lives​ (Recovery.org)​. The condition manifests through symptoms like persistent re-experiencing of the trauma, avoidance of trauma-related stimuli, negative changes in thoughts and mood, and heightened arousal and reactivity.


Alcohol as a Coping Mechanism


For many individuals with PTSD  - including myself, alcohol becomes a readily accessible means of coping with their symptoms. Alcohol's sedative effects can dull the intensity of intrusive thoughts, reduce anxiety, and promote a sense of temporary relief. However, this form of self-medication is problematic, as it often leads to the development of alcohol use disorder (AUD). Studies show that up to 50% of individuals seeking treatment for substance use disorders meet the criteria for PTSD​ (National Institute on Drug Abuse)​. This co-occurrence exacerbates both conditions, making recovery more challenging.


Biological Factors


The biological underpinnings of the PTSD-alcoholism connection lie in the brain's response to trauma and alcohol. Trauma can alter brain function, particularly in areas involved in stress response and emotion regulation. The hypothalamic-pituitary-adrenal (HPA) axis, which governs the body's stress response, becomes dysregulated in PTSD, leading to chronic stress and heightened arousal. Alcohol can temporarily modulate these stress pathways, providing a brief respite but ultimately reinforcing the cycle of stress and alcohol use​ (MentalHelp.net)​. That was my experience in a nutshell - alcohol to forget and calm my anxiety was my solution to my PTSD problem. Then alcohol/alcholism became my problem! My anxiety was through the roof towards the end.


Psychological Factors


Psychologically, individuals with PTSD often struggle with intense feelings of fear, helplessness, and guilt. These emotions can drive them to seek out alcohol as a means of numbing their pain. Additionally, PTSD is associated with negative cognitive patterns, such as self-blame and hopelessness, which can further entrench alcohol use as a coping strategy. Transformational Coaching, Cognitive Behavior Training (CBT) and the 12 Steps have shown promise in addressing these maladaptive thought patterns and reducing reliance on alcohol​ (National Institute on Drug Abuse)​​ (Recovery.org)​. Understanding the underlying beliefs behind my thinking - and thus actions/behaviors - was key to my recovery and to a happier way of living!


Social Factors


Social factors also play a critical role in the PTSD-alcoholism nexus. Individuals with PTSD may experience social isolation due to their avoidance of trauma reminders and difficulty in maintaining relationships. This isolation can drive them toward alcohol use as a solitary coping mechanism. Moreover, societal stigma surrounding both PTSD and alcoholism can hinder individuals from seeking help, perpetuating the cycle of self-medication and dependence​ (Addiction Group)​.


My Understanding of PTSD and SUD (alcoholism for me)


Understanding the connection between PTSD and alcoholism requires a holistic approach that considers the intertwined biological, psychological, and social factors. Effective treatment must address both the traumatic roots of PTSD and the patterns of alcohol use that have developed as a means of coping. Integrated treatment approaches, such as combining trauma-focused therapy with substance use treatment, have shown efficacy in helping individuals break free from this debilitating cycle. By raising awareness and providing comprehensive support, we can help those affected by PTSD and alcoholism find a path to recovery and improved mental health.


There is hope.


For further information and resources on PTSD and alcohol use disorder, organizations such as the National Institute of Mental Health (NIMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer valuable insights and support options.

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