The Connection Between Drug Addiction & PTSD

the connection between mental illness and ptsd

The Connection Between Drug Addiction & PTSD

For victims of a traumatic incident, or loved ones of a victim or bystander, unraveling the tangled connections between drug addiction and mental illness, more specifically Post-Traumatic Stress Disorder (PTSD) can be difficult, and sometimes impossible, task. This article will seek to help bring light to this discussion, by first discussing what PTSD is, and then examining how and why there is an intersection between PTSD and drug addiction.

What Is PTSD?

Getting a better understanding of the relationship between drug addiction and PTSD requires first understanding what PTSD is. A simple definition of PTSD is a difficulty coping with normal, everyday life after witnessing or experiencing a life-threatening or traumatic event.  Although PTSD was first officially entered into the Diagnostic and Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association in 1980, the disorder is not in fact new. Rather, the specific signs and symptoms of PTSD are visible to the modern observer at least as far back as World War I, and probably much further.  

The terminology that we use to describe this disorder has changed over the years. In the first World War, it was referred to as shell shock, a condition which was seen with alarming regularity due to the brutality of the conflict. Soldiers in World War II that suffered from PTSD were considered to be suffering from battle fatigue. The term continued to shift, becoming operational exhaustion during the Korean War, and eventually combat fatigue in the Vietnam War. Some historians believe that the signs of PTSD, particularly in soldiers following conflict, are visible in the historical record.

Although we can most easily trace back signs of PTSD in soldiers, due to the large amount of written material and analysis that has been done on soldiers returning from war, it is important to note that anyone can suffer from the disorder. Veterans are a highly visible community, and the effects of PTSD have been felt disproportionately across a large percentage of the community. This does not, however, detract from the fact that a large number of non-veterans are suffering from PTSD every day. Many of these people may not have even been diagnosed and may not know that they are suffering from the disorder. Still others may be too young to be able to properly vocalize what they are feeling.

Since the inclusion of PTSD into the DSM, a significant amount of research has been conducted in order to better understand the disorder and outline its common symptoms. As a result of this, an increased awareness about what PTSD is and who might be affected is now commonplace in the United States.

A benefit of the increased research on, and awareness of PTSD, has allowed researchers to gain insights into the triggers that might lead to PTSD, and to define and reach out to vulnerable populations in order to effectively manage and treat those affected by the disorder the most.   Although research on PTSD has made significant strides in our understanding of the disorder and the most effective ways to treat it, there is still much to learn on the subject, and yet more effective treatment types and modalities will certainly appear in the coming years.

Common Signs of PTSD

In the meantime, the increased research being conducted on PTSD has allowed us to recognize many of the most common signs of someone affected by the disorder. For those who have a loved one that they believe is suffering from PTSD, there are certain key signs that commonly appear. Recognizing these signs can allow a person suffering from PTSD to get the help they need, or help someone approach their loved one with a greater level of understanding and compassion.

Many people that suffer from PTSD re-experience traumatic events. This process can take a variety of different forms, and may not be visible from the outside. The hidden, internal nature of this suffering makes it especially hard to cope with, both for the person afflicted by the disorder and those around them. Those suffering from PTSD often experience unwanted memories of the traumatic event in their past. These memories can occur spontaneously, during seemingly unrelated events. Discerning the triggers for these memories can be difficult, which can lead to feelings of helplessness.

Often, these memories also lead to an emotional and physical response in the person suffering from PTSD.  This response can encompass a wide range of emotions, from anger, fear, and nervousness to shame, guilt, and sadness. Not only can these unwanted memories trigger a physical and emotional response, but some people also experience a more intense and encompassing form of an intrusive thought known as a flashback. Those suffering from a flashback may be so fully immersed in the memory that they can no longer differentiate between what is real and what is a memory. These episodes, although relatively rare, can be traumatic in their own right for the person suffering from PTSD and those around them.

Another common psychological effect of PTSD is the presence and recurrence of nightmares.  These nightmares can be extremely intense, leading to a physical and emotional response in the person suffering from them. The intensity of the nightmares often leads to thrashing or rapid movement, along with profuse sweating. While many people experience nightmares at some points in their lives, those suffering from PTSD may have intense and frequently recurring nightmares. These can quickly interrupt the sleep cycle of the person suffering from the nightmares. Many people become so frightened by the nightmare that they are afraid to attempt to sleep again, and over time this fear becomes a generalized feeling of anxiety or dread of sleeping.

The interruption of a normal sleep cycle is one aspect of how the effects of PTSD lead to a disruption in the daily life of those suffering from the disorder. Whether caused by intrusive thoughts, a physical or emotional response to some external stimuli, or intense nightmares, the disruption caused by PTSD can lead to hours or entire days spent attempting to cope with the disorder.

This often leads to problems with relationships and employment over time. It becomes more difficult to enter or maintain a stable relationship with another person for many people that suffer from PTSD. The intrusive thoughts, lack of sleep, and emotionally and physically taxing episodes can lead to decreased performance in the workplace, increased absences, and sometimes termination.

The negative effects of PTSD on the overall quality of life of the person suffering from the disorder, as well as the impact on their relationships and possibly their employment, are further exacerbated by other common symptoms. Among these is difficulty concentrating, which can lead to decreased work output, tasks being left uncompleted, and anxiety in the person suffering from the disorder as unfinished tasks pile up. Perhaps more impactful is the presence of anger. Those suffering from PTSD often express difficulty in controlling their emotions, with outbursts of anger and sometimes violence leading to trouble at home, work, or with law enforcement.

Over time, these common symptoms of PTSD lead to the person suffering from it to withdraw from those around them. They may avoid situations that make them uncomfortable, are new or unknown, or that have triggered an unwanted thought or response in the past. This withdrawal from those around them can be particularly difficult for loved ones and those closest to the person suffering from PTSD. The loved one suffering from PTSD may not be able to adequately vocalize what they are feeling, leading to further confusion or pain. The withdrawal from those around them is also usually accompanied by feelings of profound detachment from others.

Those that have survived trauma often describe feeling different, as if they don’t fit in with others, even if they had known them before the traumatic incident. This detachment often leads to difficulty letting someone get close to them, or manifests as a difficulty trusting others.  On top of this, many people who suffer from PTSD find diminished enjoyment in activities they may have enjoyed previously. This lack of enjoyment can become pervasive, affecting nearly every aspect of the life of the survivor.  This can lead to a profound sense of depression, as nearly every activity, action, or relationship fails to produce feelings of happiness or contentment.

Drugs, Alcohol, and PTSD

As continued research has gone into PTSD, one fact has become abundantly clear. Drug and alcohol abuse occurs at much higher rates in those suffering from the disorder. Unfortunately, many trauma survivors end up using drugs and alcohol to cope with the symptoms of PTSD.  There are a number of reasons for this.  

Some end up using drugs to mask the symptoms. The euphoria produced from a heroin high may mask feelings of depression, while the stimulant effects of cocaine may produce a noticeable effect on energy levels. Alcohol may be used to dampen the effects of intrusive memories. While these substances may offer a form of relief from the symptoms of PTSD, that relief is only temporary, leading to further abuse of the substance. This can quickly lead to a cycle of substance abuse, chemical dependency, and addiction.

For survivors of trauma that are addicted to drugs or alcohol, it is especially important to get help with a qualified medical professional trained in dual-diagnosis treatment. Dual-diagnosis treatment seeks to properly identify and treat comorbid conditions, such as drug addiction and PTSD.

By treating the chemical dependency and addiction alongside the effects of trauma, recovering addicts suffering from PTSD will have the best chances for a successful recovery from both conditions. Because the symptoms of PTSD may be masked by the drug or substance that is being abused, in some cases medical staff may need to monitor the patient during the detox period and afterward to fully assess their condition and make an accurate diagnosis.

By treating comorbid conditions such as PTSD and addiction concurrently, medical professionals are able to achieve much higher rates of a successful and long-term recovery. As discussed, many of those suffering from PTSD may not even be aware that they have an underlying mental health condition that has contributed to their addiction and chemical dependency.

By shedding light on this, medical staff can help victims of trauma work through the repercussions of their survival. One of the most important things that victims of trauma can learn during mental health treatment is the skills and tools to cope more effectively with their condition. Life skills classes, intensive group and individual therapy sessions, and holistic approaches that are geared towards bringing the survivor of trauma into a closer connection with their body and mind have all been shown to be effective at treating PTSD and drug or alcohol addiction.  




Getting treatment for both drug addiction and PTSD is incredibly important. The sad reality of the situation is that many people suffering from PTSD do so silently and unknowingly. Those closest to them may not even realize they are suffering. Children who experience trauma at a young age may have lived their whole life dealing with the effects of that trauma, and may not have the vocabulary to vocalize what they are going through, or the self-awareness to recognize how that trauma is impacting their life, relationships, and decision-making skills.

If you believe you or a loved one that abuses drugs or alcohol may also be a survivor of trauma, it is important to work with drug rehab centers that offer dual-diagnosis treatment and have a demonstrated record of working with people who suffer from PTSD. HARP, a treatment center, offers dual-diagnosis treatment and can help you overcome your drug and alcohol addiction. It is important to get help, or encourage a loved one to get help, as soon as possible.  

The effects of PTSD or drug and alcohol abuse alone can be debilitating. Taken together, these conditions can lead to lifelong suffering. The good news is that with the right treatment program, care provider, and level of understanding and care, both conditions are treatable, giving hope to those survivors of trauma that are also suffering from an addiction to drugs or alcohol.

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