Post-Traumatic Stress Disorder


Post-traumatic stress disorder occurs when an individual has difficulty recovering from a terrifying event or series of events. According to the National Institute on Drug Abuse, there’s a connection between PTSD and substance use disorder. Several national surveys have found that roughly half of those who experience mental illness during their lives will also fall victim to a substance use disorder and vice versa. Simply put, an individual who suffers from a mental illness is likely to develop a substance use disorder. If the substance use disorder develops first, the individual has a higher risk of developing a mental health condition, too.

The youth have not been spared. At least 60% of adolescents who enter community-based substance use disorder treatment programs meet the diagnostic criteria for mental illness, according to the NIDA. Studies have found that as youth transition into adulthood, they are more vulnerable to developing mental health issues as well as substance use disorders. The brain continues to develop into adolescence. For many, decision-making and impulse controls are among the last to mature. Therefore, an individual who starts using a substance young is more likely to get hooked worse. If a young person experiences a traumatic event and it goes untreated, this can lead to PTSD down the line.

United States agencies are stakeholders in the mental health issues of Americans. The Social Security Administration, for example, has published a PTSD fact sheet. If PTSD becomes a verifiable condition, an individual can apply for disability. 

The SSA defines PTSD as a mental disorder that can develop after a person of any age directly experiences or witnesses a traumatic event like war, physical assault or sexual violence, as well as a violent crime, serious accident or a natural disaster. 

The risk factors for PTSD include:

  •   Direct exposure to a traumatic event as a victim or witness
  •   Childhood trauma
  •   Another mental health condition like depression, anxiety or substance use disorder
  •   Having a family member with a mental health condition
  •   Exposure to combat or deployment
  •   Lack of support after a traumatic event

Federal statistics claim that 7-8% of Americans will have PTSD at some point in their lives. At least 5% of adolescents meet the criteria for PTSD in their lifetime. 

Symptoms of PTSD include:

  •   Flashbacks
  •   Difficulty sleeping 
  •   Nightmares about the traumatic event 
  •   Avoiding thoughts or feelings related to the traumatic event
  •   Being easily startled
  •   Angry outbursts
  •   Negative thoughts about oneself
  •   Guilt or blame

Children under age 6 with PTSD may become attached to their parents at all times as well as have trouble sleeping. They may also act out suddenly.

Children age 7-11 with PTSD may act out their experiences, have nightmares or exhibit increased irritability or aggressiveness. These symptoms can spill over into their relationships with their friends. They could have difficulty communicating with peers or keeping up with their schoolwork.

There is no exact time frame when the PTSD symptoms are likely to appear. For some individuals, they appear three months after the triggering event. For others, it could take years.

An individual is suffering from PTSD if the symptoms persist one month after they started. When the condition is left untreated, an individual may never get over the trauma on their own. This is why seeking professional help is highly recommended.

Several treatments are available for those suffering from PTSD. They include counseling, therapy and medication. The medical community has found that individuals with this condition are more likely to develop co-occurring issues such as:

  •   Dysthymia
  •   Substance use disorder
  •   Anxiety disorders
  •   Personality disorders
  •   Poor health

PTSD Data and the U.S. Department of Veterans Affairs

Researchers at the Department of Veterans Affairs have found that 60% of males and 50% of females experience trauma at least once in their lifetime. Males are more likely to experience trauma due to accidents, physical assault, combat or witnessing a death or injury. Females tend to experience more trauma due to sexual assault and child sexual abuse. In a given year, about 8 million adults battle PTSD, but this is just a small portion of those who have experienced trauma.

Trauma can happen to anyone. This is a condition that does not take into account gender, age or other circumstances. Whether or not an individual experiences PTSD is mostly out of their control. As mentioned earlier, it can take years for a person to develop symptoms. If enough time has passed from the event, it is less likely symptoms will occur. If the trigger is strong enough, however, the symptoms may be overwhelming. 


PTSD History

The American Psychiatric Association added PTSD to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980. This addition received some backlash, but the group needed it listed for its psychiatric theory and practice. Enough research had been conducted on sexual assault victims and Vietnam War veterans to establish a link between trauma and the condition. 

Veterans and PTSD

Military veterans are the group most associated with PTSD. The VA has several sets of statistics on this topic because they are actively trying to help military veterans who return home after serving.

A connection between PTSD and substance use disorder does exist, but it is not limited to military veterans. Civilians have that connection, too. To cope with PTSD, individuals will often:

  •   Drink heavily
  •   Use drugs
  •   Smoke too much

It works the other way, too. Someone who is misusing a substance can end up developing PTSD.

Here are some harrowing statistics regarding military veterans and PTSD:

  •   At least two out of every 10 veterans with PTSD also have a substance use disorder.
  •   Almost one out of every three veterans who seek substance use disorder treatment have PTSD.
  •   At least three out of 10 military veterans smoke.
  •   At least six out of 10 military veterans who have PTSD also smoke.
  •   Almost one out of 10 returning veterans from Iraq and Afghanistan have a problem with alcohol or other drugs.
  •   Binge drinking among war veterans who have PTSD is common.

The medical staff at the VA has found that PTSD and substance use disorders can be treated concurrently, which is good news. Some treatments the VA uses to treat military veterans are:

  •   Trauma-focused psychotherapies
  •   Cognitive processing therapy
  •   Prolonged exposure
  •   Eye movement desensitization and reprocessing

To treat substance use disorder in veterans, doctors generally utilize:

  •   Relapse prevention
  •   Cognitive behavioral therapy
  •   Contingency management
  •   Medication

If a patient exhibits specific symptoms such as pain, anger or sleep problems, those symptoms are specifically addressed, too.

For veterans, the VA encourages them to contact their local branch and speak with a representative. After answering a few questions, the next steps can be taken because recovery is very achievable. Veterans who are experiencing PTSD or substance use disorder symptoms for at least three months are encouraged to make a phone call as soon as possible. 

Civilians who are experiencing PTSD or substance use disorder symptoms have a host of treatment options at their disposal as well.


Why Mental Health Issues and Substance Use Disorders Coincide

There are a few reasons why a mental health issue and substance use disorder can coincide. Some reasons include:

  •   Illicit substances used by an addict can trigger symptoms of a mental health issue.
  •   Mental health problems can lead to alcohol or drug use because the user is attempting to self-medicate.
  •   There are shared underlying causes such as changes in brain composition, genetic vulnerabilities and early exposure to stress or trauma.

A substance use disorder is a common development when an individual already has:

  •   Depression
  •   Anxiety disorders
  •   Schizophrenia
  •   Personality disorders

Symptoms of a substance use disorder include:

  •   Behavioral changes like lost productivity, getting into fights or engaging in suspicious behavior
  •   Physical changes like bloodshot eyes, drastic weight changes or impaired coordination
  •   Social changes like a sudden need for money, changes in friends or neglecting loved ones

It is important to remember that PTSD symptoms do not always appear immediately. Prescription medicines can take the edge off once the PTSD has been diagnosed. The effects of the therapy are not always immediate, either.


Getting Help

The medical community has decades of data and research under its belt. That information is being used to improve existing treatment plans for those suffering from PTSD, substance use disorder or both. When a patient has both, the recommendation is to treat them simultaneously. The only caveat is that the patient must detox and stop using first. Preferably, the patient will be sober for an extended period of time. Since treating a trauma could be intense, there could be a trigger that sends the patient back to their substance of choice.

Treating co-occurring conditions has become more common. Due to the complexity of the combination, patients are encouraged to enter inpatient programs like the options offered by NFA Behavioral Health.

Our facility is located in the rolling countryside of New Hampshire. It sits on a 17-acre property that’s secluded from the temptations of more populated environments. The patient-to-client ratio is kept low on purpose. Plus, the accommodations are gender-separate. Our staff focuses on providing clinical excellence combined with evidence-based practices.

A focus is placed on clinical psychotherapeutic support through:

  •   One-on-one individual therapy
  •   Process groups
  •   Treatment for co-occurring mental disorders
  •   Motivational interviewing
  •   Cognitive behavioral therapy (CBT)
  •   Dialectical behavior therapy (DBT)
  •   Grief and loss therapy

The addiction treatment program features:

  •   Medication-assisted treatment
  •   Evidence-based clinical treatment for addiction and co-occurring disorders
  •   Access to weekly off-site Family Recovery Workshops
  •   24/7 on-site medical staff

Our amenities include:

  •   Nutritious chef-prepared meals
  •   Meditation and yoga
  •   Workshops and educational programs
  •   Paintball, bowling and mini-golf outings

At our center, patients have the opportunity to participate in holistic therapy, too. The medical community has found that it’s important to heal the body and mind when trying to recover from a substance use disorder. Since PTSD is also going to be addressed, the staff has to ensure that if a patient experiences intense triggers, coping mechanisms are already set up.

Patients are encouraged to participate in physical exercise to produce natural endorphins. These endorphins are one way to start replacing a substance of choice. Plus, exercise can help a patient sleep at night.

If a medical detox is necessary before the recovery treatment can begin, this can be done at our center. The length of a detox depends on the substance of choice. The withdrawal symptoms also vary. Some examples are:

  •   Heroin and prescription painkillers often have flu-like symptoms that last around five days.
  •   Benzodiazepine’s withdrawal symptoms are anxiety and/or seizures that can last three weeks up to several months.
  •   Cocaine withdrawal symptoms include depression and restlessness that last seven to 10 days.
  •   Alcohol withdrawal often includes tremors and/or seizures that last three days to several weeks.

Completing the detox and recovery program at the same center is a convenience. The patient gets to know the staff. Furthermore, we can set up a routine for the highly structured treatment. Patients can carve out their safe spaces, which could allow them to be more open about addressing their PTSD. This is a process that is going to require commitment and effort as well as honesty. To recover from PTSD and a substance use disorder, the root of the cause has to be unearthed.

To treat PTSD, a patient will usually undergo cognitive behavior therapy. CBT, a psychotherapy that is focused on the cause of the disorder, is used for some substance use disorders, like meth misuse, as well. During the sessions, patients can expect to learn more about their specific conditions. From there, they may be able to change thinking and behavior patterns. Usually, patients learn how to cope with, resist and exit triggering situations. This prepares them for life after the inpatient program is successfully completed.

Begin your journey toward recovery by learning more about treatment for PTSD and co-occurring substance use disorder.


Back To News

SBE Northeast

Louisiana Business JournalArchive