Post-traumatic stress disorder (PTSD) affects millions of Americans every day from all backgrounds, ages, and genders. The American Psychiatric Association informs that roughly 3.5% of adults in the U.S. are affected with PTSD every year. They also say that an estimated 11 people will be diagnosed with it once in their lifetime.
If you are affected by trauma, you could develop PTSD. The U.S. Department of Veterans Affairs’ National PTSD Center says that a “traumatic event could be something that happened to you, something you saw, or you saw happen to someone else.” This means you could have PTSD after being involved in or observing civil unrest, a violent accident, or have been a victim of a crime. You might also have PTSD if you lived through a natural disaster, like a hurricane or a school shooting.
Data from a report by the Florida Behavioral Health Association Mental Health stressed that:
- Thirty percent (147) of the 490 mental health treatment centers in Florida offer PTSD treatment.
- Florida ranks in the top 10 states for adults with a substance use disorder, otherwise called addiction.
Individuals who have been through trauma will often find it very hard to manage their feelings and symptoms, and thus, try to alleviate them with drugs or alcohol. This kind of “relief” is short-lived and usually results in using more drugs or alcohol.
First, let’s take a closer look at PTSD and learn what it is, what causes it, and what criteria are needed to diagnose it before it can be treated.
PTSD is a disorder that some individuals develop after experiencing a shocking, frightening, or dangerous event, per the National Institute of Mental Health (NIMH). Those who have been through traumas may continue to feel stressed or frightened even if there is no danger near. PTSD symptoms might begin within three months of the traumatic event but may also start years afterward. The symptoms have to last for more than a month and be severe enough to disrupt relationships, work, or school.
Symptoms of PTSD
PTSD symptoms are put in four categories, per the American Psychiatric Association, and may vary in severity:
Intrusion: These are intrusive thoughts, including repeated involuntary memories, distressing dreams, or flashbacks of the incident. Flashbacks should feel so real that the individual feels like they are reliving the event.
Avoidance: Avoiding any reminder of the traumatic event, including the people, places, activities, situations, and objects that could trigger upsetting memories. This also includes avoiding thinking, talking, or remembering about the incident.
Cognition and Mood Alterations: Not being able to remember key aspects of the incident, having negative thoughts and feelings about themselves or the world-at-large, having distorted feelings like blame and guilt, and not being interested in activities once enjoyed.
Arousal and Reactivity: This consists of being easily startled, feeling tense and on edge, having angry outbursts, and having difficulty sleeping. It also includes behaving recklessly and perhaps being overly watchful of immediate surroundings. These symptoms can happen constantly and usually result in the individual feeling stressed and angry.
An adult must have all of the following for at least one month for a PTSD diagnosis:
- At least one intrusion symptom
- At least one avoidance symptom
- At least two cognition and mood symptoms
- At least two arousal and reactivity symptoms
Causes of PTSD
One can develop PTSD after experiencing a trauma. Traumatic events can be:
- Physical assault
- Sexual violence and assault
- Threatened with a weapon
- Childhood physical abuse
- An accident
- Exposure to combat, either in theater or supporting combat operations
Other criteria for a PTSD diagnosis are the symptoms are not related to medication, other illnesses, or substance use.
PTSD Risk and Resilience Factors
It is essential to understand that not everyone who experiences a traumatic or dangerous event will develop PTSD. There are risk factors that could be in play that are more likely for an individual to develop PTSD. Also, there are resilience factors that could reduce the chance of a person developing PTSD.
Risk factors that increase PTSD possibility
- Living through the traumatic or dangerous event
- Childhood trauma
- Getting injured
- Seeing someone else get injured or dying, or seeing a dead body
- Feelings of horror, extreme fear, or helplessness
- Having to deal with extra stress after the event; death of a loved one; injury and pain; loss of home or job.
- Not having any social support or very little social support after the event.
- History of mental illness or substance abuse
Resilience factors that could help recovery after the traumatic event:
- Seeking out and receiving support from friends, family, and others
- Joining a support group for people who’ve been through a traumatic event
- Getting through the traumatic event and learning from it; possess positive coping mechanisms
- Being able to feel good about your own actions when facing danger
- Able to act and respond effectively despite feeling afraid
The Effects of Substance Use with PTSD
It is not uncommon for an individual struggling with PTSD symptoms to also struggle with substance use. The use of drugs and alcohol to lessen the intense symptoms of PTSD is known as self-medicating. The VA shared results from a national epidemiologic study, which found that more than 46% of people with lifetime PTSD met the criteria for substance use disorder (SUD). In another study the VA shared, almost 28% of women and almost 52% of men with lifetime PTSD also had a SUD.
Individuals who are dealing with hyperarousal symptoms may abuse substances that have depressant or anti-anxiety effects, such as alcohol, benzodiazepines, or marijuana. Medical marijuana is legal in several states, making it easy to obtain and use.
Substance use with PTSD can result in an increase in negative consequences in a person’s life. Some of these are:
- Relationship problems
- Legal problems
- Medical issues
- Possible suicide attempts
- Changes in mood and concentration
- Difficulty with sleep
- Maintains the circle of avoidance
Treatment for PTSD
- PTSD treatment typically involves behavioral therapies, like cognitive behavioral therapy, medication, and holistic therapies. Some or all may be beneficial, but it’s worth knowing what is involved. PTSD treatment should be helpful in these primary areas of concern, as indicated by the Mayo Clinic:
- Teach you skills to address your symptoms
- Teach you new coping skills to manage any symptoms that recur
- Help you gain new thought processes to like yourself, the world, and others
- Treat any other disorders you have, such as mental health disorders (depression, anxiety), or SUD
Psychotherapy for PTSD
Psychotherapy is also called “talk therapy.” It includes:
Cognitive behavioral therapy (CBT) – This therapy type will help you recognize ways of thinking that can cause negative beliefs about yourself and the possibility of traumatic events happening again. You will probably learn new coping techniques, find new ways to manage intense emotions, learn how to cope with grief or loss, and overcome emotional trauma related to the incident you experienced. Sessions are structured, and it is considered short-term therapy.
Exposure therapy – This type of therapy will help you safely deal with situations and memories that are frightening to you in order for you to cope with them effectively. The therapist will “expose” you to the objects, activities, or situations that are causing you great fear. This can be very beneficial for you if you have flashbacks and nightmares. It breaks the pattern of fear and avoidance. Exposure therapy is a scientifically proven method of treatment for PTSD.
Eye movement desensitization and reprocessing (EMDR) – EMDR utilizes exposure therapy and a series of guided eye movements that may help you process frightening memories and alter how you react to them. EMDR focuses more on the disturbing images and symptoms of the traumatic event and less on the event itself. It was first developed to treat PTSD.
Currently, the most widely prescribed medicines for people with PTSD are antidepressants. They are effective in treating sleep problems and sometimes concentration, as well as depression. Two types of antidepressants have the Food and Drug Administration approval: selective serotonin reuptake inhibitors (SSRIs), such as Zoloft and paroxetine (Paxil).
Many people with PTSD find that holistic practices help them manage their PTSD symptoms. Holistic therapies do not need a prescription and generally are not expensive to engage in. Consider these as part of your treatment for PTSD:
- Yoga and/or mediation – Reduces stress and anxiety and imparts a feeling of good well-being overall
- Reiki, tai-chi
- Hypnosis, biofeedback, guided imagery
- Relaxation therapy
If you are struggling with PTSD symptoms, there is much you can do to learn how to cope with them. If you are fighting both PTSD and substance use, you can receive the help you need at Family Recovery Specialists. We know it may seem like you are alone, but you are not. Reach out and ask what we can do for you.