Post-traumatic stress disorder (PTSD) is one of the most devastating mental health issues a person can experience. The condition floods an individual with horrifying flashbacks, intrusive thoughts or memories and persistent anxiety, interfering significantly with their ability to perform the basics of daily life.
Many people who don’t have the tools or support to manage the symptoms of PTSD can’t find healthy coping mechanisms, and turn to alcohol or drugs in an attempt to reduce the pain they feel. When PTSD meets substance abuse, a person can receive a dual diagnosis of their co-occurring disorders. Treating a dual diagnosis of this nature involves a thorough examination of the root causes of an individual’s PTSD in combination with evidence-based treatment for addiction.
PTSD is a psychiatric disorder induced by a traumatic event. The affected individual does not have to experience the event directly — they may witness it, or it may have happened to someone close to them. Some of the more common examples of a traumatic event include:
Trauma is, unfortunately, common in our world. About 70% of adults in the U.S. have experienced a traumatic event at least once in their lives. However, not every person who lives through trauma will develop PTSD. About 5% of adults have a past-year prevalence of PTSD, and the chances of someone developing PTSD sometime in their life is around 6%.
When the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-3) first codified PTSD, its definition mostly applied to those who had experienced “shell shock” and other elements of combat. While combat veterans still make up a disproportionate percentage of those who suffer from PTSD, we now know the condition can affect any person at any time. Some other groups that are particularly vulnerable to developing PTSD include:
Some of the factors that affect a person’s risk of developing PTSD include:
Studies have suggested there may even be a strong genetic component to PTSD, similar to other heritable psychiatric disorders.
PTSD does not have a set timeframe for showing symptoms. A person might start experiencing symptoms almost immediately after an event, or may not begin displaying signs for months or even years afterward. Some of the common symptoms and signs of PTSD include:
These symptoms may appear at different times and cycle through periods of getting better or worse. PTSD sometimes goes undiagnosed for significant periods because people assume it’s normal for someone to feel strange or not like themselves after a traumatic event. The affected person may wait for their new and frightening feelings to go away rather than being proactive and seeking help.
When someone does bring up their symptoms with their doctor, an exam can rule out physical sources of the symptoms. The next step is to undergo a psychological evaluation with the PTSD criteria in the DSM-5.
Substantial research links substance use disorders (SUDs) closely with PTSD. About 46% of people with PTSD also meet the criteria for an SUD, and people with PTSD may be up to 14 times likelier than the general population to have an SUD.
PTSD makes people feel like they are not in control of their emotions and responses, and the addition of symptoms like flashbacks increases this loss of agency. To try and get some control over their symptoms, many people with PTSD end up trying to numb themselves through the use of drugs or alcohol. What initially starts as a temporary “fix” quickly spirals out of control, leaving the individual to struggle with not one but two debilitating conditions.
PTSD can be so severe that someone may not feel like there is any way to reclaim their health and their life. However, several effective treatments can provide participants with the tools to manage this condition. Both short-term and long-term therapy are often necessary to stabilize a person, and these are three of the options an effective treatment program may use.
Eye movement desensitization and reprocessing (EMDR) is a technique used to dampen the effects of negative emotions by helping the patient reconnect gradually with the feelings and memories they usually avoid. The therapist uses asks the patient to recall the traumatic event while following a visual cue back and forth with their eyes. The physical movement helps dilute the anxiety the patient feels and allows them to access memories with less emotional distress.
Cognitive behavioral therapy (CBT) helps participants explore the complex relationship between their thoughts, emotions and behaviors. The guiding principle in CBT is that changes in one of these areas can impact the other areas. By recognizing and adjusting illogical or unhelpful patterns of thought, people can also improve their emotional regulation — which, in turn, allows them to decrease unhealthy or unwanted behaviors. CBT helps individuals:
People with PTSD benefit from a trauma-specific approach to therapy. Trauma-focused therapy often uses the principles of CBT, but with the specific goal of gaining an understanding of how a traumatic experience has shaped the patient’s well-being on cognitive, emotional, behavioral and physical levels. Participants untangle the mystery of how trauma connects to behavioral responses.
Trauma therapy seeks to help participants integrate the traumatic experience into their life, rather than continuing to avoid it and remaining in denial. Achieving this integration and fully processing the trauma is necessary to heal and move on.
Treating a dual diagnosis of PTSD and addiction is more challenging than treating either condition alone. For the best possible outcomes, residential rehabilitation is the right choice for most people. Both conditions create behavioral patterns that reinforce themselves over time, making it exceedingly difficult to make a lasting change in the same surroundings.
Residential treatment removes participants from the triggers that abound in everyday life. In a new setting surrounded by peers and professionals dedicated to recovery, an individual can better focus on recovery. Dual-diagnosis programs are different from center to center, but an effective addiction and PTSD treatment plan contains the following elements. Alternatively, those with less severe conditions may explore outpatient treatment options.
The addiction-related portion of treatment must start with eliminating the substance of abuse from the body. Alcohol and many drugs cause withdrawal symptoms that can be life-threatening at worst and distract from treatment at best. Medically supervised detoxification is the safest way to manage withdrawal and begin treatment.
Therapy is the core of dual diagnosis treatment, and finding the right balance of therapy types can vastly improve a person’s time in rehabilitation. A mix of individual and group therapy provides participants with personal attention and helps them realize they are not alone in their experiences.
Many people with PTSD struggle with disorders like depression, which medication can help alleviate. The addition of antidepressants can help people engage more actively in treatment, making medication a useful tool in dual diagnosis programs.
If you are wondering how to provide support to someone with PTSD, the answer is not always clear. You want to show you care about the person and support their recovery process, but you may not know what works and what to avoid. The good news is that often, making yourself available to spend time with the person can be highly beneficial to their healing process. Keep these five tips in mind as you engage with your loved one.
There is still significant stigma around PTSD and its symptoms. Even though you have the best of intentions, you may also harbor some incorrect and unhelpful misconceptions about the condition and how people experience it.
When you take the time to learn about PTSD, you’ll be able to increase your understanding and empathy — leading to more effective communication.
While it’s usually beneficial for someone with PTSD to talk about their emotions or relate their experiences, you shouldn’t push them to do so. They are working on communication in therapy, and they shouldn’t feel like they owe you any explanation.
In some cases, trying to talk about trauma with someone untrained in psychology can exacerbate symptoms. Just offer your acceptance and willingness to listen. They will engage if and when they’re ready.
People with PTSD often worry about how people will view their reaction to trauma. They are fully aware that some of their emotions may be irrational, and they are working hard to process the trauma. Avoid saying anything that could belittle the person’s experiences or emotions, such as, “At least it wasn’t worse.”
When someone has PTSD, the world often becomes a minefield of triggers that can bring on anxiety and other symptoms. If you find out what your loved one’s triggers are, you can better help them navigate the world when you’re out together. If, for example, you know loud noises are a trigger for your friend, you can monitor the volume level of a party and help them exit gracefully when things start to get too rowdy.
Many people are so concerned about their loved one that they overextend and end up with signs of burnout. Your desire to be supportive is admirable, but it should not overshadow your health and happiness. Think about how much you’re willing to do and what functions you can reasonably perform.
For example, some people might be able to take calls in the middle of the night without it impacting their schedule unduly, while other people can’t offer this form of support without it affecting their ability to perform daily tasks. Decide what you can and can’t do, and stick to it to preserve your mental health.
If you are struggling with PTSD, you’re likely wondering what it takes to make a lasting recovery. Although treatment is essential, it is only one element of long-term healing. To maintain the progress made during PTSD treatment, you have to stay focused on and committed to your journey.
If you haven’t already, take some time to consider your goals in treatment and life in general. Break goals down into bite-sized pieces so you can see your next steps more clearly. Think about how your actions, such as avoidant behavior, may impact your ability to make your goals a reality.
During PTSD treatment, you’ll receive a variety of resource materials to review from time to time. There is a lot of information transferred during treatment, and you may have missed something or have a new perspective with which to approach the material.
On a good day, you may not need to use the coping strategies you developed in treatment. However, coping mechanisms are like a muscle you must work to remain strong. Practice at least one coping strategy each week, even if you’re not feeling stressed. The more you practice, the easier the strategies will come to you if crisis strikes.
After treatment, you may be tempted to withdraw and try to continue recovery on your own. Seeking support requires vulnerability that isn’t always easy to accept, but building a support network can help ensure the adverse effects of isolation don’t impact your recovery.
Consistency is crucial in reinforcing recovery. Create daily and weekly routines that will strengthen the goals you want to achieve in your life, such as reviewing steps you’ve taken toward goals and documenting behaviors that have had a positive impact.
The immediate goal of intensive treatment is to significantly reduce PTSD symptoms so that you can get on with life on a more even keel. Even when you achieve stability, ongoing therapy can continue to provide strategies and support for identifying and achieving long-term life goals.
PTSD and addiction are conditions that impact a person’s ability to live a healthy and happy life. Diamond House Detox is committed to giving people with dual diagnoses a fighting chance at lasting recovery. Our highly tailored programs get patients clean with medically assisted detoxification, and the most current knowledge of addiction medicine back our treatments.
If you or someone you love is looking for addiction and PTSD treatment in Sacramento, call Diamond House Detox for confidential help at 800-205-6107 or bring your questions to our online contact form. We are always ready to discuss the next steps toward healing.
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