Dual-Diagnosis: PTSD and Substance Use Disorders

beautiful-latin-brunette-woman-from-bogota-colombia-between-30-and-39-years-old-sitting-on-her-balcony-with-her-arms-crossed-very-sad-for-all-the-time-she-has-locked-up-at-home-stockpack-gettyimages

Facing a mental health disorder is a struggle. Dealing with two conditions at once can be an even tougher battle. If you think you or a loved one might be facing a dual diagnosis of PTSD and a substance use disorder, here’s what you want to know.

What is PTSD?

Post-traumatic stress disorder, or PTSD, is a mental health condition that occurs when an individual has trouble processing and coping with a terrifying event. PTSD can develop in response to a single or repeated instance. Some event that may provoke PTSD are sexual assault, violence, experience in combat, living through a natural disaster, medical trauma and so on.

Post traumatic stress disorder can be diagnosed by a doctor or mental health professional. While many people are able to move on from trauma on their own, when someone struggles with PTSD, treatment is essential to healing.

What are signs and symptoms of PTSD?

PTSD manifests itself in four categories of symptoms, according to the American Psychiatric Association. These side effects include intrusive memories, avoidance behavior, negative mood and hyperarousal.

Here are some behaviors that fit into these four categories.

Nightmares
Flashbacks
Uncontrollable thoughts about the trauma
Emotional distress when reminded of the event
Making significant efforts to avoid a person, place or thing that reminds you of the traumatic event
Not wanting to talk about your experiences and symptoms
Feeling hopeless or worthless
Struggling to feel enjoyment
Distancing yourself from loved ones
Having no interest in events that were previously enjoyable
Being on-edge
Being easily angered, startled or agitated
Having trouble focusing
Insomnia
Changes in diet
Feeling shameful

These behaviors are hallmarks of PTSD. If you notice them in yourself or a loved one, it’s time to reach out for a professional diagnosis and care.

Is dual-diagnosis of PTSD and substance use disorders common?

A dual diagnosis refers to the simultaneous presence of a mental health disorder and a substance use disorder. Dual diagnoses are common for several reasons, this article explores the crossover between PTSD and substance use specifically.

According to the journal Current Psychiatry Reports, it’s estimated that half of those seeking treatment for substance use addictions also meet criteria to be diagnosed with PTSD. Moreover, those facing a dual diagnosis of PTSD and substance use disorders have poorer treatment outcomes.

The reverse is also true. According to the Archives of General Psychiatry’s article on PTSD in the National Comorbidity Study, 27.9 percent of women and 51.9 percent of men with PTSD also faced a substance use disorder.

How are PTSD and addiction linked?

It’s clear that PTSD and addiction are connected, leading many people to question the links between these two conditions. There are various ideas for the strong association, and the foremost among them is that individuals who face PTSD tend towards substances as a means to self-medicate.

Dealing with the overwhelming symptoms of PTSD is challenging for anyone, regardless of background or personal strength. As with any mental health condition, people develop coping mechanisms, be they good or bad.

Due to the pleasure and initial high of using drugs or alcohol the substances are often sought repeatedly as a means to numb, distract or relieve distress. As symptoms worsen and a dependency builds, a full-fledged addiction is a frequent outcome for those attempting to escape the pain of PTSD.

Another reason that PTSD and addiction may be linked is due to underlying risk factors that contribute to the onset of both. It’s well documented that low social support, low self-esteem, low self-efficacy, poor coping mechanisms, neuroticism and low stress tolerance can make someone more likely to struggle with both PTSD and substance use disorders.

What are signs of PTSD and addiction?

If you know someone who may be affected by a dual diagnosis, it can be hard to comb out which symptoms are characteristic of which disorders and whether two disorders are at play. Here’s what to look out for when it comes to dual diagnosis:

Worsening symptoms of both disorders
Drinking or drug use that seems excessive
An inability to control drinking or drug use
Struggling to complete normal tasks
Neglecting personal hygiene
Worsening depression
Difficulty enjoying life
Needing to use substance to feel normal
Wanting to be alone to use drugs or alcohol
Needing to use substances to handle memories of trauma
Feeling emotional distress when unable to consume alcohol
Appearing to have a compulsion to use substances when thinking about past events
Having the urge to drink or use drugs in response to the same triggers
Needed substances to calm down

These and other signs are indicative of both PTSD and addiction. A second opinion from a professional can help eradicate confusion and illuminate whether one or two conditions are present.

What substances are often used by someone with PTSD?

Any form of drugs or alcohol, or a combination of the two, can be abused by someone who is having a hard time managing PTSD. Alcohol is often used due to its widespread availability and social acceptance of casual drinking and binge drinking. Cocaine, prescription medication, heroin and other drugs are also used to numb emotional pain.