The Link Between Trauma and Addiction

A situation that may cause one person to experience feelings of trauma may not even faze another individual. Trauma is a deeply personal issue, one that some people may try to avoid dealing with through denial. Sometimes society creates an atmosphere of shaming and blaming victims of trauma, adding to the emotional burden of an already scarred psyche. Seeking help for trauma can be difficult and painful, leading many people to self-medicate with drugs and alcohol in an effort ease the pain. Denial also plays a large in this self-medication process, as the affected individual denies both his/her pain and fact that their trauma is controlling their drug consumption. These various factors place many victims of trauma at an increased risk for developing chemical dependency issues, which may in turn morph into full-fledged addictions.

What is Trauma and Post-Traumatic Stress Disorder (PTSD)?

Any dictionary defines trauma as “a deeply distressing or disturbing experience”. Experiences that most commonly cause trauma are:

• Physical, emotional or sexual abuse
• Neglect
• Family alcoholism
• War experiences
• Illness
• Surgery
• Loss of a loved one
• Natural disasters
• Accidents

Since people respond to situations in very different ways, some people may not experience trauma from something that absolutely devastated another individual. No matter what the event was that triggered trauma, the maladaptive after-effects are universal and manifest in an easily recognized disorder called post-traumatic stress disorder (PTSD). This disorder was first publicly recognized in returning war veterans, but is also prevalent among the general population with 5 percent of Americans currently suffering from the illness. PTSD does not occur in everyone who experiences trauma, but it may develop at any point in someone’s life after a traumatic experience. The course of the illness varies wildly, with some people recovering in as little as 6 months, while others develop a chronic condition.

To be diagnosed with PTSD, the following symptoms must be present for more than 1 month:

• Re-experiencing symptoms: Experiencing issues such as flashbacks, nightmares and/or frightening thoughts.
• Avoidance symptoms: Avoiding situations, places, things or people that remind an individual of the traumatic event, guilt, numbness, depression and/or loss of memories surrounding the event.
• Hyper-arousal symptoms: Feeling tense or edgy, being easily startled, being prone to emotional outbursts and/or having difficulty sleeping.

PTSD, Emotional Impact and Addiction

It is an innate urge for humans to seek comfort and alleviate pain, be it emotional or physical. It’s no surprise that many individuals turn to alcohol or drugs in an effort to avoid memories of trauma, calm feelings of hyper-arousal or help themselves sleep. It’s been estimated that 50-96 percent of substance abusers seeking treatment have experienced 1 or more traumatic events in their lifetime. Addiction diagnoses have a very high co-morbidity rate with PTSD, with a dual-diagnosis level of nearly 25 percent.

Between 20-80 percent of all PTSD cases also carry a dual diagnosis with major depressive disorders. Suffering from PTSD exponentially increases the risk for developing depression, which can be the impetus for many people to begin self-medicating. PTSD, depression and addiction oftentimes present as a triple-headed demon for individuals who enter rehabilitation programs.

PTSD, Physical Pain and Addiction

Interestingly, people diagnosed with PTSD often report much higher incidences of chronic physical pain than others patients in general, with anywhere from 10-50 percent of chronic pain sufferers also presenting with a PTSD diagnosis. There are several reasons for this occurring, one being that a physical trauma (such as a car accident or assault) can cause serious bodily injury. Another reason is thought to be based upon the hyper-arousal umbrella of PTSD symptoms, which may cause tension and over-sensitivity to physical stimuli. This results in physical pain due to the stress of constant over-stimulation of the nervous system.

Many opiate drug addictions begin when individuals take drugs to treat their physical pain. Nearly half of all young people reported using heroin after becoming addicted to prescription pain pills, due in part to the cheaper price and easy availability of the street drug. When doctors prescribe pain pills to PTSD patients living with chronic pain, they may unwittingly be paving the path to future heroin addiction. It is important for medical doctors to screen pain patients for risk factors such as PTSD and/or depression in order to avoid creating a situation conducive to abuse of prescription pills.

Gender and PTSD

Although women are less likely to report having experienced a traumatic event than are men, many societal factors increase the chances of females experiencing violence, rape and/or domestic abuse. Because of these risk factors, women are twice as likely to develop PTSD than are males. Awareness of this vulnerability can help clinicians to more effectively identify a co-morbid diagnosis of PTSD and depression in both males and females. Because of a societal culture of masculinity that denies emotional expression, many males attach a stigma to opening up about trauma. Consequently, many men are diagnosed with depression while not being screened for PTSD. Recognizing the disparity in gender roles can help professionals in the fields mental health and addiction recovery to more sensitively treat patients of both genders.

Does PTSD Cause Addiction?

Just as surviving a traumatic event puts an individual at a much higher risk of suffering from PTSD, suffering from PTSD increases the chances of developing an addiction. However, it’s important for people to realize that these are correlative and not causal factors. Effectively identifying at-risk populations for PTSD counseling interventions can greatly decrease the risk of patients developing depression and/or addiction. Early outreach helps individuals to address their traumas, regain a sense of control over their emotions and learn coping mechanisms to deal with anxiety and depression. Addiction is not an illness that people choose to suffer from, it is an illness that is developed as a reaction to pain and suffering.

The cultural stigma surrounding PTSD is slowly breaking down. Addiction is a societal illness, and correlations between the inappropriate treatment and diagnosis of PTSD in relation to the development of it are starkly evident. Perhaps as more patients are able to access proper post-trauma care, the parallels drawn between addiction and PTSD will also begin to weaken.