Mental health disorders and substance use disorder (SUD) commonly co-occur. When a person struggles with both simultaneously, they are referred to as having co-occurring disorders or a dual diagnosis. One particularly common co-occurring disorder involves post-traumatic stress disorder (PSTD) and SUD. 

The prevalence of this co-occurring combination is troubling. One national epidemiologic study found that 46.4% of individuals with PTSD meet the criteria for SUD. Unfortunately, the comorbidity of these conditions can worsen the effects of one another. Understanding how these conditions interact and affect one another can be instrumental in securing lasting recovery and healing. 

What Is PTSD?

According to the National Institute of Mental Health (NIMH), PTSD "is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event." It is normal to feel shaken after experiencing a seemingly traumatic event. However, some people experience long-lasting effects that interfere with their ability to function in their daily life. In other words, their body's "fight-or-flight" mode becomes dysregulated from trauma. This causes them to live with intense anxiety and fear. 

Some people develop PSTD after one singular event. Others develop PTSD after they endure multiple transgressions of trauma over time. It is also important to note that trauma is subjective. What one person classifies as a traumatic event depends on their unique perspective and experience with that particular event. 

Signs & Symptoms of PTSD

NIMH lists the following signs and symptoms of PTSD:

• At least one re-experiencing symptom, such as flashbacks, nightmares, or frightening thoughts

• At least one avoidance symptom, like staying away from places, events, or objects that serve as a reminder of a traumatic experience or avoiding thoughts and feelings related to a triggering event

• At least two arousal and reactivity symptoms, such as being easily startled, feeling tense, struggling with falling asleep or staying asleep, or having angry outbursts

• At least two cognition and mood symptoms include issues with remembering key features of a triggering event, adverse or distorted thoughts regarding the world or oneself, feelings of guilt and blame, or a loss of interest in activities once found pleasurable.

Understanding that most of these symptoms are natural responses to coping with trauma is essential. If these symptoms last more than one month or interfere with an individual's ability to function, it could indicate the presence of PTSD. 

When Self-Medicating Practices Develop Into SUD

When PTSD goes untreated, symptoms can become debilitating. Many people may not seek support or treatment for their symptoms due to fear of judgment or struggle to recognize their symptoms' severity. As a result, many people with PTSD turn to alcohol and other drugs to self-medicate. 

Self-medicating practices are harmful. They trick an individual into believing that numbing their pain is the only way to cope with it. Further, these practices also tend to worsen symptoms of PTSD in the long run. The dopamine surges that occur in the brain from alcohol and other drug use produce pleasure beyond any feelings achieved from natural rewards. However, what goes up must also come down. 

The comedown that happens after the effects of substance use wear off is often just as intense as the feelings of pleasure achieved from a drug. In other words, tolerance will continue to rise, and withdrawal symptoms will continue to worsen. It is only a matter of time before self-medicating practices develop into an uncontrollable SUD.

NIMH defines SUD as "a mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances such as legal or illegal drugs, alcohol, or medications." SUD and co-occurring PTSD can trigger long-lasting changes in the brain. This can cause severe disruptions in one's thoughts, emotions, and behaviors. 

Early intervention, education, and treatment are necessary to reverse these brain changes and challenge the effects of these co-occurring conditions. Although the treatment and recovery processes pose many challenges, it is important to understand that recovery from PTSD and SUD is possible. 

Treatment for PTSD & Co-occurring SUD

Effective treatment and recovery for co-occurring conditions must first be individualized. There is no one-size-fits-all treatment to recover from mental health conditions or SUD. Instead, treatment must work to address the unique needs of each client and be tailored to a client's goals for recovery. Likewise, treatment for co-occurring disorders must work to treat both conditions simultaneously. If one diagnosis is treated while the other is left untreated, relapse of symptoms is much more likely. 

The U.S. Department of Veterans Affairs suggests that individuals struggling with these co-occurring disorders can benefit from trauma-focused and trauma-informed treatments. These treatments will help to reduce PTSD symptoms and prevent future relapse. Treatments centered solely on improving coping skills do not tend to provide the most effective outcomes. It is important to work with a healthcare professional to understand if certain therapies, such as exposure therapy, could harm an individual's recovery process. 

Co-occurring disorders means they occur simultaneously. Leaving each untreated can exacerbate symptoms of both conditions. PTSD and SUD commonly co-occur as a result of self-medicating practices. While recovery can be tedious and challenging, it is possible and worth it. Next Level Recovery Associates is here to walk with you every step of the way. We provide a variety of services, including Recovery Companions, interventions, and case management, to best individualize our client's care. We believe in meeting our clients exactly where they are throughout their recovery journey to connect them with greater support and knowledge. To learn more about how we can assist you in reaching the next level of your healing, contact us today at consult@nextlevelra.com.