The symptoms of PTSD are painful and terrifying. Whether the original traumatic event was a single horrible incident (a natural disaster or a car accident, for example) or a daily life colored by chronic trauma (domestic violence or living in a war zone), when a person develops PTSD, the suffering is profound. Medications may be prescribed depending upon which symptoms present most intensely, but often they are only mildly effective. The terrible thoughts, feelings, memories and flashbacks feel inescapable and the torment feels as if it is unending. As bad as whatever it was that you initially went through, even worse is the experience of being unable to end the nightmare and having to relive it over and over again.
Suffering in Silence
For many people with PTSD, shame prevents them from seeking treatment. Many people try to muscle through the fears and flashbacks, or live life avoiding the situations that trigger re-experiencing episodes. Shame, stigma and in some cases real losses (such as losing custody of children, or losing access to specific recognition in the military) may occur if PTSD is disclosed. The suffering PTSD causes is compounded by a sense of isolation and desperation, with little escape available.
How Do You Cope?
Simply getting through the day can become a significant challenge when PTSD is severe. Sometimes, despite initial efforts in treatment, the symptoms are still very intense. Trying to function while coping with overwhelming anxiety, feeling crazy, and having flashbacks is incredibly difficult. Often by accident or coincidence, people with PTSD discover that alcohol or other substances are more effective than prescribed medications at stopping the symptoms. They may start using alcohol or other drugs that have not been prescribed as a way to deal with their symptoms. This is often referred to as “self-medicating.” Alcohol and tranquilizers such as Valium or Xanax are central nervous system (CNS) depressants. They slow the activity of the brain and nervous system, directly impacting the source of the torment: the brain. While a medical doctor might prescribe a small, safe dose of this type of substance for intense PTSD symptoms, the dose might not be enough to offer real relief. But when a person is adjusting the dose himself, by either drinking alcoholic beverages along with taking medications or taking street drugs along with medications, he may actually experience a respite from his symptoms. Naturally, getting some relief is such a powerful experience there is a strong urge to repeat it – to become numb to the feelings and finally get some peace. In this way a “co-morbid” condition (when two mental illnesses exist at the same time) develops. Addiction and PTSD fit together all too well and now you have two problems, not just one.
How Common Is This?
Self-medicating is very common. Alcohol is legal and accessible, and is a potent CNS depressant. Unlike going to a mental health clinic or seeing a “shrink,” there is very little surrounding “just having a beer.” According to the Veterans Administration, one in three veterans presenting for substance abuse treatment also have PTSD. Co-morbidity with alcoholism or addiction and several mental illnesses (not just PTSD) are also very common: people diagnosed with bipolar disorder, depression, anxiety, and psychotic disorders all have increased risk of developing addictions, especially if self medicating feels like the only option.
What to Do?
How can you help a loved one who is self medicating PTSD symptoms with drugs or alcohol? What if you are drinking too much or using drugs to deal with your flashbacks? To start with, park your judgments at the door. Forget all your biases and preconceived notions about what an addict or alcoholic is: old-fashioned ideas about laziness and will power are neither helpful nor accurate. Your loved ones’ (or your own) efforts to function led to the addiction, and functioning well is the goal. The next step is to get help. If you are already in therapy, be honest with your therapist about how much you are drinking or drugging. You may need a higher level of care while you focus on getting clean, or you may need to use other treatment modalities you haven’t tied yet. For some people, acupuncture is incredibly helpful for managing detox and cravings and some clinics offer this service. Twelve Step meetings may also be key components to add to your repertoire. If you are not already in therapy or working with a doctor, seek help. There are treatments that really do help you heal – not just numb the symptoms that lurk just beyond the next hangover. While using drugs and/or alcohol can offer relief, those substances can’t end the suffering. Using gets in the way of healing – it slows your progress and prevents you from really dealing with your PTSD and getting better. It is a bitter pill to swallow, for sure, but the very thing that gets you through the day also keeps you stuck where you are. There is no way around PTSD; you have to work through it. But healing can happen and a functional, satisfying life is possible. You made it through the trauma; you can make it through the healing process.