Post Traumatic Stress Disorder is rooted in unprocessed, irrepressible and lingering emotional responses to traumatic events or circumstances that an individual witnessed or experienced.
PTSD sufferers may be aware of the circumstances that triggered their symptoms, but are usually not qualified to effectively identify, evaluate, diagnose or resolve the underlying psychological problems it fosters. In many cases, individuals are unaware that they are suffering from PTSD or ignorant about the disorder, the extent and duration of the complications it entails.
Generally, PTSD victims anticipate or hope that the anguish they endure, after exposure to trauma, will simply dissipate with the passage of time. Unfortunately, it seldom happens and it may even become progressively more intense.
In response to the involuntary discomfort that they experience as a result of the unrestrainable primary complications of PTSD, sufferers often embrace ineffective or unnatural coping mechanisms in an attempt to contain their anguish until the PTSD symptoms fade.
Among the ineffective strategies that PTSD victims attempt, is self-healing of the condition. This is referred to as the “negative affect”, or opening a “Pandora’s box”. The drawback of this strategy is that the vast majority of sufferers are not equipped to apply their own remedies. As a result of their introspection, the person’s recollection of their traumatic experience results in an influx of negative thoughts which overwhelms them and creates the opposite of what they intended to achieve.
The most common unnatural coping mechanism employed by PTSD sufferers is as a form of self-induced chemical intervention with mood altering substances such as alcohol, drugs and prescribed medication. Initially the soothing effects of these self-medications offer momentary relief from anguish, but eventually this dependency can escalate into substance abuse disorder.
The harmful effects of addiction are more obvious and range wider than the PTSD symptoms it is meant to suppress. To curb the degenerative results of addiction, the individual is usually forced to relinquish the substance when their dependency reaches critical levels. However, they find it exceptionally difficult to avoid relapses, as the rooted PTSD symptoms are still present after cessation of the substance usage. Unless the PTSD is healed, it drives them to resume usage of the addictive substance.
PTSD victims turn to substance abuse as simply a subordinate method of bridging the gap until the haunting effects of the trauma wear off. However, the negative impact of substance abuse, in itself, becomes so prominent that those involved shift their entire focus to eliminating the substance and the destruction it creates. In the process they lose sight of the root cause that led to the addictive behaviour. Consequently, they find themselves in a constant cycle of quitting and relapsing that ends in despair.
On an emotional level, PTSD and substance abuse disorder form an augmentary comorbid relationship. Although the harmful substance creates spells of mental calm, both disorders eventually result in excessive anguish. When both disorders are active, anguish is inflated beyond the level of either disorder on its own. The negative impact of relapses also decreases the person’s confidence to cope with the PTSD symptoms, leading to an increase in both PTSD and substance abuse behaviour and symptoms.
The stages of PTSD and substance abuse
In summary, the initiation and progression of PTSD and substance abuse includes the following stages:
- Exposure to trauma.
- Inability to change circumstances.
- Manifestation of PTSD symptoms.
- Attempt to self-heal PTSD symptoms.
- Failure to self-heal PTSD symptoms.
- Attempt to self-medicate symptoms.
- Dependency on medication substances.
- Manifestation of substance abuse disorder.
- Remedial focus shifts to abusive behaviour.
- Abusive behaviour is stopped or curtailed.
- Resurgence/increase of PTSD symptoms.
- Resumption of self-medication (relapse).
- Remedial focus shifts back to addiction.
- Repetitive cycles of sobriety and relapse.
- Failure to cure addiction causes frustration.
- Submission to specialist treatment centre.
- Condition assessed by PTSD specialist.
- Formulation of individual treatment program.
- Recovery and ongoing self management.
Requirement for Specialist Treatment
The combination of PTSD and substance abuse not only intensifies the symptoms of both disorders but also complicates treatment. To address this, specialist centres conduct additional assessments that provide in-depth information about the relationship between symptoms. Their integrated treatment programs are empirically developed, expertly assessed and highly individualised to include multi-dimensional or joint treatment of comorbidity, the acquisition of unique adaptive coping skills, and a focused ability to effectively manage personal emotional states.