What Does a Dual Diagnosis of PTSD and Substance Abuse Look Like?

While Post Traumatic Stress Disorder (PTSD) can exist on its own, there are some instances where a person can struggle with this condition and a substance abuse disorder at the same time.  

The 2022 National Survey on Drug Use and Health found that nearly half of the 46.3 million adults who reported a substance abuse order also struggled with a mental health condition. Another study from the U.S Department of Veterans Affairs found that 45% of adults with PTSD also experienced drug or alcohol difficulties. 

The evidence strongly suggests that these issues are often interconnected and feed into one another. Having a mental health condition can increase the risk (or severity) of substance abuse, and substance use can also increase the risk of developing a mental health condition or worsening the symptoms of an existing condition.

Given the overlap, treating both issues at the same time is necessary and can help mental health professionals to address the root causes of both of the problems. 

Dual Diagnosis

A dual diagnosis is when a person is clinically assessed to have both a mental health condition and a substance abuse disorder at the same time. Treatment involves addressing the two conditions together, rather than separately. 

There is often a connection between the two types of issues. For instance, someone experiencing a mental health condition like PTSD may self-medicate using alcohol or drugs, resulting in a substance abuse disorder. Similarly, severe substance abuse may trigger an underlying mental health condition to come to the surface. 

Even if they arise independently, mental health conditions and substance abuse often interact with one another. The mental health condition worsens due to substance abuse, and substance abuse worsens because of increased psychological discomfort. 

PTSD

PTSD occurs in response to witnessing or experiencing a traumatic event. Military combat, physical or sexual assault, being involved in or witnessing a serious accident, and natural disasters can all cause PTSD.  Approximately 6.8% of the US population will experience PTSD at some point in their lifetime. 

PTSD presents both psychological and physical symptoms.

Psychological symptoms of PTSD include:

• Nightmares
• Flashbacks
• Negative thought cycles
• Heightened arousal (irritability, anger, or an “on edge” feeling).

Physical symptoms of PTSD can include:

• Heart palpitations
• Sudden/excessive sweating
• Nausea
• Dizziness
• Headaches
• Panic attacks 

Many people with PTSD recover naturally within 3-6 months, but it can last for years in some cases. Even seemingly dormant PTSD can come to the surface if triggered by sights, smells, stressful moments, or substance abuse. 

The Connection Between PTSD and Addiction

There is a strong connection between PTSD and addiction, and more than four out of ten adults in the U.S. who have PTSD also have a drug or alcohol abuse disorder. There are several main reasons why these conditions can be connected.

Self-Medicating Symptoms

Living with PTSD can present a wide range of challenges, including dealing with intrusive memories, a heightened state of arousal, and low self-esteem. Consequently, many with PTSD turn to substances for short-term relief and to numb the emotional pain of the trauma.

While these substances can appear to provide a respite from PTSD, they can have detrimental consequences and lead to drug or alcohol dependence. Further, these substances can worsen already severe symptoms.

Brain Changes from PTSD

PTSD can have a lasting impact on the brain. Studies have shown that patients with PTSD have heightened activity in the amygdala, incorrect memory processing in the hippocampus, and reduced activity in the prefrontal cortex.

The prefrontal cortex is the part of the brain that makes decisions. During moments of reduced activity, a person is more likely to make choices they may not ordinarily make, such as experimenting with drugs. 

Shared Risk Factors

The risk factors for developing a substance abuse disorder often overlap with the risk factors for developing mental health conditions like PTSD, including a family history of mental health conditions or addiction issues. 

Risky Behaviors

People with substance abuse issues are more likely to engage in risky behaviors, such as driving while drunk or putting themselves in unsafe social situations, which can increase the risk of a triggering episode. 

Treatment Options

At Jackson House, we draw upon a wide range of effective dual diagnosis treatment strategies, tailoring each treatment method to the patient. These treatments can include:

• Therapy: One-on-one therapy helps patients uncover and manage the underlying thoughts and emotions behind their PTSD and substance abuse issues. Speaking with a specialized therapist can allow clients to share in a safe space and find solutions.
• Medication: This is often prescribed to manage withdrawal symptoms and stabilize a person’s mood. It can help to stop the use of substances as well.
• Detoxification: We help facilitate a full detoxification process, monitoring clients in a safe space throughout each step.
• Support Groups: In groups, clients can find support from others to build a sense of community. Connecting with others who may even be going through a similar experience can be encouraging to those who have felt alone.  

Dual Diagnosis Treatment at Jackson House

Dealing with PTSD or addiction can be difficult to manage on your own, and it’s even more challenging to navigate both without additional help. At Jackson House, we offer highly individualized support for both conditions so that you can get back to feeling your best.

If you or a loved one is suffering from a mental health condition, substance abuse disorder, or both, reach out to Jackson House to find out more about our dual diagnosis treatment.