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Complex PTSD and Substance Abuse

What is PTSD?

Post Traumatic Stress Disorder, or PTSD, has increasingly made headlines since the beginning of the War on Terror in 2001. People have suffered from stress related to traumatic events since the dawn of time and symptoms have been documented by such writers as Homer and Shakespeare.

However, only in recent history with the development of psychology and medicine have people attempted to define and effectively treat symptoms related to trauma. Previously termed shell-shock, battle fatigue, and nostalgia, different historical wars spurred medical attempts to understand the condition.

Now, PTSD is understood as a condition marked by a variety of symptoms caused by the experience of a traumatic event. People who experience a near-death event such as a car crash, natural disaster, mugging, or other such traumatic event may develop symptoms as anxiety, depression, flashbacks, insomnia nightmares or emotional detachment.

Not everyone who experiences a traumatic event develops PTSD, the reasoning for which is still being studied. However, for those who do develop PTSD, the world can seem like a hostile, frightening and lonely place overnight.

What is Complex PTSD?

Complex PTSD is a distinct diagnosis emanating from deficits that PTSD fails to cover. PTSD covers exposure to a single isolated traumatic event, while those who repeatedly witnessed traumatizing events often have different or more severe symptoms.

Complex PTSD describes symptoms related to chronic trauma. Such situations include concentration camps, prostitution brothels, long-term sexual abuse, long-term physical abuse, prisoner of war camps, and child exploitation rings. Chronic abuse such as this, which might occur over months or years, has a far more devastating effect on an individual than a single event usually does.

Symptoms of complex PTSD include distortions of consciousness including extreme dissociation, forgetting or reliving traumatic events and problems with self-perception such as helplessness, hopelessness, despair, guilt and shame. Other problems arise in regulating emotions as well as experiencing extreme sadness, suicidal thoughts, and anger. Distorted views of the perpetrator are also common, including obsession with or giving all power to him or her. Additionally, relationships with others may also be difficult with problems of distrust, isolation, and looking for a savior in others. 

Clearly there is significant difference between PTSD and Complex PTSD. People who suffer from complex PTSD are not adequately represented by a diagnosis of PTSD and often receive a diagnosis of Disorders of Stress Not Otherwise Specified or DESNOS.

A diagnosis is just a code for a set of symptoms. The real issue with such severely distressing experiences and symptoms after the fact centers around the need for treatment, education and support and the all too often failure of medicine or society to provide just that.

Complex PTSD and Substance Abuse

The more distressing or traumatic an experience or symptom is the greater the association with substance abuse. People with Complex PTSD who lack proper psychological treatment or social support often turn to substances to ease their symptoms. 

People with such severe symptoms are often desperate for relief. Alcohol, opiates, uppers, downers – whatever helps ease the pain at the moment. The tendency to reach for something to get through a difficult moment is understandable – as a society we are taught that alcohol and other drugs are the answer to most every problem. If we look to a drink at the end of a hard day, the reaction of numbing oneself in response to overwhelming trauma makes sense.

Self-medicating, however, can lead to intensified or worsening of symptoms and development of new symptoms. Insomnia, depression and anxiety, for example, all tend to get worse in the aftermath of mood or mind-altering substances. The brain’s biological processes are thrown off balance by the introduction of drugs and alcohol, causing a short-term high followed by a longer recovery period.

Use of mood and mind-altering substances often leads to dependence and addiction. Regardless of the substance of choice or length of use there is hope.

How to Treat Complex PTSD and Addiction

No matter how severe the trauma or how bad the symptoms seem, there is always hope with treatment. Addiction and any other mental disorder is termed co-occurring disorders or dual-diagnosis. For individuals with Complex PTSD and addiction, both issues need to be addressed simultaneously for either treatment to have much effect.

The reason co-occurring disorders must be targeted at the same time relates to how the symptoms of each interact with each other. If a person experiences depression and uses drugs to self-medicate, treating only the addiction will not help the underlying issue. Additionally, treating the depression and not the addiction means the person continues to use and his or her depression will not heal until the using stops.

Treatment for Complex PTSD involves some of the same techniques utilized for PTSD with some additional methods. Treatments include Cognitive Behavioral Therapy (CBT), EMDR, as well as other evidence-based options. Additionally, people with Complex PTSD need to address the difficulties specific to their trauma. Interpersonal difficulties, trust issues, empowerment, regaining control of one’s life and other topics may need to be addressed.

Addiction treatment centers such as A Better Today understand fully how addiction and Complex PTSD affect each other. Anyone with these two disorders requires specialized treatment in a facility that can address co-occurring disorders. There are many great treatment centers equipped to handle just such cases across the United States.