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The Dual Diagnosis of SUD + PTSD: Two Disorders With the Same Underlying Cause

Addiction is a complex problem that can stem from a variety of different unseen issues. However, many times an addiction can happen as the result of the need, or desire to self-medicate. It is common for people to suffer with health concerns that are not appropriately diagnosed by their doctor. These health conditions can include everything from generalized anxiety disorder (GAD), and substance use disorder (SUD), to post-traumatic stress disorder (PTSD). The fact is that sometimes stress, trauma, and the need to find medication go hand-in-hand, and today many people are dealing with an additional substance use disorder (SUD), as they continue to search for an accurate diagnosis for their health problem.  

According to the VA’s National Center for PTSD this is a problem commonly seen by veterans. You see, at the VA National Center for PTSD, almost half of veterans there that are properly diagnosed still struggle with an addiction. And the number of veterans who are reported to have co-morbid SUD + PTSD in the VA has continued to rise over the course of the past 10 years – three fold! This statistic is alarming enough to trigger an increasing urgency to find the right medication to treat this combination of health problems that veterans often experience.

Digging Deeper into PTSD

As defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), PTSD is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war or combat, rape or another violent personal assault. And there are a specific set of symptoms that are indicators of this type of trauma:

  • Re-Living the Event. For people with PTSD, any type of memory of the traumatic event can trigger flashbacks. This may result in feeling like the event is happening all over again, which can cause a sufferer all types of discomfort. This can also happen during sleep if the sufferer has a nightmare.
  • Avoidance. Because reliving a traumatic event can cause flashbacks, many PTSD sufferers can become depressed as they may try to avoid people, or places that trigger memories. They may even stop talking about certain things, as it brings up bad thoughts that can trigger their PTSD symptoms.
  • More Negativity. PTSD is complex disorder, and because many of the feelings are negative, a sufferer may also become more negative as their problem continues. This is why it is so important to get a correct diagnosis, and proper treatment plan so that a PTSD sufferer does not also become clinically depressed.
  • Hyperactivity. When people are struggling with traumatic thoughts, feelings, or memories they may also become hypersensitive to what they think is threatening. For example, a PTSD sufferer may suddenly become startled, or irritable for no clear reason. But it could simply be a reaction to memories of an event, or other traumatic situation.

What is SUD?

A diagnosis for SUD (substance use disorder) is usually categorized into three major groups: mild, moderate, and severe. This complex brain disease may also include evidence of loss of control, social impairment, risky behavior, and pharmacological criteria. DSM-5 symptoms of SUD may include the recurring use of substances, including that of prescription medications, street drugs, and alcohol that can cause clinical impairment such as health problems, or functional impairment including an inability to meet workplace demands, or home responsibilities. However, no matter the degree of the severity of an SUD disorder, it is easily worsened by the additional stress of PTSD symptoms.

Putting it All Together

When we think of PTSD trauma, we often think of a soldier having flashbacks of wartime horror. However, the reality is that this type of disorder can affect anyone, including children. So, it is very important to realize that someone with PTSD may have direct trauma to their nervous system, and thus lose the ability to effectively regulate their emotions. This is one of the main reasons people with PTSD often reach for prescription medications that do not work to reduce their symptoms, street drugs, or alcohol. This is called self-medicating, and it can often worsen PTSD symptoms, triggering SUD. In attempts to relieve the stress of PTSD, many people reach for drugs, and alcohol to numb their feelings, or mentally remove themselves from situations that feel uncomfortable. This behavior is very common however, dual-diagnosis treatment options are available.

Frontline protocols often used in military cases of PTSD + SUD can include exposure therapy, and cognitive behavioral therapy (CBT). Typically, this type of treatment option was designed to include medically supervised detox, and then after the withdrawal symptoms are conquered, the focus can be turned directly onto PTSD symptoms. And there are more, new therapy options also available called “trauma-informed therapies” which deliver a safety, stability, and sensorimotor experience to include new treatments like mindfulness-based stress reduction, eye movement desensitization, and reprocessing (EMDR), as well as somatic experiencing, and sensorimotor therapy.

A Final Note on PTSD + SUD

A dual diagnosis of PTSD + SUD sounds pretty official, right? That’s because it is. The duality of these conditions is very real, and while they commonly go hand in hand, you don’t have to suffer in silence if you are noticing any of the common symptoms of one, or both of these disorders. There is now more awareness than ever before both inside, and outside of the military that PTSD is a serious medical condition. And that it is treatable!

A great place to start finding help for these disorders is online. So, search for “treatment centers that specialize in dual-diagnosis programs for PTSD and SUD” in your search bar. For military veterans, there is a specific center designed by the VA to address, diagnose, and treat PTSD.

If you are suffering with one, or both of these disorders, it is so important that you know a diagnosis is NOT any indication of your mental stability, or a reflection of your character. It is simply a way to pinpoint how to address your symptoms, so that you can heal, and take your life back! So, do not wait to contact a healthcare provider that can work with you to develop a treatment plan that fits your specific needs. If you are willing to reach out, there are plenty of providers who can make your wellness their top priority. You deserve a peaceful life, so demonstrate your courage today, and get support.

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