According to 2015 data from the National Institutes of Health, 10% of Americans have a substance use disorder at least once during their lifetimes, but 75% go without being treated. The statistics are shocking. Among patients in treatment for substance use disorder, 75% of men and women report histories of abuse and trauma. A significant 97% of homeless women with mental illness also have a background of severe sexual or physical abuse. Between 12% and 34% of individuals being treated for addiction have PTSD, and 33% of people exposed to trauma develop PTSD.
Given those statistics and the stigma associated with these disorders, it’s no wonder people don’t want to talk about it. Imagine a hotline that you could call any hour of the day or night with no charge, no insurance information required and no fear of being judged. It’s OK if you don’t know what to ask. The trained staff at The National Mental Health Hotline can help.
- Crisis Text Line: Text and Online Chat
The Crisis Text Line is a volunteer based service that provides 24/7 free support, with an online chat at crisistextline.org as well as a textable number at 741741
- SAMHSA National Helpline
SAMHSA (Substance Abuse and Mental Health Services Administration) provides a free 24-hour service in English and Spanish for any mental health or substance abuse related needs. Text: 435748, Call: 1-800-662-4357 or TTY 1-800-487-4889
- NAMI Helpline
The NAMI (National Alliance on Mental Illness) provides a volunteer helpline answering questions and offering support for all Mental Illness topics. Text: 62640 or Call (800)950-6264
- Mental Health Hotline is a free, 24-hour service established to provide resources for those seeking help and connect them with appropriate and local care.
- Crisis Text Line: Text and Online Chat
How Can a PTSD Hotline Help?
Many people don’t get the help they need because they don’t know where to start. PTSD and addiction are overwhelming enough on their own. Fortunately, hotline staff members can point you in the right direction. If they don’t know the answers to your questions, they’ll refer you to someone who does.
Below is a list of things you can ask about if you’re looking for treatment when you call 866-903-3787:
1. What PTSD is and how it’s treated
2. If there are medications for treating PTSD
3. What kinds of specialists you need to see
4. Whether care is inpatient or outpatient
5. What to ask your insurance company
6. If rehab includes private or group counseling
7. If a rehab center treats co-occurring disorders
8. The difference between cognitive and dialectical behavior therapy
9. How to approach a loved one with an addiction
10. How an intervention works
It’s important to note that if you have a medical emergency, call 911 immediately, not a hotline.
What Is PTSD?
PTSD is a mental health condition that comes from seeing or experiencing a traumatic event, but it’s not always the severity of the trauma that determines the outcome. It also depends on the person’s perspective and personal history. While many people recover after a brief adjustment period, others have symptoms that get worse, interfere with daily life and last for months or years.
Signs and symptoms fall into four categories: avoidance, intrusive memories, negative mood or thinking, and changes in emotional and physical responses. The severity varies over time and from person to person. Children may also act out the trauma.
1. Intrusive memories include disturbing thoughts about the event, flashbacks, nightmares, and emotional or physical responses to things that bring the incident to mind.
2. Negative mood or thinking includes feelings of hopelessness, memory problems or blocking things out, trouble with close relationships, and feelings of numbness or detachment. There may also be a lack of interest in things once enjoyed or an inability to feel positive emotions.
3. Emotional and physical reactions can include anxiety, feelings of fight or flight, self-destructive behavior, inability to focus, sleep problems, anger, irritability, guilt or shame.
4. Avoidance may include efforts to avoid talking or thinking about the event, or it may involve avoiding people, places or activities that trigger memories of the trauma. Hearing fireworks, for example, may trigger memories of gunfire.
PTSD and Addiction
Researchers at the Dartmouth Psychiatric Research Center studied the relationship between addiction and PTSD. They estimated that 1 in 3 people who get help for substance use disorder also have PTSD symptoms, but the number may be higher. In one survey, 70% of teens who received treatment for addiction problems also had been exposed to trauma.
Traditionally, doctors treat substance use disorder and PTSD as two separate illnesses, and rehab for the drugs or alcohol came first. After a period of sobriety, treatment for PTSD followed. Lately, that has changed, and many rehab centers now use an integrated program that addresses both conditions at the same time. Simultaneous treatment simplifies therapy and makes it easier to treat overlapping symptoms. It also allows therapists to work with triggers and feelings linked to alcohol or drug use, facilitating recovery and sobriety.
How Does PTSD Turn into Addiction?
Have you ever stood in a pool and tried to hold a beach ball beneath the surface of the water? It’s tiring, and so is the struggle to keep traumatic memories from bubbling to the conscious mind. Even if it gets easier as time passes, stressful incidents can still trigger a reaction. Whether it’s from exhaustion, physical illness or a bad day at work, buried trauma can pop up when a person’s defenses get weak. Bad memories can also surface during times of relaxation or pleasure when the effort to keep the walls up is low.
The trauma is worse if it occurred early in life but nobody was around to help a person understand or make sense of the feelings. When incidents are prolonged or intense, having a safe adult to talk to reduces the loneliness, shame and neglect that comes with abuse. Not being believed or supported is a kind of trauma itself, and children who need acceptance often make bad choices because pleasing others is so important to them. Unless the problem is identified and treated, it can last a lifetime.
It Works Both Ways
Experiencing trauma increases the odds of having a substance use disorder, and the use of alcohol or drugs lowers inhibitions and leads to risky behavior that invites more trauma. Substance use also makes it harder to deal with trauma. In one study, people who had three or more traumatic experiences in childhood were not only at risk for substance use disorder, but they were also more likely to suffer from domestic violence, depression, heart disease and sexually transmitted diseases.
Nobody wants to become addicted, but drugs and alcohol temporarily soothe the anxiety and shame of PTSD for some people. Others turn to behaviors like gambling, sex or compulsive shopping to fill the emptiness. Sometimes these become addictions in themselves, called process addiction. Drugs, especially stimulants like crystal meth or cocaine, cause the brain to reach a dopamine-releasing high, creating feelings of ecstasy and well-being. That’s how the addiction begins.
One addiction expert says that humans have a biological drive to belong. When opiates replace this natural urge, it disrupts the process of attachment. Instead of finding comfort in the care of a loving partner, an addict gets an artificial high from the drug. Children who haven’t attached to a caring parental figure may substitute chemicals for intimacy when they grow up. Childhood trauma makes it hard to cope with stress. When the stress builds up and feels overwhelming, drugs replace relationships, and addiction occurs.
Important Things to Know About PTSD
- In the United States, over 8 million people aged 18 or older have PTSD.
- Almost 70% of people exposed to mass violence develop PTSD.
- Mass violence causes more cases of PTSD than natural disasters or other kinds of traumatic events.
- People who experienced past trauma are more likely to develop PTSD after a new event.
- Women are more likely to have PTSD than men.
- PTSD can have a genetic link.
- Fewer than 8% of people with PTSD engage in violent behavior, and that may be linked to co-occurring disorders.
- Effective treatments and medications are available for PTSD.
- Childhood sexual abuse and sexual assault are the most common causes of PTSD in girls and women.
- PTSD in men usually comes from experiencing physical assault, accidents, combat or disasters. They may also witness injury or death, as in combat. Men and boys also are the victims of sexual abuse and sexual assault.
- Stress makes PTSD symptoms worse, but being part of a community makes symptoms less severe.
PTSD and Children
Although children and adults share some symptoms, young people may show other signs of PTSD. Young children may start wetting the bed again, stop talking or be unable to speak, act out scary scenes while they’re playing or cling to someone they trust. Older children can become disruptive, show disrespect for once-trusted adults and behave in self-destructive ways. Like adults, they may experience inappropriate guilt for not stopping injuries or deaths, or they may want to get revenge.
The link between chemical dependency and post-traumatic stress makes both disorders harder to understand, diagnose and treat. If the theory that addicts are trying to medicate past trauma is correct, it’s easy to see the connection. Substance use disorder, then, comes from an effort to keep intrusive memories away, calm anxiety and squelch “fight, flight or freeze” reactions.
When drugs or alcohol are the methods of escape, both substance abuse and PTSD can become more intense. Alcohol depresses the central nervous system, increasing feelings of hopelessness and shame. Opioids not only make both depression and anxiety worse, but they also disrupt sleep and lead to sleep apnea in some people. Drugs and alcohol also cause chemical changes that directly affect the biological clock that regulates sleep and wakefulness.
Treating the trauma is crucial to recovery, but it’s not enough to stop the addiction. Tolerance to alcohol or drugs has already developed, hijacking the brain’s reward system and leading to the need for greater doses to keep withdrawal symptoms at bay. Although the two disorders are intricately interwoven, recovery from one won’t make the other go away.
Trauma survivors tend to be hard on themselves, but recovery is not a time for black-and-white thinking. It’s normal to have bad thoughts or cravings, but it’s not a sign of failure. Relapse is a signal to practice self-care and remember what works.
Help Is Available
Other disorders, such as depression and anxiety, often accompany co-occurring addiction and PTSD, making it hard to tell where one stops and the other starts. The key to recovery is taking one small step at a time, and The National Mental Health Hotline is a good place to start. Call 866-903-3787 now.