Dual Diagnosis: PTSD and Substance Abuse
After a break-in and assault, a young woman self-medicates with prescription drugs. But not even the increasingly large amounts of narcotics can ease her anxiety.
Sidney had been like most of the young women attending her prestigious women’s college; she was wide-eyed, eager and intellectually curious. Her parents described her as someone who “lit up a room” just by entering it, and liked to tell how their daughter “never met a stranger.” And it was true that Sid had always been friendly, warm and interested. But these days, those closest to her missed that Sidney.
So unlike the young woman she’d only recently been, this Sidney was irritable, easily angered and too fearful to leave the house. Sidney had been the victim of a break in and armed robbery by two men during the winter of her junior year in college. The men had held her captive while they ransacked her apartment, stealing anything valuable they could find, including her precious Maltese. The robbery had ended in assault.
The event was understandably traumatic for Sidney, and police were never able to recover her beloved pet, even though they did catch the men who’d broken in on her. Since the event, she had become reliant on prescription pain medication—meds that had been prescribed as a result of her injuries—and when doctors would write her no more prescriptions, Sidney sought a way to obtain them illegally. She was now spending hundreds of dollars a week on illicit prescription drugs that she had to go downtown to buy, but otherwise, she simply refused to leave her apartment. The medication helped her to cope, she said, but the truth was that it served only to numb her symptoms of anxiety for a time.
The lovely young woman who’d only recently been seeking a degree in political science was now a terrified, drug addicted young person who writhed from nightmares and uncomfortable memories and was too easily triggered by loud sounds. She could no longer trust the world or her place in it. If two men had broken into her home on the calmest of nights, what else could happen? Not even the increasingly large amounts of narcotics kept Sidney from worrying.
Symptoms of PTSD
PTSD, or post-traumatic stress disorder, can be one of the most debilitating mental illness diagnoses—a disorder that emerges as a result of a single intense trauma, or after repeated and upsetting events like domestic or child abuse. Anyone can acquire PTSD at any age. It most often arises after a dangerous ordeal, especially one that induces fear and adrenaline, but not everyone exhibits PTSD after a shocking event. And some people may develop PTSD not as a result of their own trauma, but due to the trauma or loss of life experienced by a loved one.
PTSD shows itself in symptoms like intense anxiety, invasive memories and frightening flashbacks. These symptoms fall into the category called “re-experiencing symptoms,” but there are many others that are less known. A person who has PTSD may also express “avoidant symptoms: such as:
- A need to stay away from people, places and things that remind her of the trauma
- Feelings of emotional numbness
- Feelings of depression, guilt or worry
- A loss of interest in activities that were once enjoyable
- Memory loss, especially loss of memory of the traumatic event
There are also symptoms known as “hyperarousal symptoms” which may include:
- Feeling irritable or easily agitated
- A tense feeling of edginess
- Difficulty sleeping
- Outbursts of anger, rage or other seemingly uncontrollable emotions
Dual Diagnosis With PTSD
Many people who suffer from the symptoms of PTSD may attempt to self-medicate their distress and anxiety through the use of drugs or alcohol. When substance use becomes chronic and when a person relies on it in order to feel “normal,” dependence can be said to have developed. Drug or alcohol abuse taken in conjunction with PTSD or any other mental illness is referred to as a dual diagnosis. Individuals with a dual diagnosis are best treated when their mental illness and their substance use disorder are taken as a whole and treated as a whole—an integrative approach that addresses the full person.
It is important for the recovery of PTSD for sufferers to gain insight into what created their symptoms, as well as an understanding of how PTSD can affect the brain’s wiring over time. We are built to respond to dangerous or stressful events with a fight, flight or freeze response. For people with PTSD, this response has become hypersensitive; it is over-reacting to too many cues from the environment. While the use of drugs or alcohol may seem to silence the symptoms for a time, in reality, they only complicate them. Anyone experiencing the dual diagnosis of PTSD and substance use disorder needs a qualified helping hand, but the good news is that both addiction and PTSD can be healed.