PTSD and alcohol use problems are often found together. This pairing can be big trouble for the trauma survivor and his or her family.
People with PTSD are more likely than others with the same sort of background to have drinking problems. By the same token, people with drinking problems often have PTSD. Those with PTSD have more problems with alcohol both before and after getting PTSD. Having PTSD increases the risk that you will develop a drinking problem.
Women who go through trauma have more risk for drinking problems. They are at risk for drinking problems even if they do not have PTSD. Women with drinking problems are more likely than other women to have been sexually abused at some time in their lives. Both men and women who have been sexually abused have higher rates of alcohol and drug use problems than others.
Up to three quarters of those who have survived abusive or violent trauma report drinking problems. Up to a third of those who survive traumatic accidents, illness, or disasters report drinking problems. Alcohol problems are more common for survivors who have ongoing health problems or pain.
Sixty to eighty percent of Vietnam Veterans seeking PTSD treatment have alcohol use problems. War Veterans with PTSD and alcohol problems tend to be binge drinkers. Binges may be in response to memories of trauma. Veterans over the age of 65 with PTSD are at higher risk for a suicide attempt if they also have drinking problems or depression.
If you have a drinking problem, you are more likely than others with your same sort of background to go through a psychological trauma. You may also have problems getting close to others. You may have more conflicts with those people to whom you are close.
Problems with alcohol are linked to a confused and disorderly life. This kind of life leads to less closeness and more conflict within a family. The confusion of a life with a drinking problem makes it harder to be a good parent.
You may drink because using alcohol can distract you from your problems for a short time. You should know, though, that drinking makes it harder to concentrate, be productive, and enjoy all parts of your life.
Using too much alcohol makes it harder to cope with stress and your trauma memories. Alcohol use and intoxication (getting drunk) can increase some PTSD symptoms. Examples of symptoms that can get worse are numbing of your feelings, being cut off from others, anger and irritability, depression, and the feeling of being on guard.
If you have PTSD, you may have trouble falling asleep or problems with waking up during the night. You may "medicate" yourself with alcohol because you think it's helping your sleep. In fact, using too much alcohol can get in the way of restful sleep. Alcohol changes the quality of your sleep and makes it less refreshing.
If you have PTSD, you may have bad dreams or nightmares. You may drink because you think using alcohol will decrease the number of bad dreams or how scary they are. Yet drinking just continues the cycle of avoidance found in PTSD. Avoiding the bad memories and dreams actually prolongs the PTSD. You cannot make as much progress in treatment if you avoid your problems. Alcohol use problems make PTSD treatment less effective.
When you suddenly stop drinking, the nightmares often get worse. Working with your doctor on the best way to reduce or stop your drinking makes cutting back on alcohol easier. You will be more likely to have success in your efforts.
If you have both PTSD and drinking problems, you are likely to have other mental or physical health problems. Up to half of adults with both PTSD and drinking problems also have one or more of the following serious problems:
Having both PTSD and a drinking problem can make both problems worse. For this reason, alcohol use problems often must be part of the PTSD treatment. If you have PTSD, plus you have, or have had, a problem with alcohol, try to find a therapist who has experience treating both issues.
In any PTSD treatment, several points related to alcohol should be stressed:
Evans, K. & Sullivan, J. M. (1995). Treating addicted survivors of trauma. New York: Guilford Press.
Kofoed, L., Friedman, M.J., & Peck, R. (Summer 1993). Alcoholism and drug abuse in patients with PTSD. Psychiatric Quarterly, 64(2), 151-171.
Matsakis, A. (1992). I can't get over it: A handbook for trauma survivors. Oakland, CA: New Harbinger Publications.