Post-traumatic stress disorder (PTSD) is a mental and physical health disorder caused by experiencing or witnessing a terrifying event. Persons who experience PTSD often turn to alcohol or drugs to alleviate physical or mental symptoms. Physical symptoms include surges in levels of adrenaline or cortisol which cause a person’s body to be on perpetual “high alert.” Mental and emotional symptoms include fear, anxiety, depression, and racing thoughts.
[Note: During the summer of 2021, I was diagnosed with co-occurring PTSD and alcohol abuse. I underwent inpatient trauma therapy during the summer and am now experiencing recovery. Thus, I have written this article based not only on research but personal experience.]
PTSD exerts an impact on the parts of the brain regulate memory and emotions. Whereas a healthy brain can distinguish between past (traumatic) memories and present (non-traumatic) experiences, PTSD interferes with the process. Instead of responding to the present, the brain acts as if it is still in the past, triggering fear and anxiety, and often releasing more adrenaline and cortisol.
The Correlation between PTSD and Alcohol
Given that symptoms can persist for years after the traumatic event(s), PTSD victims often self-medicate. Alcohol can balance out the physical and mental imbalances caused by PTSD. Yet, for the same reason, PTSD victims who medicate with alcohol are significantly more likely to abuse it and even become dependent on it.
PTSD causes changes in brain chemistry that can easily trigger a substance abuse disorder. For example, following a traumatic experience, the brain produces fewer endorphins, one of the chemicals that makes a person feel happy; thus, a person with PTSD might turn to alcohol as a mood-enhancing substance that will increase endorphin levels.
Once a person has experienced a terrifying event, the body not only releases surges of adrenaline and cortisol (flight-or-fight enhancers) but heightens endorphin levels (which relieve pain and give a sense of well-being). In the aftermath of the event, the endorphin levels decrease, often causing a person to feel emotionally flatlined. At the same time, the body often continues to release adrenaline and cortisol even long after the event, causing the person’s body to be on “high alert” and his or her brain to be “racing.”
Many people with PTSD, therefore, turn to alcohol because it can numb the “high alert” feeling and give the person a sense of wellbeing. Alcohol can compensate temporarily for the post-traumatic chemical imbalance. Indeed, studies have proven a correlation between PTSD and alcohol abuse. One study [link to article by Alcohol Research Current Reviews, including European Study of the Epidemiology of Mental Disorders] found that persons with PTSD were twice as likely to have co-occurring alcohol abuse than persons without PTSD.
Yet, the flipside of medicating symptoms with alcohol is that withdrawing from alcohol can make the post-traumatic chemical imbalance even worse than it was before. Thus, the trauma victim tends to begin drinking again, and at a higher level than before, trapping himself or herself in a vicious loop.
Treatment for Co-Occurring PTSD and Alcohol Abuse
The most effective treatment plans for persons with co-occurring PTSD and alcohol abuse combine the patient’s therapy into one coordinated plan. Many facilities treat these co-occurring disorders together. Often, the facilities use a combination of the following elements:
- Empirically proven brain-based PTSD treatments such as Eye Movement Desensitization and Reprocessing (EMDR) is designed to alleviate the distress triggered by traumatic memories. Current EMDR models often use not only visual but audio and sensory mechanisms to help reconnect the person’s “left brain” and “right brain,” allowing the PTSD victim to process past events in light of present reality. Unlike talk therapy, EMDR helps the victim by accelerating the victim’s intellectual and emotional processes rather from psychotherapeutic talk
- Physiological therapies such as Cranio-Sacral Therapy (CST) use massage and light touch to stimulate membranes and move fluids in an around the central nervous system. Doing so relieves tension, dissipates cortisol, and promotes a feeling of well-being.
- Physical exercise can be a highly effective part of recovery. Physical activity causes the release of endorphins, soothing depression and anxiety.
- Talk therapy, in coordination with EMDR, helps the person reframe past traumatic events, recognizing himself or herself as a person of strength and resilience rather than a person of vulnerability and fear. For instance, a rape victim might moves away from feelings of self-disgust and perpetual vulnerability to feeling, “I survived this event and I will move forward with enhanced strength and hope.”
- Substance abuse courses (1) explain medically the brain’s alteration by co-occurring PTSD and alcohol use, making the person significantly more susceptible to alcohol-related abuse or addiction; and (2) give the person coping mechanism to deal with post-traumatic temptations toward substance abuse.
- Small support groups help persons with co-occurring PTSD and alcohol abuse to share their experience, strength, and hope with one another.
A Christian Reflection on Co-Occurring PTSD and Alcohol Abuse
A faithfully Christian approach can and should incorporate healing mechanisms such as the ones mentioned above. Additionally, the Bible’s narrative of the world provides the framework within which a co-occurring person can make sense of what has happened, understand the present situation, make plans for the future, and launch or enhance their relationship with God the Great Physician.
The biblical story’s opening plot movement is Creation. When God created the world, he provided a stage upon which humanity could flourish. At the time of creation, there were no traumas and consequently no mental disorders. Neither PTSD nor alcohol abuse would have existed.
However, with the Bible’s second plot movement, the Fall, we see that human sin corrupted and misdirected God’s good world. Now his good world was disordered. Now, there would be traumatic events. Now, substances would be abused to medicate the pain.
Yet, as the Bible reveals in its third plot movement, Redemption, God’s promise to heal the world of its corruption. He is doing so right now through the Great Physician, Jesus Christ. And he will consummate the healing of his creation one day when Christ returns to make all things right.
A faithfully Christian approach, therefore, will combine instruction from God’s word with other forms of therapy. Doing so increases the chances that the person with co-occurring PTSD and alcohol abuse will achieve chemical balance and spiritual growth.
Thus, when we encounter a traumatized person who may be abusing alcohol, and who most likely is ashamed and increasingly isolated, we can recommend to them neither mere therapy nor mere biblical instruction but instead a powerful combination of the two.