Helping Veterans Cope: Ptsd And Alcoholism

Alcoholism and post-traumatic stress disorder (PTSD) are prevalent issues among veterans. Alcohol is the most commonly misused substance among veterans, with nearly 23% of male veterans and 14% of female veterans engaging in binge drinking. PTSD, a severe anxiety condition, is often the result of a traumatic event, such as combat experiences or military sexual trauma (MST). Veterans with PTSD may turn to alcohol to cope with symptoms such as anxiety, depression, and insomnia. However, alcohol use can prolong and intensify PTSD symptoms, creating a cycle of co-occurring disorders. Addressing both conditions simultaneously through professional treatment is crucial for effective recovery.

Understanding the link between PTSD and alcoholism in veterans

Post-traumatic stress disorder (PTSD) and alcohol use often go hand in hand, with one increasing the risk for the other, leading to a destructive cycle. People with PTSD are more likely to abuse alcohol, and people who abuse alcohol are more likely to have PTSD. This connection is especially prevalent among military veterans.

PTSD is a severe anxiety condition that is often the result of a traumatic event. In the case of soldiers, PTSD generally occurs as a result of events witnessed during combat, such as explosions, gunfire, and grave injuries. The symptoms of PTSD are difficult to live with and tolerate, and many people with PTSD turn to alcohol as a way to cope with their symptoms. Drinking may provide momentary relief, but ultimately it makes the situation worse. Since alcohol is a depressant, drinking can exacerbate some PTSD symptoms such as anxiety, depression, and insomnia. When alcohol enters the body, it lowers serotonin and norepinephrine levels, which have been linked to depression. In veterans who suffer from mental health conditions, excessive drinking can make situations seem worse than they are, leading to an increased risk of self-harm or suicide.

Research has found that males expressed a biomarker that predicted alcohol use after trauma, and it is expected that females have a different biomarker yet to be discovered. Binge drinking is particularly prevalent among veterans with PTSD compared to other groups. A study found that those with combat experience were more likely to use alcohol to cope with PTSD symptoms. This finding could lead to more intensive substance use screening for patients with combat trauma.

Veterans are at risk of being diagnosed with co-occurring disorders, such as substance abuse and a mental health disorder. If left untreated, co-occurring disorders can lead to more serious health complications in the future. Seeking professional help from an alcohol treatment center is the safest and most effective way to overcome a drinking problem. Alcohol counselors can work with veterans one-on-one to identify any signs of PTSD and provide tools to prevent future triggers.

Treatment options for veterans with PTSD and alcoholism

Veterans with PTSD are at a higher risk of developing an alcohol use disorder. This can be attributed to various factors, such as military culture, exposure to trauma, stressors related to service or combat, and the challenges of reintegrating into civilian life. Binge drinking is a common issue among veterans, with nearly 23% of male veterans and 14% of female veterans engaging in this dangerous drinking pattern.

Veterans with PTSD may turn to alcohol to self-medicate or manage their symptoms, such as anxiety and depression. However, alcohol use can have detrimental effects on their mental health. As a depressant, alcohol lowers serotonin and norepinephrine levels, which can exacerbate PTSD symptoms, including anxiety, depression, and insomnia. It can also increase the risk of self-harm or suicide.

To effectively address PTSD and alcoholism in veterans, a comprehensive treatment approach is necessary, targeting both conditions simultaneously. Treatment options include:

• Cognitive-Behavioral Therapy (CBT): This therapy helps veterans identify negative thinking patterns and behaviours and teaches them how to live a healthier, substance-free life.
• Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a specialised therapy that assists individuals in resolving traumatic events and life experiences.
• Family Systems Theory: By considering the family as an emotional unit, this approach helps veterans find their place within the family dynamic after returning from service.
• Pain Management Groups: These groups address the physical injuries and pain resulting from military service, which can be a contributing factor to substance use.
• Twelve-Step Groups: Veterans can find free mutual support in groups like Alcoholics Anonymous (AA), which encourages members to admit their powerlessness over alcohol and create an alcohol-free life.
• Veteran-Specific Programs: Organisations like the American Addiction Centers (AAC) offer veteran programs that treat alcohol use disorder and co-occurring diagnoses, recognising the unique challenges faced by veterans.

The role of alcohol in exacerbating PTSD symptoms

Alcoholism is a significant problem among veterans. There is a strong bidirectional relationship between alcohol misuse and PTSD. PTSD can increase the risk of alcohol misuse, and alcohol misuse can worsen symptoms in people who already have PTSD. Further, when the initial problem is with alcohol, individuals may place themselves in dangerous situations that can lead to trauma, such as driving while intoxicated.

Alcohol use can have a detrimental impact on both active-duty and retired military personnel. For veterans suffering from PTSD, alcohol consumption can prolong and intensify symptoms. As a depressant, alcohol lowers serotonin and norepinephrine levels in the body. Serotonin is a chemical that affects mood, appetite, sleep, and memory. Norepinephrine, a stress hormone, controls how the body reacts to different situations and events. When levels of these chemicals decrease, the risk of depression increases. In veterans with mental health conditions, excessive drinking can distort their perception of situations, making them seem worse than they are. This distortion can lead to an increased risk of self-harm or suicide.

The symptoms of PTSD typically emerge within three months of a traumatic event but can develop much later. To receive a PTSD diagnosis, symptoms must persist for longer than a month and significantly impair one's ability to function normally. Symptoms include re-experiencing trauma through flashbacks, nightmares, and distressing thoughts, avoiding reminders of the traumatic event, persistent negative beliefs, ongoing feelings of fear and anger, a reduced interest in previously enjoyable activities, irritability, hypervigilance, and problems concentrating.

When PTSD and alcohol misuse co-occur, both conditions must be addressed and treated together. Seeking professional help from an alcohol treatment center is the safest way to overcome a drinking problem. Alcohol counselors can work individually with veterans to identify PTSD triggers and provide tools to prevent future triggers. Family therapy can also help in recovery from mental illness or addiction.

The importance of addressing both conditions simultaneously

It is important to address PTSD and alcoholism simultaneously as these two disorders commonly co-occur and can trigger each other, leading to a vicious cycle of relapse. If left untreated, co-occurring disorders can lead to more serious health complications in the future.

PTSD and alcoholism are interconnected, with alcohol often used to self-medicate the symptoms of PTSD. Alcohol may initially provide relief from anxiety, depression, flashbacks, sleep disturbances, and irritability associated with PTSD. However, as alcohol is a depressant, drinking can exacerbate PTSD symptoms over time, creating a cycle of worsening symptoms and increased alcohol consumption. This can lead to significant losses in various areas of life, including relationships and finances.

Treating both conditions together is crucial for effective and long-lasting recovery. Co-occurring treatment offers an integrated approach, targeting both disorders with specific therapies and medications. Psychotherapy, or talk therapy, helps individuals identify their emotions and triggers, develop healthier coping mechanisms, and manage symptoms of both PTSD and alcoholism. Medications such as SSRIs (e.g., sertraline, paroxetine, fluoxetine, and venlafaxine) are recommended for PTSD, while naltrexone, acamprosate, and disulfiram are FDA-approved for treating alcoholism. These medications can help reduce alcohol consumption and prevent relapse.

By addressing both PTSD and alcoholism simultaneously, veterans can develop the skills and strategies needed for recovery, improve their overall lifestyle, and reduce the risk of future relapse. This comprehensive approach to treatment ensures that all aspects of an individual's life are considered, providing the best chance for a successful and sustainable recovery.

Support groups and resources for veterans with PTSD and alcoholism

Support groups and resources are available for veterans suffering from PTSD and alcoholism. The US Department of Veterans Affairs provides a range of services, including:

• The Veterans Crisis Line: a confidential, free, and private service available 24/7 for veterans in crisis or emotional distress. This service can be accessed by calling 988 then pressing 1, texting 838255, or initiating an online chat on the Veterans Crisis Line website.
• The 24/7 Veteran Combat Call Center: veterans can call 1-877-WAR-VETS (1-877-927-8387) to speak with another combat veteran.
• Local support groups: the Vet Center homepage provides information on local support groups.
• VA Caregiver Support Line: offers services and support to family members caring for a veteran. Call 1-855-260-3274 or visit the VA Caregiver Support website.
• Peer support groups: veterans can connect with peers who have undergone treatment and are living in recovery from mental health conditions such as PTSD and substance abuse disorders.
• Residential (live-in) rehabilitation, peer support, and other programs at medical centers across the country.
• Free private counselling, alcohol and drug assessments, and other support at one of the 300 community Vet Centers.
• The National Helpline for Mental Health, Drug, and Alcohol Issues: a free, confidential, 24/7 referral and information service provided by SAMHSA for individuals and families facing mental and/or substance use disorders. Call 1-800-662-HELP (4357) or TTY: 1-800-487-4889.

In addition to the VA, other organizations also provide support and resources for veterans with PTSD and alcoholism:

• The PTSD Foundation provides counselling and networking services for veterans, as well as raising awareness about PTSD to better prepare families to deal with it. They support programs such as Camp Hope and Warrior Groups, and facilitate one-on-one mentoring and larger support groups.
• The ADAA provides information and resources for individuals struggling with anxiety or depression, including articles, a directory of therapists, and links to other organizations that may be beneficial to veterans and their families.
• Facebook groups and the PTSD Coach mobile app, provided by the VA, offer resources, articles, self-assessments, and support for veterans and their families.
• Vet Friends is an online search site that helps veterans reconnect with friends from their military days.
• The American Legion has served wartime veterans since 1919 and provides local chapters with youth mentoring programs, help with seeking benefits, an education center, a health center, and a career center to aid veterans in finding employment.

Frequently asked questions