Dual Diagnosis Treatment for Post-Traumatic Stress Disorder and Addiction

There’s no telling who will develop post-traumatic stress disorder (PTSD) in their lifetime, but the odds are very high that if you endure a traumatic event, you can develop the disorder. It can be something minor like a car accident that triggers the condition, causing them to be afraid of cars and avoid getting behind the wheel or being a passenger. It may be something more severe, such as sexual assault. For veterans returning from war, many are diagnosed with the condition and have significant challenges integrating back into society.

According to the National Center for PTSD, 6 percent of the population will develop post-traumatic stress disorder at some point in their lives. PTSD can be debilitating, and an estimated 12 million adults in the United States are dealing with the condition during a given year, accounting only for a small portion of those who have gone through a trauma. Many others won’t get help for PTSD, meaning these figures could be much higher. About 8 percent of women develop PTSD in their lives, compared to 4 percent of men.

What is Post-Traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that often occurs in those who experience or witness a traumatic event. These include a serious accident, natural disaster, war/combat, terrorist acts, rape, threatened with death, severe injury, or sexual violence. The severity in which you experience something is not an indicator of whether you develop the disorder. For some, something others might consider “minor” can wreak havoc, while others encounter something severe and don’t have lingering effects.

If you’ve ever heard the term “shell shocked” or “combat fatigue,” these are outdated terms previously used to describe PTSD. They were given after World War I and World War II. While PTSD does occur in a disproportionate number of combat veterans, it does happen in the general population as well. Latinos, African Americans, and Native Americans are three ethnic groups in the United States that experience PTSD more than non-Latino whites.

Those diagnosed with the condition will often experience intense and disturbing thoughts or feelings caused by the traumatic event. PTSD is known to cause them to relieve their experience through nightmares and flashbacks. It’s common to feel angry, fearful, and sad. Individuals with PTSD often detach themselves from others and isolate themselves because they think no one else can relate. Something like a loud noise or accidental touch can trigger them and cause adverse reactions.

A PTSD diagnosis requires that the person was exposed to a traumatic event, whether it’s indirect or direct. PTSD can occur in someone who learns about the loss of a family member or friend. However, it can also stem from repeated exposure to horrific scenes, such as one’s police officers or paramedics often endure.

How Trauma Shapes Us

Most people will experience traumatic events in their lives. However, most of us will recover and forget about it ever happening. Going through trauma isn’t rare, with six out of every 10 men and five out of every 10 women experiencing a traumatic event at one point in their lives. While men are more prone to experiencing physical assaults, accidents, combat, or witnessing injury or death, women are more likely to be the victims of sexual assault or child sexual abuse. PTSD can happen to anyone. If you’re concerned you’ve developed it, don’t think of it as a sign of weakness – it’s not. It’s something out of your control.

Trauma Experienced by Women

Trauma is extremely common in women, with 50 percent of women experiencing a traumatic event. Women experience trauma differently from men. However, both report similar symptoms of PTSD, including hyperarousal, avoidance, re-experiencing, and numbing. Some symptoms are more common for men than women.

These figures are much higher than the general population for those who serve in the military. When you serve your country, you’re exposed to various traumas the average person could never encounter at home. The war you served also affects your risk due to the specific types of trauma that were common. Training accidents, war zone deployment, and military sexual trauma also cause PTSD.

An estimated 11 percent to 20 percent of those who served in Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) have PTSD in a given year, with about the same for Gulf War (Desert Storm) survivors. However, those who returned from the Vietnam War experience PTSD at a much higher clip. An estimated 30 percent of veterans had PTSD in their lifetime. While military combat is enough to cause anyone to develop the condition, military sexual trauma is also another factor. Studies show that 23 percent of women reported sexual assault while in the military.

Gender-Based Violence

Many women experience trauma at some point in their lives, often linked to gender-based violence, abuse, or significant life events. Studies show that women are disproportionately affected by sexual assault, domestic violence, and childhood abuse, which can leave lasting psychological and emotional scars. Trauma may also arise from medical complications, loss, or systemic inequalities that impact safety and well-being.

These experiences can contribute to mental health challenges such as anxiety, depression, or post-traumatic stress disorder (PTSD), and in some cases, may lead to self-medicating with drugs or alcohol. Understanding the unique ways trauma affects women is an important step toward providing compassionate, gender-responsive care and support.

Symptoms of PTSD

If you develop PTSD, symptoms often occur within three months of the event. However, a person can go an entire year before the symptoms begin in some cases. If you have PTSD, the duration and severity of your symptoms will vary from one person to the next. Some people can recover in as little as six months after the incident, while others can battle it for years.

According to WebMD, PTSD symptoms are grouped into four main categories.

Reliving

Those diagnosed with PTSD repeatedly relive their nightmare ordeal through thoughts and memories. These include hallucinations, flashbacks, and nightmares. They’ll experience significant distress when they encounter something that reminds them of the trauma, including driving by the scene or the anniversary date of the event.

Avoiding

Individuals with PTSD will avoid places, people, situations, and even thoughts that cause them to remember the trauma. It can lead to feelings of isolation and detachment from their friends or family. They might also lose interest in activities that once brought them joy.

Increased Arousal

Increased arousal refers to problems related to others, increased emotions, inability to feel or show affection, fall or stay asleep, and irritability. They might also have outbursts of anger, startle easily, and have trouble concentrating. Physical symptoms can also occur, including rapid breathing, increased heart rate, and blood pressure, nausea, vomiting, diarrhea, and muscle tension.

Negative Cognitions and Mood

This refers to estrangement, thoughts, and feelings caused by blame and memories of the traumatic event.

Causes of Post-Traumatic Stress Disorder

We all react to trauma differently. For example, think back to a time you were in the car with friends or family. If an animal suddenly jumped in front of the vehicle, there was likely one friend who screamed while others were silent but reacted later. We’re all unique in how we manage our stress, fear, and threats caused by a traumatic situation. Based on the scenario above, not everyone who witnessed the accident will develop PTSD. The type of support and assistance someone gets from their friends, family, and professionals following the incident will also impact the development of PTSD or how severe the symptoms could become.

Post-traumatic stress disorder first came to the attention of doctors and the medical community by veterans returning from war, which is where the terms shell shock and battle fatigue syndrome stem. Those abused as children or are repeatedly exposed to life-threatening situations are at increased risk of developing the condition. Physical and sexual assault victims have the highest risk of developing the disorder.

While those at the highest risk are likely to be physical and sexual assault victims, you’re more likely to develop the condition after a traumatic event if you have a history of mental health issues, have relatives with mental health issues, or have a history of abusing drugs or alcohol.

What Happens After Trauma?

After the trauma occurs, individuals are likely to feel depressed, start drinking or using drugs, or develop post-traumatic stress disorder. As was mentioned earlier, women are twice as likely to develop the condition than men. Ten percent of women will develop PTSD compared to 4 percent of men. What puts women at a higher risk? Well, there are several reasons. These include the following:

• Women are more likely to be the victims of sexual assault.
• Women are more likely to blame themselves for the trauma than men.
• Sexual assault is more likely to cause PTSD than other events.

A survivor’s immediate reaction, is complicated and affected by their own experiences, natural supports and healers, their coping skills, and the response of the community. The reaction to the trauma will range in severity. However, even the most acute responses are only natural responses used to manage what the person endured. Coping styles can vary from emotionally expressive to action-oriented. In the past, clinicians believed expressing the emotions caused by the trauma was necessary. However, those who don’t process their trauma are as healthy as those who do.

In addition to depression, the initial reactions to trauma can include anxiety, sadness, confusion, exhaustion, dissociation, numbness, and blunted affect. Bear in mind that these responses are normal, and most survivors are socially acceptable, effective, and self-limited. More severe responses include prolonged stress without any calm or rest, severe dissociation, and intrusive thoughts, despite returning to safety. Delayed reactions to trauma include avoidance of emotions, anxiety, depression, insomnia, nightmares, and persistent fatigue.

Emotional

Emotional reactions to an incident will vary from one person to the next and are influenced by the individual’s history. Beyond the initial response, the most likely to boil to the surface are sadness, anger, fear, and shame. However, it’ll be hard to identify these feelings in the earliest stages, which could stem from a lack of experience with prior exposure to emotions in their family. They could deem these feelings of past trauma dangerous and can lead them to feel like they’re going crazy. Others might deny they have any feelings associated with their experience and be numb or lack emotion.

Physical

To be diagnosed with PTSD, an emphasis is placed on psychological symptoms, but as was mentioned above, everyone reacts differently. For some, they might present physical symptoms, and there is a connection between trauma and adverse childhood experiences. The most common physical disorders include gastrointestinal problems, sleep disturbances, cardiovascular issues, neurological problems, respiratory, musculoskeletal, urological, and substance use disorders.

Behavioral

The reactions to trauma vary. Many people will engage in behaviors to manage the after-effects, the intensity of their emotions, and the distressing aspect. Many will reduce their tension through self-medicating, avoidance, overeating, or self-harm. Others will attempt to gain control over the situation through aggression and reenacting the aspects of their trauma.

Some people find healthy ways to cope and heal from their trauma. They reevaluate their values and discover what’s important after a trauma. These responses include the following:

• Revised priorities
• Bonding with family members and the community as a whole
• Redefining their sense of purpose and meaning in the world
• Increased volunteering or donating time to charity
• Increased commitments to personal missions

How is Post-Traumatic Stress Disorder Diagnosed?

You will not receive a PTSD diagnosis until one month has passed since the trauma occurred. If PTSD symptoms are present, your doctor will evaluate you by performing a complete medical history, coupled with a physical exam. No lab tests are available to determine if you have the disorder, but doctors will use these tests to determine if there’s another root cause of your symptoms.

If no physical illness is present, you’ll be referred to a psychologist, psychiatrist, or other mental health professionals trained to diagnose and treat mental health conditions. They will use specific tools to evaluate you for PTSD and other psychiatric disorders. They will then decide if the symptoms indicate PTSD. If you’re diagnosed with the condition, it means you’ve had symptoms present for a month or longer.

Eventually, drugs won’t work anymore, and the thought of suicide can get even louder in your mind.

Post-Traumatic Stress Disorder and Suicide

Each year in the United States, an estimated 40,000 people die by suicide. It’s a disturbing statistic and provides a glimpse into the mind of how much suffering someone is going through. We must remind you that, no matter how alone you might feel, someone is here to listen to you. Even if you feel like you don’t have friends or family, there is a stranger out there ready to listen, be your friend, and perhaps become like family. However, suicide is a reality for those battling PTSD. Please contact the Suicide Prevention Lifeline at 1-800-273-8255 if you’re considering hurting yourself.

Statistics show that men are more likely to die by suicide than women. In a survey of people across the United States, those who experienced physical or sexual assault had a higher likelihood of attempting to take their own life. Almost 22 percent of those who had been raped attempted suicide. Those diagnosed with PTSD are also at a greater risk of suicide. About 27 percent have attempted suicide, and 24 percent of military personnel have experienced suicidal thinking in the past year.

While it may seem like there is no hope out there and that PTSD has had a tremendous impact on your life to which no treatment exists, that’s not true. Fortunately, recovery and healing are possible.

Post-Traumatic Stress Disorder Treatment

The objective of PTSD treatment is to reduce the physical and emotional symptoms you might be going through. It’ll also help you improve daily functioning and teach you how to manage the triggers you experience. PTSD treatment includes a combination of medication and psychotherapy.

Medication

For some, psychotherapy alone won’t be enough, and medication may need to be used. Doctors will use antidepressant medications to manage your PTSD. It is not something you’ll need to take forever. However, it will be important in the short term to help you gain control back of your life. The most common medications used include:

• Selective serotonin reuptake inhibitors (SSRIs), including Zoloft, Celexa, Luvox, Prozac, or Paxil
• Tricyclic antidepressants, including Doxepin or Elavil
• Mood stabilizers, including Depakote or Lamictal
• Atypical antipsychotics, including Seroquel or Abilify
• Prazosin to control nightmares
• Clonidine to induce sleep
• Propranolol to minimize new traumatic memories

Tranquilizer drugs like Ativan or Klonopin should not be used as they have not been found to be helpful. These are also more likely to cause physical dependence or addiction.

Psychotherapy

Therapy has evolved way beyond the stereotype we think of it as, and psychotherapy for PTSD can help bring you peace of mind. Therapy will also teach you about PTSD and develop new ways of coping that don’t involve drugs or alcohol. It can help you work through the fears attached to the event and hopefully, give you the ability to get in a car again or face the trauma head-on. The most common psychotherapy approaches include the following:

• Cognitive-Behavioral Therapy (CBT)
• Prolonged Exposure Therapy
• Psychodynamic Therapy
• Family Therapy
• Group Therapy
• Eye Movement Desensitization and Reprocessing (EMDR)

While nothing is perfect, a combination of these can help you immensely. Remember, you can’t get better without putting yourself out there and accepting help. You don’t need to suffer another day.

Dual Diagnosis Treatment for Post-Traumatic Stress Disorder and Addiction

Post-traumatic stress disorder (PTSD) and addiction often occur together, creating a challenging cycle that requires specialized care. Many individuals turn to drugs or alcohol as a way to numb painful memories, intrusive thoughts, or the intense emotions associated with trauma. While substance use may provide temporary relief, it ultimately worsens symptoms over time, making both the PTSD and addiction more severe. Dual diagnosis treatment recognizes this complex relationship and focuses on addressing both conditions at the same time rather than treating them separately.

Therapy

In a dual diagnosis program, individuals receive trauma-informed care that provides a safe and supportive environment to process their experiences without judgment. Evidence-based therapies, such as cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and exposure therapy, are commonly used to help patients manage triggers and reframe traumatic memories. At the same time, addiction treatment strategies—like medical detox, relapse prevention planning, and peer support—work to stabilize recovery and reduce reliance on substances as a coping mechanism.

Support

An integrated approach is crucial because treating only the addiction without addressing the underlying trauma often leads to relapse, while focusing solely on PTSD can leave substance use unchecked. By combining trauma therapy with addiction recovery, dual diagnosis treatment helps individuals build healthier coping skills, improve emotional regulation, and create a solid foundation for long-term healing. This comprehensive care empowers patients to move beyond the cycle of trauma and addiction, offering the chance to reclaim control over their lives.

Our team is here to guide you through every step of your recovery journey, offering hope, healing, and long-term success.