Is It PTSD or Something Else? 6 Conditions That May Occur With the Mental Health Condition

Addiction and PTSD are commonly linked. They’re bidirectional, meaning there are high rates of substance use disorder (SUD) with PTSD because PTSD is a risk factor for developing SUD, and SUD is a risk factor for developing PTSD after a trauma.

Overall, research suggests about 45 percent of people with PTSD meet the criteria for an SUD. SUDs stem from the recurrent use of alcohol or drugs despite negative consequences. These may be disruptions in relationships or at school or work, and may also include other health problems that result from using substances. Examples of common SUDs are alcohol use disorder, tobacco use disorder, and opioid use disorder. SUDs can range from mild to severe.

“When people with PTSD [turn] to alcohol use or [drug] use, they might be trying to numb themselves from their problems and their trauma,” Dr. Emrani says.

Feeling an urge to self-medicate with drugs or alcohol is a key sign of an SUD. Substance use often worsens PTSD symptoms in a number of ways:

Interferes With Sleep People with PTSD may have sleep problems, so they may try to self-medicate with drugs or alcohol to help them sleep. However, self-medicating this way has the opposite effect: Drug and alcohol consumption can worsen sleep quality and exacerbate symptoms of PTSD.
Alters Mood PTSD can make people feel emotionally cut off from others, depressed, hypervigilant, and irritable — all symptoms that can get worse with alcohol and drug use.
Affects Concentration People with PTSD have difficulty concentrating, something that substance use can exacerbate.
Perpetuates the Cycle of Avoidance Substance use can increase avoidance of your feelings, which is a symptom of PTSD.

Elspeth Cameron Ritchie, MD, MPH, a psychiatrist at MedStar Washington Hospital Center in Washington, DC, says that many of the military veterans with PTSD she has worked with over the years engage in marijuana and alcohol use with the hope that the substances will help them better deal with their trauma.

“A lot of them don’t know where to turn … [they] are just looking for an escape from these [traumatic] experiences,” says Dr. Ritchie, who retired from the U.S. Army in 2010 as a colonel and has been working with veterans and members of the military for the past three decades.

Contrary to popular belief, however, veterans experience PTSD at about the same rate overall as the general population — 7 percent and 6 percent of people in each group, respectively, will experience the condition in their lifetimes. But research also shows that veterans are 2 times more likely to have an alcohol use disorder than others with PTSD. They’re also 3 times more likely to have either a drug use disorder or tobacco use disorder.

Where can you find help if you’re dealing with both PTSD and an SUD? Ritchie says your primary care physician is a good person to start with. If they can’t assist you, they can at least point you in the direction of a specialist who can. You may also consider seeking guidance or advice from a therapist who treats SUDs or even a religious figure, like a chaplain, rabbi, or priest, whom you may regularly turn to for advice.

People generally have improved symptoms of both SUD and PTSD when the conditions are treated together. A good treatment plan may involve individual therapy or couples therapy with a partner, support groups like Alcoholics Anonymous, or medications that can help you manage both conditions.

Given how variable PTSD and SUD symptoms can be, be sure to consult your doctor about the best way to move forward with treatment.

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