Drug Use among Those with Complex Post-Traumatic Stress Disorder
What Is Complex Post-Traumatic Stress Disorder?
Complex post-traumatic stress disorder (CPTSD) is a more involved form of PTSD that may occur in people who repeatedly experience trauma. In addition to feeling many of the same things as people with PTSD, those with complex PTSD (CPTSD) may experience changes in how they respond to stress or how they see themselves.
Complex PTSD is usually seen in people who have survived the following (usually for long periods of time):
- Child abuse
- Child exploitation
- Domestic violence
- Concentration camps
- Wartime imprisonment
- Sex trafficking or brothel work
Some common PTSD symptoms include:
- Re-experiencing symptoms: This involves re-experiencing the trauma in the form of flashbacks, physical reactions, nightmares, and stressful memories or thoughts.
- Difficulty relaxing: This can be in the form of insomnia, lack of focus, anger, or irritability. This state of mind is known as hyperarousal, and it keeps a person excessively alert.
- Emotional detachment: Some people refuse to discuss what triggers them, and they may even avoid places or people that remind them of the trauma they have experienced.
- Mental health issues: This may include the development of phobias or depression.
- Physical symptoms: These may include headaches, pains in the chest area, dizziness, or stomach pains.
People with complex PTSD suffer from the above symptoms, but they usually also experience additional symptoms.
- Changes in beliefs: One may lose their faith or change their entire moral code.
- Disturbing thoughts: Some people may experience disturbing thoughts about the person who wronged them. They may have an increased desire for revenge and give that person more power over them in later recounting of events.
- Changes in their self-concept: The victim may feel guilty, helpless, or different from other people.
- Emotional changes: Some people may feel extremely angry, repressed, depressed or sad, or suicidal.
According to a 2015 study published in Clinical Psychological Science, between 0.6 percent and 13 percent of military veterans who have been exposed to trauma may suffer from CPTSD. Some things can make CPTSD more severe, such as:
- Trauma happened during childhood.
- A parent or trusted adult was the person responsible for the trauma.
- The person responsible for the trauma is still in contact with the victim.
Effects of CPTSD
The most prevalent effect of complex PTSD is feeling intense anxiety when remembering the event at hand. Again, those suffering from CPTSD may feel that they are reliving the traumatic event, and they may often think of the trauma despite their desire to not focus on it.
A person may completely change their life after a series of traumatic events. That is, they may change their behaviors, belief systems, and self-perception.
Complex PTSD often presents differently in men and women. As mentioned in Medscape, men are slightly more likely to experience trauma than women; however, about half of all women experience a traumatic event in life, and most often, this trauma involves sexual assault. While not all women who experience trauma develop PTSD, it is more likely to develop in women who have survived trauma than in men.
One common issue that is often diagnosed with PTSD or CPTSD is misuse of alcohol. In addition, CPTSD is often connected to mental health illnesses, misuse of other substances, and a need for healthcare.
Many existing treatments for PTSD can also treat CPTSD effectively.
- Therapy: This can be done individually or as part of a group. Cognitive Behavioral Therapy (CBT) can provide tools for people with CPTSD to deal with their grief and triggers. It can also help people strengthen their relationships with friends and loved ones.
- Medication: Some medication that is traditionally used for depression can help people with CPTSD. These are best used along with therapy, and they may be used in the short-term until individuals can learn how to deal with underlying issues.
- Eye Movement Desensitization and Reprocessing (EMDR): Used for PTSD, this technique can also assist people with CPTSD. EMDR helps people process traumatic events. It involves thinking about a past trauma and moving their eyes along with a therapist’s hand motion.
CPTSD and Misuse of Substances
Though we still need more data on CPTSD and substances, the National Center for PTSD has a lot of data on PTSD and the use of alcohol and drugs. Living with PTSD may contribute to problems with drinking. Some illuminating statistics about drinking and PTSD are:
- Up to 30 percent of people who have survived accidents, disasters, or ailments report issues with drinking.
- Up to 75 percent of people who have experienced violence or abuse also have drinking issues.
- Vietnam veterans who seek treatment for PTSD report drinking issues 60–80 percent of the time.
Dissociation interrupts self-awareness, memory, identity, and consciousness. These interruptions can cause a person not to remember certain things and cause people to feel a break in their personality. Some PTSD and CPTSD sufferers may use dissociation as a way to cope with trauma.
Some common signs of dissociation caused by CPTSD and PTSD are:
- Inability to remember certain events
- Losing touch with certain life events
- Experiencing unwanted flashbacks
Even more severe symptoms can include:
- Derealization (feeling that one’s surroundings aren’t real)
- Depersonalization (feeling that one’s thoughts and feelings aren’t real or that they belong to someone else)
Some risk factors for people who experience these more severe symptoms are:
- Experiencing trauma repeatedly
- Being male
- Dealing with other mental health issues
- Having a disability that causes many daily obstacles
More research needs to be conducted on the prevalence of CPTSD and dissociative identity disorder (DID). The Australian and New Zealand Journal of Psychiatry reports that DID may be present in up to 1 percent of the general population.
According to a paper published in Depression and Anxiety, about 20 percent of people who suffer from PTSD self-medicate with substances in order to deal with its symptoms and their past trauma. This results in a lower quality of mental health, and it increases the risks of suicide ideations and attempts. Still, the report emphasizes the need for additional research on self-medication and PTSD.
Though some people with PTSD may use prescription or illegal drugs in order to cope with symptoms of PTSD, many use alcohol. One theory on the link between alcohol and PTSD is that alcohol might release endorphins that help an individual feel better.
Treating CPTSD and Drug Abuse
According to the National Institute of Drug Abuse, using an integrated approach can help people dealing with co-occurring substance abuse and mental illnesses, such as CPTSD. Up to 6 out of 10 users of illegal or illicit drugs may also be dealing with mental health issues.
According to the Substance Abuse and Mental Health Services Administration, there are ways to recover from both a mental health ailment and drug abuse.
- Supportive services: Case management can help people find work and housing, and help them meet their goals.
- Therapy: This can include behavioral treatment or talk therapy. It can take place individually or in groups.
- Medical detox: Detox can help people deal with withdrawal symptoms and successfully stop using drugs.
Where to Find Help
In order to treat both CPTSD and substance use disorder, individuals should look for centers that take a comprehensive approach to dealing with physical and mental health. It’s important that doctors, nurses, case managers, and social workers are on staff. Any program — whether inpatient or outpatient — should be accredited and have a license.
It’s important that treatment facilities have services available right away because people who deal with mental health and substance abuse issues may change their minds quickly and decide against treatment. As soon as the person agrees to get treatment, they should enter a program.
- Treatment needs to deal with the whole person, not just the addiction or mental health issue.
- Treatment needs to be customized because everyone does not respond to one form of treatment the same way.
- Clients must remain in treatment for the right amount of time. Follow-up care is important to a sustained recovery.
- Care providers should assess and modify treatment as necessary, according to the person’s progress and needs.
Support from family and friends is critical to a successful recovery process. During treatment, providers will encourage clients to build a strong support system. This will consist of people the individual can turn to for encouragement and support when they are facing temptation to relapse.
While there is no cure for CPTSD or addiction, both disorders can be managed with long-term care.