What Is the Connection between PTSD and Alcohol?

Many individuals who have been exposed to an extremely traumatic or life-threatening event develop symptoms of anxiety commonly related to post-traumatic stress disorder (PTSD). Although military combat is often associated with PTSD, traumatic events also can include sexual or physical assault; serious accidents; terrorist attacks; or natural disasters, such as earthquakes, fires, tornados, hurricanes or floods. PTSD and alcohol abuse are commonly paired. The likelihood varies depending upon the nature and severity of the traumatic event, but research shows that a person experiencing PTSD symptoms is much more likely to abuse alcohol. Drinking alcohol might blot out PTSD-related anxiety for a short time, but chronic alcohol intoxication usually makes PTSD symptoms worse.

During a traumatic event, most people feel strong emotions. A person might fear for his or her life when forced to witness things that are horrific. Someone in the throes of a life-threatening event is more likely to feel helpless and to feel a loss of control over his or her own life.

For many people, these strong emotions subside after the event, and the natural post-traumatic anxiety dissipates with time. The PTSD sufferer, however, can develop symptoms weeks, months or even years after the traumatic event, and these anxiety-riddled symptoms typically get worse, not better, as time passes. PTSD symptoms might include episodes of reliving the event, flashbacks, trouble concentrating, angry outbursts or sleeping disorders such as insomnia or nightmares. He or she might also consciously or unconsciously avoid anyone or anything that might trigger memories of the traumatic event. Some PTSD sufferers find little joy in activities that they might have enjoyed before and might be unable to have positive or loving feelings toward other people, which causes them to avoid relationships altogether.

People who have PTSD often have other problems along with their PTSD symptoms, such as employment instability, physical ailments or feelings of shame or despair, but the most common co-problems are alcohol or drug abuse. Alcohol, in particular, is used by many PTSD sufferers to alleviate or at least to tamp down their PTSD symptoms. Although some people who have PTSD are chronic alcoholics or daily drinkers, studies have shown that a disproportionate number are binge drinkers. PTSD binge drinkers are reactive; they drink large quantities of alcohol as a direct response to a triggered re-experiencing episode.

On the surface, PTSD and alcohol might seem like a problem-solution pairing, but the relationship actually is problem-problem. The PTSD drinker might consume alcohol to calm his or her hyperaroused nerves, but the result is only a temporary alcohol-induced numbness, at best. A PTSD sufferer might self-medicate with alcohol to sleep, but drinking alcohol actually results in sleep that is less restful or refreshing. Using alcohol is another form of avoidance, making alcohol a figurative co-conspirator with other PTSD symptoms.

Rather than curing anything, when PTSD and alcohol are mixed, problems are compounded. The combination of PTSD and alcohol causes emotional wounds to fester, not heal. Although alcohol might temporarily relieve PTSD symptoms, alcohol withdrawal can increase and intensify such symptoms. In this way, the PTSD sufferer is trapped in a vicious cycle — he or she must continue to drink to avoid the intensification of PTSD symptoms following an alcoholic binge. Of course, alcoholism brings with it its own set of health and social problems, and many of them are just as bad if not worse than those of PTSD.

The successful treatment of PTSD-alcohol comorbidity requires that both problems be treated together, or at least simultaneously. Treatment most often includes education, therapy, medication and support groups. Research has shown that cognitive behavioral therapy (CBT), especially exposure therapy, is the most effective type of counseling for the treatment of PTSD. Cognitive therapy brings the traumatic incident to the surface and exposes it so that the memory of it can fade.