Veterans and Victims - Post Traumatic Stress Disorder May Lead to Addiction
War and disasters of all kinds, such as the 9/11 attacks and Hurricane Katrina cause mental anguish for their survivors, including what is becoming a common malady for veterans and natural disaster victims, Post Traumatic Stress Disorder, or PTSD. Left untreated, PTSD often results in drug and alcohol addiction, as victims struggle to cope with and self-medicate mental anguish.For those who have been victims of physical and mental trauma or abuse, as well as those whove witnessed trauma, assault or death, the significant mental anxiety or depression they experience may be transient PTSD if it lasts only for several months after the event(s). This is normal grief, and appropriate counseling may prevent the onset of PTSD, which occurs after at least three months following trauma exposure. Six months, or even years may pass before PTSD symptoms surface. At any given time, the percentage of Americans who suffer from PTSD is about four percent.
According to recent findings from the World Trade Center Health Registry in a published report of the NYC Health Department, one in eight World Trade Center rescue and recovery workers developed the disorder. PTSD is clearly showing up in returning Iraq war veterans, and the U.S. Department of Veterans Affairs has clearly acknowledged the link between drug and alcohol abuse and PTSD. Although such problems as substance abuse and anxiety disorders are widespread among veterans of both Afghanistan and Iraq conflicts, soldiers are often ashamed to admit mental health issues. A report by the American Psychological Association, the APA Presidential Task Force on Military Deployment Services for Youth, Families and Service Members, mental health needs for soldiers and their families are straining the current military mental health system.
We may not fully understand the impact of Katrina or 9/11 on its survivors for years to come, nor do we know the effects of trauma and chronic anxiety on Iraq and Afghanistan war vets, but 15 percent o 500,000 Vietnam veterans have been diagnosed with PTSD.
Experiencing PTSD
With PTSD, people often experience flashbacks, virtually reliving a traumatic event. Or people experience sleep disturbance, frequent bouts of anger or inability to concentrate. PTSD can result in a dis-association from reality, extreme mental anguish and inability to sustain work or relationships. In an effort to numb the disabling effects, a new disability, addiction to sedating drugs or alcohol often evolves.Victims of sexual abuse often experience chronic PTSD, and at the Hanley Centers Center for Womens Recovery, we have found that up to 80 percent of female patients recovering from alcohol or drug addiction have experienced abuse, usually sexual. Creating a safe gender-specific treatment environment has been the first step in reconnection for many.Victims of Hurricane Katrina are widely reported to suffer from PTSD, many of whom became despondent or turn to alcohol and drugs. PTSD affects every family of every victim. When PTSD becomes part of an addiction picture, the syndrome must be treated along with the disease of addiction.
Treatment for addiction with PTSD: create a safe environment.
In the first stages of primary addition treatment, it is imperative that a safe environment of care is established. As with the recent aftermath of a hurricane, immediately re-living the traumatic event(s) may exacerbate the situation. In a holistic treatment program, the Twelve Step philosophy is the foundation on which a multidisciplinary treatment program is built, treating mind, body and spirit.
The incidence of dual diagnosis, such as substance addiction co-occurring with anxiety disorders such as PTSD, depression or other mental health issues, is growing. A treatment program must be based on a physical and psychological assessment that takes into account the total person, for long term successful recovery, Treatment therapies for patients with co-occurring disorders like alcoholism and PTSD may include appropriate medications in an integrated approach with wellness therapies like yoga, meditation and aquatic exercise, and interactive and expressive therapies such as cognitive behavioral therapy and Motivational Interviewing (MI). With MI, patients are guided at their own pace to engage in their own recovery process. Art therapies from sculpture to painting and writing may help patients work through and express painful experiences in a healing process. Pet-assisted therapies have been found to help free patients to connect emotionally to another being, and to express affection and joy.
Addiction is a family disease, and coupled with chronic anxiety disorders, are likely to be disruptive and certainly difficult to understand. Often PTSD requires a long course of treatment, as well. The Family Program, which also incorporates a co-dependency program, is an educational experience that assists families of patients in understanding dysfunctional family systems and helps them to lean how to build healthy family patterns of interaction and support. Continuing care plans encourage support through ongoing Twelve Step program participation, and when appropriate, ongoing outpatient treatment, sometimes in combination with transitional living.
Alan Lyme, MSW, BSW, LCSW, CAP, is director of clinical practice improvement, Hanley Center, http://www.hanleycenter.org Find gender or age-specific treatment for recovery from addiction as well as prevention and family programs for all ages.
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