PTSD symptoms and alcohol-related problems among veterans: Temporal associations and vulnerability PMC
As much as 70 percent of the U.S. population has experienced at least one trauma, such as a traffic accident, assault, or an incident of physical or sexual abuse. Many people are able to cope with their traumatic experiences and do not suffer from prolonged consequences. For about 8 percent of the population, however, the consequences of experiencing trauma do not abate and may indeed get worse with time (Breslau et al. 1991; Kessler et al. 1995). The degree to which a person or animal can control a traumatic event is an important factor in understanding the impact of the event (Seligman 1975).
The link between PTSD and alcohol-use disorders
It’s a good practice to keep this list at the back of a notebook, allowing you to add to it over time. Initially, your “whys” might be rooted in the negative aspects of drinking – feeling low, disliking your behaviour when you drink, or financial concerns. However, as you make the adjustment to drinking less or going alcohol-free, you’ll notice a transformation in your “whys.” You’ll find yourself sleeping better, feeling more in control, and experiencing a deep sense of pride in your journey. They possess the expertise to guide you safely through the process of reducing your alcohol consumption while monitoring your well-being. And sometimes alcohol usage disorders are simply a comorbidity that appears alongside PTSD, without one necessarily causing the other. Blackouts involve complete memory loss caused by your brain’s inability to record new memories for a period of time due to the effects of excessive alcohol, substance misuse or some other condition.
PTSD and Alcohol Use: Functional Associations
Alcohol is a depressant, which means it can exacerbate PTSD symptoms such as anxiety and depression. If you’re struggling with alcoholism and PTSD, American Addiction Centers (AAC) can help you find treatment. Alcohol.org is a subsidiary of AAC, a nationwide provider of rehab centers. Ms. Tripp, Dr. McDevitt-Murphy, Ms. Avery, and Dr. Bracken report no financial relationship with commercial interests and, outside of the listed affiliations and acknowledged grant funding, we have no additional income to report. Within the past three years, Ms. Tripp has been employed by the University of Memphis and Department of Veterans Affairs. Ms. Avery has received funding from the University of Memphis and the Bureau of Prisons.
Prevalence in veterans
Some people with PTSD, such as those in abusive relationships, may be living through ongoing trauma. In these cases, treatment is usually most effective when it addresses both the traumatic situation and the symptoms of PTSD. People who experience traumatic events or who have PTSD also may experience panic disorder, depression, substance use, or suicidal thoughts.
What Causes Blackouts?
Sometimes people feel unable to talk about trauma, and alcohol can become a way to block out the pain. Alcohol-use disorders fall into the ‘avoidance’ category of PTSD symptoms, because often the person is using alcohol as a way to escape their memories. The term alcohol usage disorder covers a broad spectrum that affects individuals differently, and many don’t fit the conventional stereotype.
Reduced neurogenesis and a lack of neurotrophic support, such as that reflected in reduced plasma brain-derived neurotrophic factor (BDNF) levels, as well as increased stress hormones are consistent findings in stress-related disorders, including PTSD [29, 30]. It’s crucial to understand https://sober-home.org/what-is-alcohol-withdrawal/ that individuals who are clinically dependent on alcohol may face severe health risks if they abruptly cease drinking. If you find yourself experiencing symptoms such as seizures, trembling hands, excessive sweating, or hallucinations, these could be signs of clinical alcohol dependence.
Serious road traffic accidents constituted the most frequent trauma type and a substantial proportion of PTSD cases were attributed to this trauma type (Table 1). Fifty-six per cent of the participants reported a positive history of driving under the influence of alcohol. Events that most frequently resulted in PTSD were torture (53%), being threatened with a weapon/kidnapped/held captive (39%), and sexual assault (37%). Eleven patients (6%) satisfied the defined criteria for complex trauma PTSD. Activated innate immune response is also noted in other psychiatric disorders, such as major depression (MD) and bipolar affective disorder, which are often comorbid with PTSD [31].
For example, in a study with rats we found very modest increases in alcohol consumption on days when shocks were administered but dramatic increases in alcohol preference on subsequent days (Volpicelli et al. 1990). We termed this the “ happy hour effect” and have noted that even among social drinkers, alcohol consumption increases following, but not during, exposure to stress. These results were the opposite of what we expected based on a tension-reduction theory of alcohol use. If one uses alcohol solely to reduce anxiety, alcohol consumption should increase during times of stress rather than after the stress. The evidence suggests that there is no distinct pattern of development for the two disorders. Some evidence shows that veterans who have experienced PTSD tend to develop AUD, perhaps reflecting the self-medication hypothesis.
Similarly, women exposed to childhood rape often report turning to alcohol to reduce symptoms of PTSD (Epstein et al. 1998). In addition, investigators found that 40 percent of inpatients receiving treatment for substance abuse also met criteria for PTSD (Dansky et al. 1997). Ultimately, each veteran’s experience is unique, and there is no experience that you have to go through to be considered traumatized. If you find it hard to live with the aftermath of your service, particularly if you are engaging in blackout drinking or other unhealthy behaviors, you may be at higher risk of developing alcohol addiction due to an underlying mental health issue.
These neural structures are fundamental to emotional regulation and functional differences are linked to lability, trauma exposure, and PTSD (Bruce et al., 2012; Forster, Simons, & Baugh, 2017; Silvers et al., 2016; Simons, Simons, et al., 2016). Looking more specifically at facets of emotion dysregulation, PTSD symptoms had an indirect effect on alcohol-related consequences through Impulse Control Difficulties and Difficulties Engaging in Goal-Directed Behavior in the full sample. When we examined men and women separately, Impulse Control Difficulties remained significant only for men. Men with higher PTSD symptoms may have a higher level of impulsivity that leads to reckless behaviors such as risky alcohol use. It is important to note that urgency, or engaging in impulsive behaviors when experiencing negative affect, and impulse control difficulties are very similar constructs, and urgency may be higher in individuals with PTSD (Weiss, Tull, Anestis, & Gratz, 2013).
- People may experience a range of reactions after trauma, and most people recover from initial symptoms over time.
- This instrument has demonstrated reliability and validity in a similar setting to this study [45].
- Ms. Avery has received funding from the University of Memphis and the Bureau of Prisons.
- This study was carried out in eight institutions specialized for the treatment and rehabilitation of drug and alcohol-related problems in the Kathmandu and Lalitpur districts of central Nepal.
And from there, we can help you with recovery from residential alcohol treatment to ongoing, outpatient support. At Heroes’ Mile, you get a personalized care plan that uses compassionate, research-based therapies administered https://sober-home.org/ by veterans. Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe.
Whether the comorbidity between PTSD and AUD accompanies a neuroimmune profile that is predominantly proinflammatory in nature, and whether the added morbidity represents an aggravated proinflammatory state, remains unknown. Furthermore, it is unclear whether the correlates of comorbid PTSD in AUD are uniform across different countries and ethnicities. Tryptophan degradation along the kynurenine pathway by causing the release of neurotoxic metabolites is reported to be increased in stress-related psychiatric disorders [28].
Some people who either experience several traumatic events or continually reexperience the same event, as people with chronic PTSD do, will drink to reproduce the numbing effects experienced with increased levels of endorphins. The constant reexperiencing of the PTSD symptoms causes an initial increase in endorphin activity followed by a rebound withdrawal. One study conducted with Vietnam combat veterans with chronic PTSD showed that their alcohol use generally began after the onset of PTSD symptoms. For many of the patients, alcohol consumption continued to increase as their symptoms of PTSD increased (Bremner et al. 1996). Second, we used these residual scores as predictors in the analytic models. Each model included the 1-day lagged residual for the outcome (i.e., autoregressive effect).
The dataset pertaining to this study will be shared upon reasonable request. Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. Breaking the cycle of Alcohol Usage Disorders and PTSD requires acknowledging the problem and seeking help. By shedding light on the hidden link between Alcohol Usage Disorders and PTSD, we can guide individuals towards healthier choices and a brighter future.
Therefore, the interaction of co-occurring disorders is important to consider in otherwise heterogeneous psychiatric patient populations. Recently, Lindqvist et al. [32] reported that the inflammatory rise in PTSD among war veterans could not be explained by early life stress or depressive symptomatology, suggesting independent associations between immune activation and PTSD pathophysiology. Moreover, there is a dearth of knowledge on the relationships between PTSD and other psychiatric conditions in non-Western settings. To begin, two systematic reviews discuss the current state of behavioral (Simpson et al., 2017) and pharmacological (Petrakis & Simpson, 2017) treatments for comorbid AUD/PTSD. The consistent association between PTSD and AUD has led to debate about which condition develops first.
In the 1990s, more than 100,000 Bhutanese citizens of Nepali origin took refuge in Nepal [33]. Other circumstances, such as sex trafficking, natural disasters (mainly flooding, landslide, and earth quakes), adverse childhood events, as well as socioeconomic inequality are potential contributors to the PTSD burden in Nepal. A few studies from Nepal have reported the prevalence of PTSD among vulnerable groups, such as tortured refugees (14%), former child soldiers (55%), and victims of political violence (14%) [34] and human trafficking (30%) [35]. In a sample of patients admitted for treatment and rehabilitation of drinking problems in eight different institutions in Nepal, we reported sociodemographic, drinking-related and neuroimmune correlates of comorbid depression [36,37,38]. We identified positive associations between inflammatory cytokines and lifetime MD, but not recent symptoms of depression, in the AUD sample [20].
Combat exposure is a common source of trauma, and these wounds may not heal on their own. The VA estimates that 11-20% of the veterans deployed to Iraq or Afghanistan may have PTSD. These individuals are at higher risk to engage in unhealthy behaviors like blackout drinking, particularly if they are not receiving mental health support.
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