Substance Use

PTSD, Trauma, and Substance Abuse Counseling

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When people go through really difficult events, they might get PTSD. PTSD can cause someone to keep having flashbacks, feel super anxious all the time, have nightmares, or repeated thoughts about what happened. (1)

Trying to deal with these hard feelings and memories, some folks might start drinking or using drugs to try to feel better. Unfortunately, this can turn into a substance abuse problem where they depend on these substances too much and need help to stop. (1)

To truly help someone heal from these issues, a special plan must be created that fits their specific needs. It’s also important for them to have support from a team of caring experts who know a lot about both trauma and addiction. This kind of support can lead to real healing and give someone the strength to overcome addiction while dealing with past traumas.

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What are Post-Traumatic Stress Disorder and Trauma?

Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition that may develop in individuals who have experienced or witnessed a traumatic event, such as natural disasters, serious accidents, war/combat situations, or other violent personal assaults. (2)

This condition involves having very upsetting thoughts and feelings about what they went through that stick around long after the event is over. People with PTSD might keep reliving the trauma in their minds through flashbacks or bad dreams; they often feel sad, scared, or mad, and might feel disconnected from others.

Those with PTSD may steer clear of places or people that bring back memories of the trauma and can have a big reaction to common things like a loud sound or someone accidentally bumping into them. This issue can really affect how well they manage day-to-day life—in their social circles, at work, and on a personal level.


Diagnosis involves exposure to one or more events involving death, threatened serious injury, sexual violence, or direct experience, witnessing, or learning about a close family member or friend’s exposure to actual or repeated extreme details of these events. 

Not everyone develops PTSD after trauma, as there are risk factors that increase the likelihood, including having little support in the aftermath, experiencing additional stressors, subsequent traumas, or pre-existing mental health conditions. (4)


Treatment typically includes psychotherapy, medications, and cognitive-behavioral therapy (CBT).

CBT, in particular, is an effective type of therapy for helping patients process and confront emotions and memories. Eye movement desensitization and reprocessing (EMDR), a newer form of therapy, has been shown to reduce symptoms. (3)

Exposure therapies aim to teach coping skills effectively, reducing avoidance behaviors and improving emotional regulation. Medications such as antidepressants can help manage concurrent depression and anxiety and are sometimes used alongside therapeutic interventions.

Signs and Symptoms of Trauma and PTSD

We know now that PTSD and substance abuse are linked. Many people with this and other forms of trauma are seeking safety, but without knowing how to treat PTSD, they may turn to alcohol or drugs.

Whether the incidents come from childhood or are more recent, unresolved trauma can register both in the body and behavior.

Some signs of trauma and PTSD include: (4)

  • Fatigue
  • Depression
  • Panic attacks
  • Anxiety
  • Guilt
  • Detachment
  • Dissociation
  • Low self-esteem
  • Flashbacks 
  • Sleep disturbances, including nightmares
  • Self-harm
  • Avoidance of triggers
  • Physical pain and/or chronic illness
  • Suicidal thoughts and behaviors
  • Substance use or abuse

The good news is that trauma can be treated. Someone who is dealing with trauma or PTSD has the potential to overcome it with the right approach.

What Causes Post-Traumatic Stress Disorder?

Post-traumatic stress disorder is a chronic disorder that can arise after any kind of trauma. While it is most often associated with those in the military, you don’t have to go to war to develop this condition. (5)

Some people who have post-traumatic stress disorder have gone through serious medical problems or sexual assault. Others have been in automobile accidents or witnessed a major traumatic event. 

Those who develop PTSD have almost always gone through an event that involved or threatened a sexual violation, serious injury, or death. They may have seen the event, heard it, or learned about it in another way. (6)

As for what causes the prolonged symptoms of PTSD, there is still much research to do. Researchers and doctors believe that the reason some people develop this condition is because of a complex mix of issues, such as:

  • Having lived through stressful experiences throughout their life
  • Inheriting mental health issues from family members, like anxiety or depression
  • Not having a good balance of the chemicals in the brain predisposes a person to PTSD
  • Having an anxious or timid temperament

There are some risk factors for PTSD that you should be aware of. These may include:

  • Experiencing an intense or long-lasting trauma
  • Having a diagnosed mental health condition, such as anxiety or depression
  • Having a history of substance use disorders
  • Having a job that exposes you to traumatic events, like working in the military or emergency room
  • Having a history of childhood abuse
  • Having relatives with mental health conditions

Some of the common traumatic events that tend to trigger PTSD include:

  • Physical assaults
  • Sexual violence
  • Accidents, like auto accidents or work accidents
  • Childhood physical abuse
  • Exposure to combat
  • Being threatened with a weapon

Not everyone who experiences these traumatic events will go on to develop PTSD. Some will be able to process the trauma and move forward with support.

Others will develop chronic symptoms of stress and have a hard time processing what happened to them.

This may lead to self-medicating with drugs or alcohol, which can then lead to a substance use disorder. It’s also possible to develop suicidal thoughts, eating disorders, and other health issues as a result of untreated PTSD. (7)

Military and Veterans with PTSD

Military veterans and personnel are uniquely susceptible to Post-Traumatic Stress Disorder (PTSD) due to the high-risk environments they operate in, which often involve exposure to life-threatening situations, violence, and loss. 

PTSD among veterans is characterized by symptoms that mirror those found in the general population but can be intensified by the specific nature of military combat and service. (8)

The path to diagnosis and treatment for military members and veterans with PTSD requires an understanding of both the common manifestations of the disorder as well as the prevalence of aspects unique to their experiences. The U.S. Department of Veteran Affairs does offer some assistance. 

Symptoms for many American veterans show evidence-based effects such as:

  • Recurring flashbacks
  • Nightmares about combat or traumatic events
  • Heightened reactivity or hypervigilance
  • Feelings of isolation and alienation
  • Intense guilt given the context of operations, where split-second decisions could mean the difference between life and death
  • Profound sense of betrayal if they believe their sacrifices were not recognized or understood by civilian society

Treatment methods should consider the unique cultural and military values that focus on strength and resilience. This means creating plans that respect the importance of structure and discipline but also allow room for showing vulnerability and starting to heal. 

Important therapy techniques include:

  • Trauma-focused cognitive-behavioral therapy (CBT)
  • Prolonged exposure (PE) therapy
  • Eye movement desensitization and reprocessing (EMDR).

These have all been effective in helping veterans reduce their symptoms. (9)

Also, support groups are a great help. They let people talk about their experiences in places like Iraq or Afghanistan and the struggles of adjusting after service with others who really get what it’s like.

Care plans bring together different services to tackle issues that often happen at the same time—like substance abuse, depression, and anxiety disorders. It’s very important to make mental health services easier for veterans to access through special programs aimed at them. 

This can help overcome the challenges and negative views that might stop someone from asking for help.

Why Is There a Connection Between PTSD, Trauma, and Substance Abuse?

There are three hypotheses about why PTSD, trauma, alcohol use, and drug addictions are linked. These include: (10)

  • The self-medication hypothesis suggests that people with PTSD use substances to either cope or try to mitigate and manage their symptoms.
  • The susceptibility hypothesis, which states that people who use substances are actually more likely to develop post-traumatic stress disorder after being exposed to trauma
  • The high-risk hypothesis suggests that people who abuse substances are likely to experience higher rates of trauma because of substance abuse and their lifestyle choices. 

Since there is a connection between PTSD, trauma, and substance abuse, these diagnoses need to be treated simultaneously. Co-occurring disorders tend to have poorer treatment outcomes, especially when only one issue is treated while the other is not. 

Addressing Trauma And Substance Abuse

At first, alcohol and drugs might seem like they help dull the tough emotions and bad feelings linked with trauma and PTSD. However, using these substances as a way to cope can quickly turn into a problem of substance abuse. (11)

People dealing with depression caused by their traumatic experiences might start using stimulants like cocaine or methamphetamine to lift their mood. Meanwhile, some may use alcohol or benzodiazepines in an attempt to calm their anxiety.

Individuals dealing with unresolved trauma and PTSD often feel like things are spiraling out of their control. Turning to substances is a way they try to handle these overwhelming feelings.

However, relying on addictive substances can create more issues, such as addiction itself, which can make the symptoms of trauma worse. Additionally, the risky behaviors that often accompany addiction might result in new traumatic experiences, trapping someone in what feels like a never-ending cycle.

In America, around 30.5  million people 12 and older struggled with a substance use disorder in 2017. Around 70 percent of all adults in the country report that they have gone through a traumatic experience of some kind at least once in their lifetime. (12)

Sadly, about 5 percent of individuals with post-traumatic stress disorder also end up meeting the criteria for substance abuse disorders. Falling into a cycle of trying to dull the symptoms of trauma is all too common, underscoring the importance of exploring all available treatment options at specialized centers.

Substance Abuse Counseling for Trauma and PTSD

Substance abuse counseling for individuals grappling with trauma and PTSD is a critical component of the recovery process, designed to address the complex interplay between traumatic experiences, their psychological aftermath, and resultant substance use disorders. 

Trauma can elicit a range of distressing symptoms, such as:

  • Flashbacks
  • Severe anxiety
  • Hyperarousal states—feeling perpetually on edge
  • Avoidance behaviors that significantly disrupt daily life (13)

In an attempt to mitigate these overwhelming sensations and regain some semblance of control over their emotional state, many individuals may resort to alcohol or drugs as self-medication tools.

This form of coping not only fails to address the root cause—the unresolved trauma—but often compounds problems by leading down a path towards dependency and addiction. The cycle becomes increasingly detrimental; substances might temporarily numb painful memories and emotions but also impair the ability to engage effectively in therapeutic interventions aimed at healing.

Additionally, repeated substance use in response to stressors exacerbates the risk of developing chronic health issues beyond the original PTSD diagnosis.

These include:

  • Liver disease
  • Heart conditions
  • Mental health disorders 

Treating PTSD, Trauma, and Substance Abuse

We believe that while treatment of PTSD and substance abuse treatments are vital, it’s necessary to make sure you’re physically stable first. Most of the time, individuals begin with the detox treatment program so they can eliminate the substances from their systems.

The length of time detox takes will depend on the substances that have been used. 

Alcohol detox could take as little as one to three days with treatment or several weeks when left without treatment. The severity of withdrawal symptoms will depend on how often you were drinking and the amount of alcohol your body was used to. 

Drug withdrawal can vary, too. Short-acting opioids, for instance, may cause withdrawal symptoms for four to 10 days on average.

Benzodiazepines may cause withdrawal that peaks within the first two weeks. Long-acting opioids may have a withdrawal peak within ten days. (14)

When you combine these substances, it may take longer to go through detox. A clinician is there to help you manage withdrawal symptoms or behavioral health issues safely and as comfortably as possible.

As part of your individual treatment plan at Zinnia Health, you can take advantage of trauma therapy, as well as other therapeutic options like cognitive behavioral therapy, dialectical behavior therapy, and rational emotive behavior therapy.

Together, these integrated treatments can help you achieve healing and balance — so your trauma no longer controls your emotions and behavior. 

Cognitive Behavioral Therapy

Cognitive-behavioral therapy is a type of psychological therapy that helps reduce depression, anxiety, and a number of health problems. It can also be used to treat alcohol and drug dependency and addiction, PTSD, and other disorders. 

CBT is based on the idea that psychological problems are at least partially a result of unhelpful ways of thinking and learning patterns of unhelpful behavior. People who have psychological issues may be able to learn better coping strategies, which then would help relieve their symptoms.

CBT requires patients to recognize when their thinking is distorted and learn more about others’ motivations. They will develop problem-solving skills and become more confident in their own abilities.

Dialectical Behavior Therapy

Dialectical behavior therapy is similar to CBT, but it combines mindfulness with learning how to cope with stress, improve relationships, and regulate your emotions. This treatment was originally designed to help those with borderline personality disorder, but it is helpful for those with post-traumatic stress disorder, self-destructive behaviors, and other issues. (15)

DBT is unique in that you can complete sessions over the phone, individually or in a group.  

Rational Emotive Behavior Therapy

Rational emotive behavior therapy is another kind of psychotherapy that could help. It is similar to DBT and CBT but is a bit different in practice. REBT helps you focus on the present to see how your thoughts and beliefs may create distressing emotional issues for yourself.

By understanding your own thoughts and feelings, you can change your actions to result in more positive outcomes. (16)

REBT has been used to help people deal with inappropriate anger, depression, guilt, anxiety, and other issues in their lives. REBT evolved from the original work that went into developing cognitive-behavioral therapy, so the two are related (though this does not go back into the past as much as CBT would).

How Does Trauma Therapy Help?

When we experience a traumatic event or situation, our bodies respond by releasing stress hormones that prevent our brains from processing the event. When we are triggered by something that reminds us of the trauma, our bodies react with a “fight or flight” response.

While we are asleep and dreaming, our eyes dart back and forth quickly, which triggers the part of the brain that reprocesses the day’s memories. (17

Trauma therapy may use EMDR (or eye movement desensitization reprocessing), which simulates those eye movements. This stimulates the brain to reprocess the trauma. 

Trauma-focused therapy doesn’t just include EMDR, though. There are other forms of trauma therapy, like talk therapy, that will help you learn new skills and strategies to understand, process, and cope with the traumatic experiences that you’ve been through. 

In a good trauma therapy program, there are five goals. These are to:

  • Reestablish safety
  • Identify triggers
  • Develop healthy coping skills
  • Decrease stress symptoms
  • Practice trauma processing and integration

With these goals in mind, the first step is to help a person feel more comfortable in their environment. It is essential to improve a sense of safety by creating a space where they are seen and heard.

This can also help relapse prevention because those just finishing treatment have an increased risk for continued drug use.

Identifying triggers, the next step, helps you learn to explore, understand, express, and identify the triggers that cause you additional stress and further trauma.

While you may feel like anxiety or stress comes out of nowhere, the reality is that there is usually a trigger that starts the body’s reaction. Identifying the trigger helps you avoid or learn to live with it again.

Healthy coping skills also make a difference. In a trauma-focused session, you will learn to cope with anxiety and stress positively. Anxiety management and relaxation strategies are at the core of this process. 

Decreasing the symptoms of a traumatic response comes next. A therapist may help you practice skills to decrease the physical and emotional symptoms that you go through after being triggered.

This will help decrease the likelihood and severity of:

  • Panic attacks
  • Flashbacks
  • Nightmares
  • Other negative side effects

Finally, the fifth stage is to focus on trauma processing and integration. You can help yourself regain your power and well-being by taking control of your history. This is most important for war veterans because the trauma that comes with war is intense.

You can essentially rewrite your story with the right help. 

Healing From Trauma and Substance Abuse at Zinnia Health

While trauma therapy has the potential to feel intense at first, it can provide a powerful sense of relief both psychologically and physically for you and your loved ones. You deserve to feel better and can do so with the right support. Whether you go through an inpatient program or work with an outpatient therapist, the right team will get you on a path to recovery.

To learn more about how Zinnia Health treats PTSD, trauma, alcohol use disorder, and substance abuse, please reach out today. We’re here for you and will help you overcome the challenges that you’re dealing with. Call our healthcare professionals at (855) 430-9439 today for specialized addiction treatment or dual diagnosis for your conditions.


Call us
Ready to get help?
(855) 430-9439
Why call us? Why call us