PTSD and Alcoholism in Combat Veterans
By: Lakeview Health Staff
Published: July 4, 2015

Over the past century, Americans have slowly come to realize the devastation of war on the psyche of those involved, and nobody is more involved than combat veterans. According to The U.S. Department of Veterans Affairs, post-traumatic stress syndrome affects at least 30 percent of Vietnam veterans, ten percent of Gulf War veterans, and 11 percent of those who served in Afghanistan. PTSD has a crippling effect on every aspect of life, and many veterans turn to alcohol to cope with the symptoms, which can range from flashbacks of combat to feelings of numbness and disconnectedness from life. Unfortunately, a combination of PTSD and alcoholism in combat veterans only complicates the problem.

What is PTSD?

Post-traumatic stress syndrome disorder is a disabling anxiety disorder that results from exposure to traumatic events, such as the gunfire, explosion, and bodily injuries that soldiers experience. It may also be caused by feelings of guilt for having hurt another person in combat or seeing a comrade wounded and being unable to help. One study showed that soldiers who killed someone during the Iraqi conflict were more likely to abuse alcohol, have anger control problems, or experience marital difficulties than their peers. PTSD can develop immediately, or it may take years for the signs to show up or to be properly diagnosed. Combat veterans with PTSD may suffer from the following symptoms:

  • Flashbacks of the event
  • Depression
  • Anxiety
  • Sleeping problems, such as insomnia or nightmares
  • Self-destructive actions
  • Paranoia
  • Thrill-seeking behavior
  • Emotional outbursts
  • Substance abuse

How are PTSD and Alcoholism in Combat Veterans Linked?

Statistics show that three out of four veterans who have PTSD also abuse alcohol or have problems controlling its use. It is not unusual for people to reach for alcohol to manage the stress that comes from witnessing a traumatic event, but there is also a biological mechanism that comes into play. Research suggests that during trauma, endorphin levels spike to help numb the physical and emotional pain of the event. Endorphins are the feel-good hormones that create a calming effect after a stressful incident. After the hormones spike, levels return to normal, and a state similar to withdrawal results. Alcohol raises endorphin levels and initially helps people cope with the stressful event, but it makes things worse in the long run.

Why Does Alcohol Make PTSD Worse?

Sleeping problems are a common result of PTSD and alcoholism in combat veterans. Although alcohol may help a person fall asleep, it negatively affects the quality of sleep, complicating the problems it is ingested to help. Because alcohol is a depressant, it also increases feelings of defensiveness, anger, and irritability, making it harder to cope with already-existing stress. While drinking may help to keep disturbing memories at bay, it prevents recovery from the painful event and complicates diagnosis and treatment. Binge drinking, in fact, rewires the brain, causing tolerance to the alcohol and requiring a greater quantity to produce the same result over time. Unfortunately, there is a stigma attached to PTSD that makes it difficult for some people to ask for help. Even when a veteran is willing, he must have resources to pursue the treatment, and people who have trouble coping with daily life sometimes lack access to necessities like insurance or transportation. Others fear side effects from prescribed medications or treatments.

How Can Alcoholism and PTSD Be Treated?

As many as eight out of ten people who have a problem with alcohol also have one or more psychological disorders that contribute or coexist with the alcohol issues. The most successful recovery programs incorporate a person’s emotional and physical conditions into a comprehensive plan. These regiments often include the following practices:

  • Medical detox
  • A spectrum of counseling methods
  • Educational strategies for patients and their families
  • Cognitive behavioral training and coping mechanisms
  • Group support or therapy
  • Relaxation practices like yoga, prayer, and meditation
  • Art or music therapy

If substance abuse is significant, treatment may be the first step in a recovery plan, but it may also temporarily increase the symptoms of PTSD if the treatment facility is not addressing the co-occurring disorder first. In some instances, exposure therapy may be helpful in helping an individual learn how to assess fears and overcome past trauma. The best approach to treat PTSD and alcoholism in combat veterans is to seek a dual diagnosis treatment center.

What Happens After Treatment?

For people who learn to manage issues with alcohol and PTSD, the recovery process is an ongoing lifestyle adjustment. The theory of neuroplasticity, first introduced by a Canadian behavioral psychologist in the 1930s, explores the theory that the brain can rewire itself after traumatic episodes, physical injuries, or physical illnesses like strokes, hence the expression “neurons that fire together, wire together”. Just as the brain can be damaged by stressful events, it can also change again in a healthy way. Research suggests that mindfulness, or the practice of awareness of the present moment, can ease the process. When a person has PTSD, the areas of the brain that regulate the emotions and memory respond to situations with anxiety, and the fear center of the brain, called the amygdala, is activated. A mindfulness practice slowly trains the brain to reverse these patterns by quieting the amygdala and increasing activity in the calming prefrontal cortex and hippocampus. A state of living in the present moment has the following effects:

  • Serves as a reminder that the present is safe
  • Links positive feelings to the present moment
  • Forms new pathways in the mind for positive feelings
  • Trains the brain to accept good feelings as being real

A lifestyle of seeing and enjoying the good in the present moment helps the brain make the changes it needs to recover from PTSD or substance abuse, but the process is an ongoing one. Researchers say that it only takes ten to twenty seconds of good feelings to affect the neurological portion of the brain in a positive way. A community of caring friends and family is crucial to the maintenance of a healthy lifestyle during the recovery process. Support groups are helpful, and so is a connection to others. Some people find activities like exercise classes or volunteering at a local charity to help them forge new connections and find new ways of looking at life and dealing with PTSD and alcohol.