Mar 01, 2023

War can be traumatic and have a significant impact on a person's life, especially for combat veterans who have been in high-stress circumstances for a long time. The amygdala, the part of the brain responsible for the "fight or flight" response, can be negatively impacted by prolonged periods of stress, and it is frequently overactive in combat veterans.

The constant "fight or flight" response negatively changes brain chemistry, is physically and mentally draining, and leads to post-traumatic stress disorder (PTSD) in approximately 20% of veterans. It is common to find combat veterans with PTSD who also struggle with addiction, since they may turn to unhealthy coping mechanisms like drugs and alcohol in an effort to relieve their PTSD symptoms. 

While not all veterans suffer from prolonged effects of trauma or have issues related to addiction, to help combat veterans who are dealing with both trauma and addiction, it is important to know how the two are linked.

What is PTSD?

PTSD is a serious condition in which symptoms such as flashbacks, nightmares, anxiety, or trouble sleeping persist for over a month and cause significant distress in a person's daily life, affecting their relationships, work, and well-being. These symptoms can include:

• Re-experiencing traumatic events through nightmares, flashbacks, or intrusive thoughts
• Avoiding situational reminders of traumatic events
• Negative changes in mood, such as feeling detached, sad, guilty, or ashamed
• A decline in mental functioning, including loss of concentration and memory
• Hyperarousal/Hypervigilance, being easily startled, anxious, lashing out in anger, or constantly on the lookout for danger

What is Addiction?

Addiction is a disease that creates a compulsive need to use substances or participate in activities that can have harmful and dangerous consequences. Addiction can take over all aspects of an individual's life as they are consumed by their addiction.

3 Different Categories of Addiction

While there are many different kinds of addiction, most of them fit into one of three categories, which include substance addictions, impulse control disorders, and behavioral addictions.

Substance Addictions

A combat veteran who becomes so reliant on a substance that they require it to function may be diagnosed with a substance use disorder. Substance abuse is dangerous to an individual's health and, if nothing is done about it, can result in worsened mental and physical health, problems such as occupational problems, financial stress, strained relationships, or even death. Some examples of common addictive substances include:

• Alcohol
• Cocaine
• Tobacco
• Prescription drugs
• Cannabis
• Hallucinogens
• Opioids such as heroin

Impulse Control Disorders

A person has a problem with impulse control if they have strong urges they have difficulty controlling. These urges can sometimes show up in combat veterans as an intermittent explosive disorder, causing moments of explosive anger and aggression. Even though the person is aware of the negative consequences of these outbursts after the fact, the impulse in the moment is so powerful that they are unable to gain control of themselves. Other examples of impulse control disorders include:

• Kleptomania, a compulsive need to steal
• Pyromania, a compulsive need to start fires
• Trichotillomania , a compulsive urge to pull out your hair
• Gambling

Behavioral Addictions

The diagnosis of behavioral addiction in combat veterans is often made when they compulsively engage in an activity that results in harm to themselves and/or those around them. Although these activities are not inherently negative, individuals with behavioral addiction engage in these activities to the extent that they disrupt typical functioning. Examples of behavioral addictions include:

• Eating
• Playing video games
• Pornography
• Shopping
• Exercising

Combat veterans have different addictions, and they are often linked to PTSD.

The Relationship Between PTSD and Addiction in Combat Veterans

PTSD and addiction are often co-occurring disorders. Studies have shown that people with PTSD are more likely to develop an addiction than those without PTSD. In addition, people with addiction are more likely to have experienced trauma. This means that combat veterans are at a high risk of developing PTSD and addiction.

The nature of combat can expose soldiers to intense and repeated trauma, which can lead to PTSD. Veterans may turn to drugs or alcohol to cope with the stress of combat, PTSD symptoms, and the difficulties of readjusting to civilian life. In turn, the combination of PTSD and addiction can make it difficult for combat veterans to function in society, maintain relationships, and hold down jobs. This can quickly lead to negative social, financial, and legal consequences that can be long-lasting. Isolation, depression, and drug use can make PTSD and addiction symptoms worse, but there is hope.

Treatment for PTSD and Addiction in Combat Veterans

Treatment of PTSD and addiction in combat veterans necessitates a multifaceted approach that addresses both. The goal of treatment is to help combat veterans learn to manage their symptoms and improve their coping skills. This can be done through the following evidence-based practice techniques:

• Psychotherapy: Psychotherapy, also known as talk therapy, has been proven to be an effective treatment option for PTSD and addiction. Psychotherapy can help combat veterans understand the link between their PTSD and addiction and address the underlying causes of their trauma. By talking to a trained mental health professional about one’s thoughts, feelings, and experiences, combat veterans are better equipped to process their emotions and behavior and develop coping skills outside of addictive substances/behaviors. Cognitive-behavioral therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure Therapy, and Narrative Exposure Therapy are all examples of psychotherapy techniques.

• Medication: Medication can also be used to treat the symptoms of both PTSD and addiction in combat veterans. For example, antidepressants such as Zoloft, Prozac, and Paxil are commonly prescribed for PTSD to help alleviate depression and anxiety symptoms. Benzodiazepines help to alleviate symptoms of anxiety and insomnia. Prazosin is another effective medication used to reduce the symptoms of PTSD, particularly those related to sleep disturbances and nightmares. Finally, medications like Naltrexone or Buprenorphine can be prescribed to treat drug addiction directly.

• Self-Help Methods: Self-help methods can also be useful for combat veterans. Studies have shown journaling, exercise, a healthy diet, mindfulness, meditation, and connecting with others are beneficial in reducing daily stress. Support groups can provide combat veterans with a safe and supportive environment to discuss their experiences and learn from others who have gone through similar struggles. Support groups can also help combat veterans stay motivated and committed to their recovery.

Therapy with CHE

PTSD and addiction are complex and interrelated. Together, they can have a significant impact on combat veterans. Understanding the link between PTSD and addiction and addressing both with a compassionate and comprehensive approach is crucial to helping veterans heal and recover. With the right treatment and support, combat veterans can learn to manage their symptoms, improve their coping skills, and lead fulfilling and productive lives.

If you are a combat veteran who is struggling with trauma and addiction, don't hesitate to reach out for support. CHE Behavioral Health Services is here to help you on your journey to healing and recovery.

For more information about post-traumatic stress disorder and addiction in combat veterans and the treatment options offered by CHE, please call 888-515-3834. We are ready to talk and ready to listen.