The link between PTSD and alcohol-use disorders

The link between PTSD and Alcohol Usage Disorders

 

Alcohol, for many, is an ever present part of social life. It can be a way to unwind after a long day, celebrate special occasions, or simply enjoy the company of friends and loved ones. However, beneath the surface of what might seem like harmless social drinking lies a complex web of behaviours and consequences that can lead to Alcohol Usage Disorder (AUD).

It’s a spectrum of drinking behaviours that encompass everything from occasional binge drinking to daily consumption that negatively impacts one’s life. Research shows that people with PTSD are around four times more likely to be affected by alcohol use disorders than the general population.

The Not-So-Obvious Spectrum: Understanding Alcohol Usage Disorder

When people hear the term “alcoholic,” they often conjure up images of the old-school stereotype: someone day-drinking on a park bench or consuming alcohol from a brown paper bag. This antiquated perception of Alcohol Usage Disorders is not only outdated but dangerously misleading.

The term alcohol usage disorder covers a broad spectrum that affects individuals differently, and many don’t fit the conventional stereotype. Some may indulge in a nightly glass of wine but find it challenging to stop at one. Others may have periodic bouts of binge-drinking where alcohol consumption spirals out of control. There are those who engage in day drinking, hidden behind closed doors, and those who experience blackouts or damaging incidents during nights out. Despite the differences, the common thread is that alcohol use has a negative impact on their lives.

The Hidden Connection: PTSD and Alcohol Usage Disorders

A critical aspect of Alcohol Usage Disorders often overlooked is its strong connection with PTSD, a condition triggered by traumatic experiences. Trauma survivors often wrestle with a relentless barrage of distressing symptoms. In their pursuit of relief, some individuals turn to alcohol as a form of self-medication, to numb their symptoms and flashbacks, or to try to feel a bit more in control of their thoughts and daily life. 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. 

However, this temporary solace comes at a steep price: it can rapidly lead to the development of an Alcohol Usage Disorder.

Additionally, using alcohol to self-medicate can create a vicious cycle. Alcohol is a depressant, which means it can exacerbate PTSD symptoms such as anxiety and depression. When those symptoms get worse, the need to drink becomes more urgent.

We were honoured recently to be chosen as a stakeholder for the update to the National Institute for Health and Clinical Excellence (NICE)  ‘Alcohol-use disorders: diagnosis and management’ quality standard.  Recognising this strong correlation between PTSD and Alcohol Usage Disorders, we engaged in advocating for guidelines that encompass comprehensive screening for PTSD or C-PTSD in people with alcohol usage disorders and to ensure that their care delivery takes into account the potential presence of PTSD or C-PTSD and any necessary adjustments required. You can find out more about our work with NICE here

The Sobering Statistics: The Troubling Link

Research reveals that individuals with PTSD are almost four times more likely to develop Alcohol Usage Disorders compared to those without PTSD.

But the link between the two is a little more complicated: alcohol use disorders can actually  be a risk factor or trigger for PTSD as well as a symptom (meaning that for some people, alcohol consumption increases the likelihood of developing PTSD after a trauma).

And sometimes alcohol usage disorders are simply a comorbidity that appears alongside PTSD, without one necessarily causing the other.

In many cases, those with PTSD may resort to alcohol to cope with symptoms they find unbearable. While alcohol initially offers a sense of relief, it eventually compounds the problem, trapping individuals in a cycle of trauma, alcohol usage disorders, and deteriorating mental health. And of course, if someone is using alcohol to mask the symptoms of PTSD, that means they may go longer without realising they have PTSD, so the root cause of the symptoms goes untreated. 

Seeking Positive Change: Redefining Problematic Drinking

The first step in addressing problematic drinking is to redefine what it entails. By removing traditional stereotypes, we can encourage people to recognise that their relationship with alcohol deserves attention and care.

Understanding that problematic drinking exists along a broad spectrum can empower people to seek help proactively. Positive change comes in various forms, from seeking therapy to explore healthier coping mechanisms to finding support within peer networks and educational resources. The emphasis is on fostering a culture of well-being and empowerment.

This is where organisations like like SoberBuzz come in. SoberBuzz is not just an organisation; it’s a lifeline for those who may be questioning their relationship with alcohol and are seeking guidance on how to navigate this journey of change. At SoberBuzz, they understand the complexities and challenges that can arise when re-evaluating your connection with alcohol. They offer a safe, non-judgmental haven where you can openly share your experiences, be heard, and find unwavering support.

The mission at SoberBuzz is to empower you to step into the exciting opportunity of reconnecting with your true self. Along this transformative path, you will acquire essential life skills and tools to effectively manage your emotions and confront life’s challenges without relying on alcohol as a crutch.

At PTSD UK, we are excited to join forces with SoberBuzz to extend our support to people dealing with PTSD or C-PTSD who are seeking to take control of their alcohol consumption. The valuable hints and tips that follow are a result of our partnership with SoberBuzz, aimed at empowering you on your path to well-being.

Practical hints and tips as to how to cut-down/go alcohol free

IMPORTANT: It’s crucial to understand 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. In this case, it’s vital not to suddenly and completely stop drinking.

However, please know that you can still take control of your drinking habits and work towards a healthier life. Your first step should be to reach out to a GP (General Practitioner) or your local community alcohol service. They possess the expertise to guide you safely through the process of reducing your alcohol consumption while monitoring your well-being.

Your journey toward sobriety is a courageous and empowering one, and you are not alone. Seeking professional support is a significant stride towards a healthier, brighter future.

Discover Your Why and Embrace Positive Change

Embarking on a journey to cut down or go alcohol-free is a significant step towards a healthier, happier life. To help you along this empowering path, it’s essential to get clear on your reasons for making this positive decision.

Start by creating a list of your “whys.” Why do you want to change your relationship with alcohol? What are the driving forces behind this choice? 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.

This list of “whys” serves as a powerful reminder of your commitment to positive self-care. When you feel the urge to drink, turn to this list. It forms the foundation of your new and exciting lifestyle choice, reinforcing your resolve and inspiring you to keep moving forward.

Create Your Distraction List: Embrace Alternatives

It’s perfectly normal to experience urges, but the good news is that most of them tend to fade after just 15 to 20 minutes. To make this transition smoother, compile a Distraction List – a collection of activities to engage in instead of reaching for a drink. Knowing you have a list to refer to during these moments can be incredibly helpful.

Consider activities like organising a drawer, giving your home a quick clean, enjoying a refreshing shower, taking a brisk walk, planning your meals, or engaging in physical somatic movement (dance around the kitchen, go for a run, do some exercise). By shifting your focus to these positive actions, you can dissipate the desire to drink and naturally boost your serotonin levels.

Shame Has No Place Here: Embrace Self-Compassion

One of the most crucial aspects of this journey is to eliminate any sense of shame. We know that this can be difficult, especially if you have thought negatively about your drinking for a long time, but it is an important step. Recognise that this is the first step towards an incredibly empowering life decision. Shaming ourselves rarely leads to positive change.

To let go of shame, consider starting a gratitude practice. SoberBuzz founder, Kirsty, has been journaling her gratitude every day since she stopped drinking, and she attests that it’s the most powerful tool for self-care and self-compassion. Dedicate a moment each day, whether in the morning or at night, to jot down five things you’re grateful for. This practice will help you shift your focus towards self-compassion, nurturing a positive outlook on your journey.

Here’s a simple yet impactful routine to follow:

  1. Gratitude for Your Decision: Begin by expressing gratitude for your decision to address your drinking. Recognize the significance of this choice in your life’s transformation.
  2. Self-Appreciation: Extend gratitude to yourself for the positive actions you’ve taken. It might be a moment of self-care, like going for a refreshing walk during lunch, or a decision that filled you with pride.
  3. Cherish Your Relationships: Acknowledge the value of the people in your life. Express gratitude for friends or loved ones who offer support, understanding, and meaningful connections.
  4. Savour Life’s Simple Pleasures: Find joy in the little things. Take a moment to appreciate the small pleasures that enrich your day, like savouring a cup of coffee before diving into your daily tasks.
  5. Nourish Your Well-Being: Show gratitude for the essentials that contribute to your well-being. Recognise the abundance of nourishing food in your cupboards, ensuring you eat well and stay energised throughout the day.

Remember, you’re embarking on a path of transformation, and every step forward is a testament to your strength and resilience. Embrace this journey with kindness and optimism, for it is a journey towards a brighter, more fulfilling life.

Think about the times you drink

Begin by reflecting on the times when you would typically turn to alcohol. Whether it’s every weekend or more frequently, consider alternative plans to disrupt this habit cycle. Simple activities like going for a walk, calling a friend, or engaging in journaling or reading can be excellent substitutes. By retraining your brain to embrace positive actions during these times, you pave the way for healthier habits.

Explore Alcohol-Free Alternatives

Today, there’s an array of alcohol-free options available for every taste. Supermarkets offer a variety of choices, and platforms like The Wise Bartender provide a wide selection. Even many bars now offer more than traditional non-alcoholic beverages like Becks Blue. Exploring these alternatives can make your journey more enjoyable.

Rediscover Your Free Time

Change the way you perceive your free time, especially during weekends. Consider making weekend mornings a dedicated period for activities that help you unwind and relax. Meet friends for a coffee or an invigorating walk in nature. Look for wellness activity groups that align with your interests, whether it’s walking, meditation, yoga, or even adventurous experiences like wild swimming.

Prioritise a Restful Sleep Routine

Cultivating a healthy sleep routine is pivotal to your well-being. Begin winding down a couple of hours before bedtime without alcohol. Create a plan for this transition, which might include a soothing shower or bath, reading a book, and trying wellness practices like breathing techniques or meditation. Enjoy herbal tea and engage in journaling to nourish your self-care journey. Consistency is key, so aim to go to bed and wake up at the same times each day. This commitment to a regular sleep schedule not only helps re-establish healthy sleep patterns but also communicates to yourself that you are a priority.

Harnessing the Power of Journaling for Positive Change

Journaling can be an invaluable tool on your journey towards making positive changes in your relationship with alcohol. It’s a way to connect with yourself, track your progress, and gain insights into your habits and triggers. Here are some helpful tips on how to make the most of journaling:

  • Weekly Check-Ins: Consider setting aside time each week to reflect on your alcohol-free journey. Take note of your accomplishments, celebrate your successes, and acknowledge what went well. Equally important is identifying any triggers you encountered and how you managed them. This self-awareness can guide you toward better decision-making in the future.
  • Exploring Wellness Techniques: Making changes in your life often involves adopting new wellness practices. Alongside journaling, you might find meditation, grounding exercises, and breathing techniques to be incredibly beneficial. These practices can help you stay grounded, manage stress, and build resilience, making your journey towards healthier choices more empowering.

Discover the Power of Mindful Breathing Techniques

Engaging in mindful breathing exercises can be a transformative practice, helping you regain control, reduce anxiety, and stay present in the moment. Here are two effective techniques:

  1. Box Breathing: This simple yet powerful method is perfect for calming the mind and alleviating anxiety. Find a comfortable seated position and begin by inhaling deeply for a count of four. Then, hold your breath for another four counts. Exhale for four counts and hold again for four counts. Continue this rhythmic cycle for a few minutes or until you feel centred and at ease. It’s a great tool to use when facing the temptation to drink. Once you’ve calmed your mind, ask yourself important questions: What will happen if I give in to the urge to drink? How will I feel tomorrow? What healthier alternatives can I explore instead of drinking?
  2. 4-7-8 Breathing (Relaxing Breath): Similar to box breathing, this technique is designed to promote relaxation and reduce tension. Find a comfortable seat, whether in a chair, on the floor, or your bed. Inhale deeply to the count of four, then hold your breath for a peaceful seven seconds. Finally, exhale slowly to the count of eight. The relaxing breath exercise is not only effective for managing temptation but can also be particularly helpful before bedtime, ensuring you enjoy a restful night’s sleep.

Ultimately, just know it’s ok to not drink, loads of people do for many reasons but they all boil down to the same thing, they want to live a life that makes them feel good, proud and in control.

Navigating Social Situations with Confidence

Explaining your decision to friends is a vital step in your journey towards a more empowered, healthier you. It’s important to frame it positively to help your loved ones understand your motivations better.

Instead of saying things like, “I feel like my drinking is out of control,” which might trigger well-meaning but unhelpful responses, consider using phrases like:

  • “I feel so much more capable when I don’t drink or drink less.”
  • “I’m enjoying the benefits of this break from drinking, like my improved sleep and more energy.”
  • “I’m looking forward to our get-together, and I’ll be enjoying it without alcohol. I find I can savour the moment better this way.”

These positive statements can help your friends and family recognise that your choice is rooted in self-improvement and well-being. Remember, if you want to see change, you need to make changes. Continuously subjecting yourself to situations that lead to discomfort is counterproductive.

If you’ve decided to take a break from drinking, it’s wise to adapt your social activities accordingly. Consider alternatives like going out for dinner, brunch, or enjoying non-drinking-friendly activities such as a trip to the cinema or a live sports event. If you’re comfortable, take your car along. If you fear peer pressure might be overwhelming, it’s perfectly acceptable to decline invitations. As you progress in your alcohol-free or alcohol-reduced journey, you’ll find that navigating social situations becomes easier.

A helpful tip for socialising is to call ahead and inquire about alcohol-free options at the venue. With a knowledge of what you can drink, you’ll feel more at ease before arriving, making social interactions more enjoyable and stress-free.

Treatment for Alcohol usage disorders and PTSD

Not everyone with PTSD will be affected by an alcohol usage disorder. Equally, going through trauma can lead to an alcohol use disorder, whether or not you develop PTSD. But if you or someone you know has PTSD, an alcohol usage disorder or both, it’s important to get support.

Seeking treatment for both at the same time is encouraged, since they tend to feed off each other. Unfortunately, both alcohol usage disorders and alcohol withdrawal can intensify the symptoms of PTSD, so support during the detox process will be essential to increase the effectiveness of any treatment.

Conclusion: The Path to Recovery Begins with Understanding

Understanding the complex relationship between Alcohol Usage Disorder and PTSD is a vital step towards recovery. It’s not about conforming to outdated stereotypes of “alcoholism” but recognising that problematic drinking exists along a broad spectrum. Anyone who experiences negative consequences due to alcohol use deserves support and the opportunity to make positive changes.

Breaking the cycle of Alcohol Usage Disorders and PTSD requires acknowledging the problem and seeking help. The path to recovery begins with understanding. By shedding light on the hidden link between Alcohol Usage Disorders and PTSD, we can guide individuals towards healthier choices and a brighter future.

IMPORTANT: Seek Professional Guidance

It’s crucial to understand 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. In this case, it’s vital not to suddenly and completely stop drinking.

However, please know that you can still take control of your drinking habits and work towards a healthier life. Your first step should be to reach out to a GP (General Practitioner) or your local community alcohol service. They have the expertise to guide you safely through the process of reducing your alcohol consumption while monitoring your well-being.

Your journey toward sobriety is a courageous and empowering one, and you are not alone. Seeking professional support is a significant stride towards a healthier, brighter future.


Meet Kirsty Mulcahy: Your Partner in Embracing an Alcohol-Free Life

Kirsty Mulcahy is a compassionate transformational life coach with a special focus on helping individuals embrace the beauty of an alcohol-free existence. Kirsty is not just a coach; she’s the visionary founder and dedicated Managing Director of SoberBuzz Scotland CIC.


Please remember, these aren’t meant to be medical recommendations, but they’re tactics that have worked for others and might work for you, too. Be sure to work with a professional to find the best methods for you

Sources
  • Reynolds M, Mezey G, Chapman M, Wheeler M, Drummond C, Baldacchino A. Co-morbid post-traumatic stress disorder in a substance misusing clinical population. Drug Alcohol Depend. 2005 Mar 7;77(3):251-8. doi: 10.1016/j.drugalcdep.2004.08.017. PMID: 15734225.
  • Head, M., Goodwin, L., Debell, F., Greenberg, N., Wessely, S., & Fear, N. T. (2016). Post-traumatic stress disorder and alcohol misuse: comorbidity in UK military personnel. Social psychiatry and psychiatric epidemiology, 51(8), 1171–1180. https://doi.org/10.1007/s00127-016-1177-8
  • Lehavot, K., Stappenbeck, C. A., Luterek, J. A., Kaysen, D., & Simpson, T. L. (2014). Gender differences in relationships among PTSD severity, drinking motives, and alcohol use in a comorbid alcohol dependence and PTSD sample. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 28(1), 42–52. https://doi.org/10.1037/a0032266
  • Head, M., Goodwin, L., Debell, F., Greenberg, N., Wessely, S., & Fear, N. T. (2016). Post-traumatic stress disorder and alcohol misuse: comorbidity in UK military personnel. Social psychiatry and psychiatric epidemiology, 51(8), 1171–1180. https://doi.org/10.1007/s00127-016-1177-8
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