The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 5th Edition outlines the following criteria for a PTSD diagnosis.2
Veterans with PTSD are approximately three times more likely than veterans without PTSD to develop a substance use disorder. For most individuals, PTSD tends to occur before a substance use disorder because many individuals use substances to self-medicate to help with PTSD symptoms.
Individuals with both PTSD and a substance use disorder benefit the most from a trauma-focused, cognitive behavioral therapy such as CBT, EMDR, or Prolonged Exposure Therapy.5 Studies have shown that people with a dual diagnosis of PTSD and substance use disorder had lower PTSD symptoms when they received psychotherapy than people who received treatment that was only focused on treating the substance use disorder. Trauma-focused treatment also lowers the risk of relapse because the trauma is often the reason for the substance abuse issue. PTSD treatment can often help individuals address the root causes of their addiction and try to find coping strategies to work through PTSD and substance abuse. Some forms of treatment that are beneficial for managing PTSD and substance abuse are:
Prolonged Exposure Therapy is a type of cognitive-behavioral therapy that is specific to treating trauma. The idea behind prolonged exposure therapy is that individuals with PTSD tend to avoid anything that might remind them of their trauma, reinforcing the fear and negative feelings surrounding the trauma.6 During prolonged exposure therapy, you gradually approach memories, feelings, and trauma-related situations, allowing them to understand that the memories and feelings are not dangerous and do not need to be feared. Over time, the hope is that being exposed to the triggers will help you not react so strongly to trauma triggers. Prolonged exposure typically occurs over about three months with weekly sessions.6
In some cases, medication may be necessary to help treat PTSD and allow successful psychotherapy. Medications used for PTSD are antidepressants such as SSRIs and SNRIs. The four medications typically used to treat symptoms of PTSD are: sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), and venlafaxine (Effexor).7