A psychological dark cloud was slowly emerging from the west of Southern Highlands to our idyllic farm life. I was sinking into some deep unexplained abyss. Three children were educated and through high school successfully and studying what they wished at University and we were incredibly proud of them. Our joyful, vibrant, creative youngest was keeping us on our toes but I was having days that are black. It was hard to get out of bed. Then all is okay again. The black cloud lifts. No tears today. No need to have a drink today but maybe I will need to tomorrow, so I better buy enough in case I do. No way of predicting how I am going to be on any given day. Some Leviathan is consuming my soul and my life as I know it. I am questioning God in my life, who is he? Do I believe in him? Have I ever believed in him? He “Who doth seek his heavenly Father, for he shall have eternal life. He that dwelleth in the secret place.” Maybe that was a path I needed to follow yet there was a simmering anger towards the Church I could not explain. I was resenting the children being at a Catholic School. I no longer attended school functions. I could not put my finger on this disquiet in mind and soul but I could not ignore it but unfortunately, it was driving me more and more towards alcohol.
Help, help’, said a man, ‘I’m drowning’
‘Hang on’, said a man from the shore.
‘Help, help’, said the man, ‘I’m not clowning’.
Yes, I know, I heard you before.
Be patient dear man who is drowning.
You see, I’ve got a disease.
I’m waiting for a Dr J. Browning.
So do be patient please, man who is drowning.
The Ning Nang Nong Spike Milligan
Since the age of four I had been given alcohol to make me compliant to the men’s invasions. If the men did not bring it with them, my Mother gave it to me before they came. At first it tasted repulsive and astringent, too bitter to swallow and caused a gagging reflex. Not to be defeated, she simply added Coke to disguise it’s poisonous taste. Coke became the elixir of life. A strong, bubbly, black, sickly sweet reliever of anticipated violation. As it snaked it’s way down my throat and entered my stomach I knew I had to wait but a short time before it suspended the present and allow my mind to enter the crack in the wall behind the roses where the fairy lived. My fairy, my mental liberator, if even short lived. The alcohol made me light headed at first and sick in the stomach particularly if I had not eaten but then slowly it flowed through my tiny body, releasing me from my dementors.
That was my introduction to the clear fluid contained in the bottle with the red label, with its embossed emblem and red cap. Red like her shoes that kicked indiscriminately when she was in its grip. When I was thrown out of home by her at eighteen and lived on the streets of Dublin it was my first time in fourteen years to not drink. It was hell. Excruciating headaches, vomiting and uncontrollable shaking. Night time was the worst. Sleep was elusive and when it did come it brought nightmares of the unimaginable kind. The street was not a safe place. Men circled like hungry wolves, plying food and more alcohol. I wanted neither. I just wanted to be free. I did not drink from age nineteen to forty eighty-eight when the flashbacks of the abuse kept coming back and then I was a full blown alcoholic again, drinking secretively behind my husbands’ back. I was in real trouble. My Complex PTSD was out of control. I was drowning in it.
PTSD and alcohol use problems are often found together. This pairing can be big trouble for the trauma survivor and his or her family. People with PTSD are more likely than others with the same sort of background to have drinking problems. By the same token, people with drinking problems often have PTSD. Those with PTSD have more problems with alcohol both before and after getting PTSD. Having PTSD increases the risk that you will develop a drinking problem.
Women who go through trauma have more risk for drinking problems. They are at risk for drinking problems even if they do not have PTSD. Women with drinking problems are more likely than other women to have been sexually abused at some time in their lives. Both men and women who have been sexually abused have higher rates of alcohol and drug use problems than others.
Up to three-quarters of those who have survived abusive or violent trauma report drinking problems. Up to a third of those who survive traumatic accidents, illness, or disasters report drinking problems. Alcohol problems are more common for survivors who have ongoing health problems or pain.
Sixty to eighty percent of Vietnam Veterans seeking PTSD treatment have alcohol use problems. War Veterans with PTSD and alcohol problems tend to be binge drinkers. Binges may be in response to memories of trauma. Veterans over the age of 65 with PTSD are at higher risk for a suicide attempt if they also have drinking problems or depression. Alcohol use problems often lead to trauma and problems in relationships
The symptoms of PTSD can be extremely distressing because they cause such a great amount of stress on the individual, many with PTSD will be unable to cope and turn to drugs or alcohol as a means of escape. As a result, 52 percent of males and 28 percent of females with PTSD meet the lifetime criteria for alcohol abuse or dependence, according to findings on posttraumatic stress disorder in the National Comorbidity Survey, published in 1995 in the Archives of General Psychiatry (Kessler et al.). When it comes to drug abuse, statistics from the same study show that 35 percent of men and 27 percent of women with PTSD meet the criteria.
Endorphin withdrawal plays a part in the use of alcohol or drugs to control PTSD. When an individual experiences a traumatic event, his or her brain produces endorphins — neurotransmitters that reduce pain and create a sense of well-being — as a way of coping with the stress of the moment. When the event is over, the body experiences an endorphin withdrawal, which has some of the same symptoms as withdrawal from drugs or alcohol:
- Emotional distress
- Physical pain
- Increased cravings for alcohol or drugs
According to Alcohol Research & Health, many of those with PTSD will turn to alcohol as a means of replacing the feelings brought on by the brain’s naturally produced endorphins. But the positive effects of alcohol are only temporary.
If you have a drinking problem, you are more likely than others with your same sort of background to go through a psychological trauma. You may also have problems getting close to others. You may have more conflicts with those people to whom you are close.Problems with alcohol are linked to a confused and disorderly life. This kind of life leads to less closeness and more conflict within a family. The confusion of a life with a drinking problem makes it harder to be a good parent.
Alcohol can make PTSD symptoms worse. They most definitely do. I can attest to this and they make suicidality and self-harm worse too. Dissociating becomes harder to manage also.
You may drink because using alcohol can distract you from your problems for a short time. You should know, though, that drinking makes it harder to concentrate, be productive, and enjoy all parts of your life. Using too much alcohol makes it harder to cope with stress and your trauma memories. Alcohol use and intoxication (getting drunk) can increase some PTSD symptoms. Examples of symptoms that can get worse are numbing of your feelings, being cut off from others, anger and irritability, depression, and the feeling of being on guard. If you have PTSD, you may have trouble falling asleep or problems with waking up during the night. You may “medicate” yourself with alcohol because you think it’s helping your sleep. In fact, using too much alcohol can get in the way of restful sleep. Alcohol changes the quality of your sleep and makes it less refreshing.
If you have PTSD, you may have bad dreams or nightmares. You may drink because you think using alcohol will decrease the number of bad dreams or how scary they are. Yet drinking just continues the cycle of avoidance found in PTSD. Avoiding the bad memories and dreams actually prolongs the PTSD. You cannot make as much progress in treatment if you avoid your problems.
Alcohol use problems make PTSD treatment less effective.
When you suddenly stop drinking, the nightmares often get worse. Working with your doctor on the best way to reduce or stop your drinking makes cutting back on alcohol easier. You will be more likely to have success in your efforts.
Other Mental Health Issues
If you have both PTSD and drinking problems, you are likely to have other mental or physical health problems. Up to half of adults with both PTSD and drinking problems also have one or more of the following serious problems:
- Panic attacks, extreme fears or worries, or compulsions (being driven to do things like checking the door locks over and over)
- Mood problems such as depression
- Attention problems or behaving in ways that harm others
- Addiction to or abuse of street or prescription drugs
- Long-term physical illness such as diabetes, heart disease, or liver disease
- Ongoing physical pain
What are the most effective treatment patterns?
Having both PTSD and a drinking problem can make both problems worse. For this reason, alcohol use problems often must be part of the PTSD treatment. If you have PTSD, plus you have, or have had, a problem with alcohol, try to find a therapist who has experience treating both issues.
In any PTSD treatment, several points related to alcohol should be stressed:
When planning your treatment, you should discuss with your therapist the possible effects of drinking on your PTSD symptoms. As noted above, alcohol can affect sleep, anger and irritability, anxiety, depression, and work or relationship problems.
Treatment should include education, therapy, and support groups that help you with your drinking problems in a way you can accept. Treatment for PTSD and alcohol use problems should be planned in a way that gets at both problems together. You may have to go to separate meetings on each issue, or see providers who work mostly with PTSD or mostly with alcohol problems. In general, though, PTSD issues should be included in alcohol treatment, and alcohol use issues should be included in PTSD treatment.
Once you become sober (stop drinking entirely), you must learn to cope with your PTSD symptoms in order to prevent relapse (return to drinking). This is important because sometimes the PTSD symptoms seem to get worse or you notice them more right after you stop drinking. Remember that after you have stopped drinking, you have a better chance of making progress in your PTSD treatment. In the long run, you are more likely to have success with both problems.