PTSD–Case In Point

Effects of PTSD

 Sally was acting out behaviors that were harming herself because of how she regarded herself from past relationships. For Sally, drinking had become the shield from which she lived her life– afraid of feeling so she numbed and avoided her inner turmoil.

Sally classifies as a candidate for dual diagnoses: PTSD and Alcoholic abuse.

 Information on Affecting Relationships

An article from New York City Alliance against Sexual Assault called: “Factsheets: PTSD and Relationships” listed how past trauma may affect current relationships not only with others but with oneself:

  • Trauma survivors with PTSD often experience problems in their intimate and family relationships or close friendships.
  • PTSD involves symptoms that interfere with trust, emotional closeness, communication, responsible assertiveness and effective problem solving.
  • Partners, friends or family members may feel hurt, alienated or discouraged because the survivor has not been able to overcome the effects of the trauma and they may become angry or distant toward the survivor.
  • Feeling irritable and on guard is common.
  • Survivors may experience a loss of interest in social or sexual activities. They may feel distant from others and they may be emotionally numb.
  • They are easily startled, worried or anxious. Survivors may be unable to relax, socialize or be intimate without feeling tense or demanding. Significant others may feel pressured, tense and controlled as a result.
  • Difficulty falling or staying asleep and severe nightmares may prevent both the survivor and partner from sleeping restfully, which may make sleeping together difficult.
  • Trauma memories, trauma reminders or flashbacks and the avoidance of such memories or reminders can make living with a survivor feel like living in a war zone or like living with the constant threat of vague but terrible danger.
  • Reliving trauma memories, avoiding trauma reminders and struggling with fear and anger greatly interfere with a survivor’s ability to concentrate, listen carefully, and make cooperative decisions. As a result, problems often go unresolved for a long time.
  • Survivors of childhood sexual and physical abuse and survivors of rape, domestic violence, combat, terrorism, genocide, torture, kidnapping, and being a prisoner of war often report feeling a lasting sense of terror, horror, vulnerability and betrayal that interferes with relationships.
  • Alcohol abuse and substance addiction, which can result from an attempt to cope with PTSD, can destroy intimacy and friendships

 What Can be Done

The PTSD: National Center for PTSD in a recent article suggests the following most effective treatment patterns when clients like Sally who have both PTSD and a drinking problem:

  • Alcohol can affect sleep, anger and irritability, anxiety, depression and work or relationship problems. Therapist and patient should discuss.
  • Treatment should include education, therapy and support groups that help the patient with drinking problems in a way they can accept.
  • Treatment for PTSD and alcohol use problems should be planned in a way that gets at both problems together. Patients 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 the patient becomes sober (stop drinking entirely), he/she must learn to cope with PTSD symptoms in order to prevent relapse (return to drinking). Sometimes the PTSD symptoms seem to get worse after drinking ceases. More progress can be made with PTSD treatment once the drinking stops.

“Even in times of trauma, we try to maintain a sense of normality until we no longer can. That, my friends, is called surviving. Not healing. We never become whole again … we are survivors. If you are here today… you are a survivor. But those of us who have made it through hell and are still standing? We bare a different name: warriors.”

Lori Goodwin

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PTSD–Case In Point