According to the National Institute on Drug Abuse (NIDA), 7.7 million adults in the United States have co-occurring mental health disorders and substance use disorder (SUD). Yet, only 9.1% of people receive treatment for SUD and comorbid mental health disorders. Several barriers contribute to comorbid conditions, like a lack of treatment options and awareness of existing dual diagnosis programs. However, a foundational problem with addressing co-occurring conditions is recognizing the relationship between addiction and trauma. Therefore, understanding addiction and trauma is an important first step toward dismantling the harm of co-occurring conditions.
At The Guest House, we know self-defeating thinking and behavior patterns like SUD are coping mechanisms rooted in trauma. Traumatic life experiences often overwhelm you, making it difficult to respond to stress healthily. Through unaddressed trauma, you develop maladaptive coping strategies like self-medicating to alleviate or suppress difficult-to-process thoughts and feelings. Moreover, addiction and trauma exasperate psychological distress, which can contribute to the development or exasperation of mental health challenges. Thus, understanding addiction and trauma is vital to dismantling the roots of your challenges to build a healthier you.
Yet, you may question how treating a dual diagnosis can help you. How does your mental health relate to addiction? What is trauma, and how do you know you have experienced it? It can be difficult to recognize that mental health challenges contribute to or hinder recovery from addiction. With more understanding of dual diagnosis, you can gain insight into the complexities of trauma.
What Is Dual Diagnosis?
According to Medline Plus, dual diagnosis is a term that denotes that you have a mental health disorder and SUD. Dual diagnosis is also often referred to as comorbid disorders or co-occurring disorders. The term dual diagnosis is important for understanding that conditions can exist at the same time. Much like polysubstance use, there is a lack of understanding among the public, legislative bodies, and policymakers that co-occurrence between conditions exists. Often, people think of mental health and addiction as separate, unrelated experiences.
Despite the commonality of co-occurring disorders, few programs exist to address and treat comorbid conditions. The lack of support for dual diagnosis is often tied to barriers like stigma and information and knowledge gaps. As noted in Psychiatric Services, traditional mental health and SUD services have been provided by different systems of care. These different systems of care have their own administrative, financial, and human resource restrictions. Further, mental health and SUD services have differing program structures, assessment procedures, treatment modalities, and continuity of care protocols that do not meet the needs of other conditions.
Therefore, awareness and understanding of dual diagnosis are vital to building holistic programs that can address interdependent challenges like addiction and trauma. Without a clear understanding of co-occurring conditions, greater harm and chronic relapse can occur. When mental health disorders and SUD co-occur, they can worsen each other’s symptoms. More specifically, unaddressed co-occurrence can lead to greater symptom severity, complicate and impede effective treatment, and lead to poor treatment outcomes. Thus, the challenges of a dual diagnosis can impede your ability to function in your daily life, impair productivity at work or school, and strain your relationships.
Despite awareness of the challenges of unaddressed co-occurring conditions, you may question the cause. What has led to the commonality of co-occurring disorders? Listed below are some of the risk factors that can contribute to the development of dual diagnosis:
- SUD
- Substance use can cause changes in the brain that contribute to the development of mental health disorders
- Mental health disorders
- You may engage in self-medicating with substances to temporarily alleviate mental health symptoms
- Mental health disorders can cause changes in the brain that make you more susceptible to addiction
- Genetics
- Family history
- Stress
- Frequent exposure to high-stress situations
- Trauma
- Unaddressed trauma, especially in childhood, increases your risk for psychological distress and mental health disorders like post-traumatic stress disorder (PTSD)
- Certain mental health disorders like PTSD increase your risk of developing SUD
With a better understanding of dual diagnosis and its importance, you can address trauma as a root cause of addiction.
Addressing the Co-Occurrence of Addiction and Trauma
According to the European Journal of Psychotraumatology, SUD and traumas frequently co-occur with each other. In fact, as the article notes, between 20%-50% of adults seeking treatment for SUD also have PTSD. Yet, why is the co-occurrence between addiction and trauma so common? If trauma is a root cause of addiction, how does trauma lead to addiction? The correlation between addiction and trauma is not unusual or unsurprising, as trauma has a profound impact on your mental and emotional well-being.
Traumatic experiences often take a toll on your ability to cope with stress. Moreover, the thoughts and feelings attached to traumatic experiences can make it challenging to talk about processing those difficult emotions. However, while unfortunate, everyone will and has experienced trauma in their life. Trauma comes in many different forms, and some are more common for a majority of people than others. Everyone will not experience traumatic experiences like sexual abuse, but most people will experience the loss of a loved one. Thus, trauma can be as common as losing a loved one or dealing with a life-threatening or chronic health condition.
Yet, not everyone develops PTSD or SUD after experiencing a trauma. What makes some more susceptible to the harm of trauma? Several facts can contribute to the development of trauma-related mental health disorders and SUD. As noted by the National Institute of Mental Health (NIMH), many factors play a part in developing PTSD. Some factors may be present before the trauma, while others may occur during and after the trauma. Thus, everyone has risk factors and resilience factors that contribute to trauma impeding long-term well-being.
Listed below are the risk and resilience factors that can contribute to the development of mental health challenges after traumatic experiences:
- Risk factors: Can increase your risk of developing one or more mental health disorders
- A history of exposure to traumatic experiences, especially in childhood
- Getting injured or witnessing other people sustaining injuries
- Exposure to situations that leave you feeling horror, helplessness, or extreme fear
- A personal history or family history of SUD and or other mental health disorders
- Little or no social support following the traumatic experience or in general
- Experiencing other stressors after the traumatic event
- Loss of a loved one
- Chronic pain
- Painful and or life-threatening injury
- Loss of your job and or home
- End of a significant relationship like divorce or a breakup with a long-term partner(s)
- Multiple or prolonged exposure to traumatic experiences
- Sexual abuse
- Physical abuse
- Emotional abuse
- Resilience factors: Can decrease your risk of developing one or more mental health disorders
- Having a strong and mutual support network
- Seeking and reaching out for support from family, friends, and or support groups
- Help-seeking behavior to reach out for professional support
- Learning how to feel okay with your response to a traumatic event
- Building adaptive coping skills to respond to and learn from traumatic events
- Having a coping strategy that helps you feel prepared and able to effectively respond to upsetting life events
Risk factors and resilience factors are important components in determining if the relationship between addiction and trauma will be present in your life. For example, children are often resilient to trauma when they have at least one stable and committed relationship with a supportive parent, caregiver, or another adult. As stated in “Resilience” from the Center on the Developing Child at Harvard University, having at least one stable and supportive relationship gives children the skills needed to effectively cope with stress and traumatic experiences. Some of the ways one support person can help build resilience and act as a buffer to developmental disruptions include:
- Informing personalized responsiveness
- Scaffolding
- A learning process that enables, typically, a child to solve a problem, complete a task, or achieve a goal
- Children can receive support, empathy structure, encouragement, and guidance to learn and grow
- A learning process that enables, typically, a child to solve a problem, complete a task, or achieve a goal
- Providing protection
- Assisting in planning for the future
- Building monitoring skills
- Fostering the ability to regulate behaviors
- Building key capacities like planning, monitoring, and regulating behavior enables adaptivity
Access to supportive relationships, adaptive skill-building, and positive experiences are the foundational pieces of resilience. Additionally, as the National Child Traumatic Stress Network (NCTSN) states in “Resilience and Child Traumatic Stress,” children’s resilience can be further enhanced by factors like:
- Having access to resources that help buffer the negative consequences trauma has on daily life
- Creating environments in which children feel safe at home, school, and in their community
- Building self-esteem and self-worth
- Encouraging a sense of self-efficacy in different areas of life
- Understanding and building a sense of meaning in your life
- Connecting with others to foster a sense of belonging
- Having dreams
- Setting and achieving goals
- A strong foundation of spiritual and or cultural beliefs
- Recognizing your talents and skills in certain areas
- Drawing and or painting
- Writing
- Making crafts
- Sports
- Academics
- Building adaptive and flexible coping skills for different situations
There are many opportunities to support and build resilience in childhood and adulthood to reduce the harm of trauma. However, without those points or resilience, there is a greater risk of addiction and trauma in childhood and adulthood. As noted in Depression and Anxiety, early trauma exposure significantly increases your risk for mental health disorders in adulthood. Childhood trauma can compromise the neural structure and function in the brain, making you more susceptible to cognitive deficits and challenges with SUD and other mental health disorders.
For everyone who experiences trauma, there is an understandable desire to not relive those traumatic experiences. With resilience factors, you can eventually recover from the distress of trauma. However, with risk factors and fewer resilience factors, trauma is left to fester, which increases negative thoughts and feelings. Then greater distress makes it more difficult for you to manage those negative thoughts and feelings related to your trauma. Difficulty regulating your emotions can then lead to maladaptive coping strategies. Expanding your understanding of maladaptive coping mechanisms will provide more insight into how addiction and trauma work together.
Maladaptive Coping: Understanding Addiction and Trauma
Awareness of maladaptive coping mechanisms can help you better understand how addiction can take root. According to the Archives of Women’s Mental Health, coping strategies are your cognitive and behavioral efforts to manage stressful experiences. Moreover, different coping styles are a reflection of the tendency to select certain strategies based on the stress demands. The term coping strategies is a broad concept with multiple styles of strategies categorized within it. Coping strategies can encompass active or passive, approach or avoidant, problem-focused or emotion-focused, and adaptive or maladaptive coping.
For many people dealing with trauma, there is a gravitation toward maladaptive coping strategies. Typically maladaptive coping strategies include thinking and behavior patterns that perpetuate the relationship between addiction and trauma. Listed below are some common maladaptive coping strategies:
- Avoidance
- Avoiding others and or memories of the trauma
- Self-blame
- Self-medicating with substances
- Always staying on guard
- Responding to different situations and interactions with anger and or violence
- Overworking yourself
- Engaging in risky and or dangerous behaviors
- Driving too fast
- Quick to get into physical altercations
- Risky sexual behaviors
- Taking up other potentially addictive habits like smoking or vaping
- Excessive gambling
- Overspending
- Seeking dangerous activities for an adrenaline rush
- Disordered eating
- Restricting food intake
- Binge eating
- Purging food
- Engaging in self-harm
Various maladaptive coping strategies can contribute to harm from addiction and trauma over time. Typically, maladaptive coping temporarily alleviates distressing thoughts and feelings. That sense of relief from your symptoms can convince you that avoidance, distraction, and replacement behaviors are the best way to deal with challenges with addiction and trauma. However, not only is the relief temporary, but maladaptive coping worsens your mental health symptoms in the long term. Thus, it is important to address difficulties with addiction and trauma with trauma-specific approaches to treatment.
Finding Value in Trauma-Specific Approaches
Trauma-specific treatment modalities like eye movement desensitization and reprocessing (EMDR) and brainspotting are effective interventions for addiction and trauma. Although EMDR was originally developed as a therapeutic modality for PTSD, it has evolved to treat a variety of conditions. EMDR can support a wide variety of conditions like phobias, anxiety, dermatological disorders, and pain. Addiction is often rooted in trauma, and trauma perpetuates mental health disorders and SUD, thus making EMDR a valuable tool for co-occurring conditions. Some of the ways EMDR can address addiction and trauma is by using the mind-body connection of bilateral eye movements or other rhythmic forms like tapping to unlock stuck traumatic memories.
Thus, through movement, you can focus on changing the traumatic emotions, thoughts, or behaviors rather than talking directly about the trauma. Furthermore, brainspotting is another mind-body approach that can support healing addiction and trauma. Brainspotting focuses less on the direct traumatic experience and more on the feelings associated with the experience. By connecting the eyes to the brain, you can recognize trauma stuck in your body to process traumatic memories. Thus, at the root of trauma-specific interventions like EMDR and brainspotting is awareness and understanding of the self in mind, body, and spirit.
Trauma often makes you feel disconnected from yourself and others. Therefore, by reconnecting to your body with mindfulness, you can give attention, understanding, and compassion to your inner experiences to heal. Additionally, on your journey to recovery from addiction and trauma, 12-Step programs can give you the support, guidance, and accountability needed to thrive at every stage of recovery. A 12-Step program and other mutual support groups offer a wealth of services and resources for long-term recovery. However, one of the components of 12-Step programs that stands out as a tool for recovery is the social support aspect.
Social support is an important tool for building resilience against addiction and trauma. As noted in Substance Use & Misuse, 12-Step groups provide a sober and supportive social network to build stress-coping skills, as well as psychological and social well-being. Despite the barriers that exist in treating co-occurring disorders, access to holistic treatment can support healing dual diagnosis.
Empowering Recovery With Dual Diagnosis Treatment at the Guest House
At The Guest House, we know a targeted approach with dual diagnosis is vital to preventing relapse and supporting long-term recovery. Thus, it is our mission to work in collaboration with you to uncover and help you process the roots of addiction and other co-occurring disorders. When the focus is placed on understanding addiction and trauma, you can find the support and tools needed to build a treatment plan that supports a healthier you in mind, body, and spirit. Trauma-specific care allows space to treat the whole person rather than the symptoms alone. While the co-occurrence of addiction, trauma, and mental health disorders is complex, you deserve access to care that supports long-term recovery.
Experiencing trauma is a common part of life like the loss of a loved one, a life-threatening medical diagnosis, or divorce. However, when trauma is combined with risk factors and fewer resilience factors, your well-being can be harmed. Trauma can manifest as self-defeating thinking and behavior patterns like SUD and other mental health disorders. Additionally, trauma can lead to maladaptive coping strategies like avoidance and self-blame, which only worsens your psychological health and increases addiction. Thus, co-occurring challenges like addiction and trauma must be addressed and treated together to support long-term recovery. Therefore, at The Guest House, we are committed to providing holistic trauma-specific treatment modalities like EMDR and brainspotting to heal. Call us at (855) 483-7800 to learn more.