Trauma and Alcohol Misuse: What's the Connection?

You constantly feel on edge, in a perpetual state of anxiety and stress. You have trouble sleeping and just can’t seem to relax. The only relief you get comes from alcohol, but even then, it never seems to last: you always return to a high-strung state of hypervigilance. 

Living with trauma can be incredibly debilitating, affecting nearly every part of our lives. In this post, we’ll gain insight into why people who have experienced trauma are more likely to struggle with alcohol misuse. We’ll also look at healthier coping mechanisms and ways to heal from trauma. What is the link between PTSD and alcoholism (as well as complex trauma and alcohol)? Let’s get started.

What Is Trauma?

There are many different definitions for trauma, but at root, trauma is the lasting emotional response resulting from experiencing a distressing event. Trauma can be experienced in a number of different settings: at home, school, or in the wider community. 

There are a number of different types of trauma, which generally fall into two categories: type 1 and type 2 trauma. Type 1 trauma — otherwise referred to as shock or acute trauma — refers to unexpected, single-incident traumas: 

Complex Trauma and Alcohol

Type 2 trauma — otherwise referred to as complex trauma — describes trauma which may have been experienced as part of childhood or in the early stages of development. It might involve repeated events, like ongoing emotional abuse or childhood neglect:

Some experts break down traumas into “big T” and “little t” events. “Big T” traumas are usually associated with things like military combat and sexual assault. “Little t” traumas may involve emotional abuse or bullying. However, it’s worth noting that repeated exposure to “little t” traumas may cause as much emotional harm as exposure to “big T” traumas. 

What Are the Signs and Symptoms of Trauma?

Trauma can happen at any age and each person’s experience is unique. But trauma usually has lasting adverse effects on our mental, physical, emotional, and social well-being. These are some of the more common symptoms of trauma:

Trauma can also become evident physically through chronic pain, sleep problems, chest pain, or headaches. While not everyone who has experienced a traumatic event will have long-lasting effects, around 20% of people will develop post-traumatic stress disorder (PTSD). 

The Relationship Between Trauma and Alcohol Misuse

Research shows that going through a trauma — whether or not we develop PTSD — can lead to alcohol misuse. In fact, up to 75% of people who survive abuse or violent traumatic events report drinking problems. Up to a third of those who survive traumatic accidents, illness, or disaster report misusing alcohol. 

Interestingly, the risk is slightly higher for women: studies show that women with PTSD are 2.5 times more likely to struggle with alcohol misuse than women without PTSD, while men with PTSD are 2 times more likely than men without it. 

Furthermore, in a survey of adolescents receiving treatment for substance use, more than 70% had a history of trauma exposure. And 60-80% of Vietnam veterans seeking PTSD treatment have alcohol use issues, often binge drinking in response to traumatic memories. 

Why Trauma Survivors Turn to Alcohol

What is it about trauma that can cause people to struggle with alcohol misuse? To understand this connection, it’s helpful to first look at how trauma affects the brain. We might not realize it, but undergoing trauma can cause long-term changes in our neurobiology. 

Researchers have found that trauma physically alters the structure and function of our brain. Three different areas of the brain are most affected by trauma: 

• The amygdala: This is the part of our brain responsible for our fight-or-flight system. When it senses danger, it triggers a natural, protective response. Research shows that people who have experienced trauma have overactive and oversensitive amygdalas. 
• The hippocampus: This is considered the brain’s learning and memory center. Research shows that the hippocampus is smaller and less active in people who have experienced trauma. This may be why it’s harder for trauma survivors to distinguish between past and present dangers, which ultimately keeps them in a state of hypervigilance.
• Prefrontal cortex: This is the part of our brain responsible for rational decision making. It helps us calm down when we realize that something we feared isn’t actually a threat. Research shows that the prefrontal cortex in people suffering from trauma is smaller and less active. In other words, people struggling with trauma have an impaired ability to calm their amygdala or override their fight-or-flight response. 

Taken together, these changes in the brain can cause unpleasant symptoms associated with trauma, such as panic, flashbacks, and hypervigilance. Essentially, when we experience trauma, our alarm system becomes overly sensitive and is triggered much more easily. This can leave us in a perpetual state of “alarm,” wreaking havoc on our mental and physical health. 

To alleviate these symptoms, many people who experienced trauma start turning to alcohol or other substances for temporary relief. They might use alcohol to manage or numb their emotions, or avoid or forget traumatic memories. Since alcohol triggers the release of dopamine — the “feel good” chemical — drinking alcohol can help us feel better, but only temporarily. 

The Problem With Using Alcohol To Cope With Trauma

Sadly, even though alcohol can provide a sense of relief, it actually worsens and prolongs trauma-related symptoms. In fact, studies show that alcohol can increase anger and irritability, depression, anxiety, and insomnia. This can create a dangerous cycle. 

For instance, many people with trauma have trouble falling and staying asleep due to memories related to trauma or intrusive thoughts. They might turn to alcohol to help them relax and get a good night’s sleep. However, research confirms that alcohol disrupts our sleep and reduces overall quality. Inadequate sleep further contributes to a poor mood and anxiety, which can cause us to turn to alcohol for relief, perpetuating a destructive cycle. 

Furthermore, research shows that if we have both PTSD and alcohol misuse, we’re more likely to have other mental or physical health problems. For instance, up to half of adults with both PTSD and alcohol misuse have one more of the following problems:

The bottom line? While alcohol can briefly dull the effects of trauma or manage associated distress, it doesn’t treat the underlying cause and ends up exacerbating symptoms over time. 

Healing From Trauma 

Healing and recovering from trauma is not easy, but it is possible. It usually involves participating in trauma-focused psychotherapy. These are a few of the most effective types:

• Cognitive behavioral therapy (CBT): This type of therapy can help us reconceptualize both our understanding of the traumatic experience and our understanding of ourselves. It helps us challenge the unhealthy thought processes and emotions connected to our trauma and reduces the severity of our response to triggers. 
• Cognitive processing therapy: This form of CBT helps us restructure negative or maladaptive beliefs we developed due to the traumatic event. It focuses on changing painful trauma-related emotions (such as shame or guilt) and beliefs (such as “I have failed” or “the world is dangerous”). This type of therapy helps people confront distressing memories and think about what happened in a realistic way. 
• Prolonged exposure therapy: This type of therapy is designed to help us face and gain control of our fear and distress. It gradually and repeatedly exposes us to our trauma in a safe way. It also gives us self-soothing techniques for coping with triggers. 
• Eye movement desensitization and reprocessing (EMDR): This relatively new treatment method has been found to reduce symptoms of trauma. It involves making side-to-side eye movements, usually by following the movement of a therapist’s finger or a light bar, while recalling a traumatic event. Other methods include our therapist tapping their finger or playing a tone. The goal is to change how our memories are stored in our brain, reducing the amount of stress and anxiety related to the memories.

Depending on the severity of our condition, a medical professional might also prescribe certain medications to help us manage symptoms. The most commonly prescribed medications for trauma are antidepressants known as selective serotonin reuptake inhibitors (SSRIs), including Zoloft, Paxil, and Prozac. Research shows that these medications can help control some of the main symptoms of trauma, such as sadness, anxiety, anger, and sleep problems.

Coping With Trauma 

In addition to psychotherapy, self-care techniques that nourish our mental and physical well-being can be helpful. While we might not experience immediate relief, practicing these regularly will likely lead to improvements:

• Mindfulness: Research shows that mindfulness provides numerous emotional benefits, such as helping decrease anxiety, depression, rumination, and emotional reactivity. It’s also been shown to reduce activity in the amygdala, that overactive part of the brain in people with trauma. Just five minutes of mindfulness a day can help.
• Physical activity: Studies show that physical activity can help our brains better cope with stress. Even a 10-minute walk outside can boost our mood and help relieve anxiety and depression. Try to find something you enjoy doing, and then stick with it. There are so many ways to get moving — from running and biking to swimming and rowing. One of them is bound to speak to you. 
• Journal: Writing down our thoughts and feelings can help us better process them and make sense of our experience. Research shows that journaling offers a number of emotional benefits for people suffering from trauma, such as decreasing flashbacks and intrusive thoughts. It’s even been shown to reduce body tension and restore mental focus. Start with setting aside five minutes a day to write, and then gradually increase over time. 

The Bottom Line

Trauma comes in many different forms. While each person’s experience is unique, it often leaves a lasting impact that wreaks havoc on our physical, mental, emotional, and social well-being. It’s not uncommon for people suffering from trauma to turn to alcohol as a way to cope with the difficult thoughts and emotions related to their experience. While alcohol provides temporary relief, it only exacerbates symptoms in the long run. To truly heal and recover, it’s vital to seek professional treatment in the form of psychotherapy and/or medication. 

If you’ve been using alcohol to cope with trauma, consider trying Reframe. We’re a neuroscience-backed app that has helped millions of people cut back on their alcohol consumption and become healthier, happier versions of themselves.