The Relationship Between Stress Disorders And Addiction

Substance use disorders with co-occurring stress disorders require special treatment considerations. Symptoms can include avoidance of specific situations and increased negative thoughts. Treatment aims at lowering stress levels and teaching coping mechanisms.

Stress, and how the brain responds to it, often plays a key role in the development of alcohol and drug addiction.

People with stress disorders may use drugs or alcohol as a way to cope with high levels of stress related to past difficult experiences.

This can make substance abuse more likely, leading to co-occurring addiction and mental health disorders.

Treatment options should consider the stress disorder and the addiction for best results.

What Are Stress Disorders?

Stress disorders can occur to anyone of any age after experiencing a traumatic or stressful event. It isn’t fully known why some people develop them while others do not.

The two main stress disorders have the same symptoms but differ in how long the symptoms last.

Acute stress disorder (ASD) usually appears directly following a stressful experience and lasts for only a few days or up to a few weeks.

Post-traumatic stress disorder (PTSD) lasts longer than a month. It is often associated with veterans, but its prevalence is more common than most people are aware of.

Acute Stress Disorder And Addiction

Acute stress disorder is more likely to occur after events involving violence, such as assaults and mass shootings, than events such as accidents or natural disasters.

Risk factors include having experienced other traumatic events or having had PTSD or another mental health disorder.

Substance use disorder (SUD) is one mental health condition that can co-occur with ASD. In fact, addiction and acute stress disorder comorbidity is fairly common.

Alcohol or drug use can seem, at first, to work in bringing stress levels down. However, signs of addiction can develop, which makes it even more difficult for the brain to self-regulate.

Symptoms Of Acute Stress Disorder

The symptoms of acute stress disorder appear soon after the stressful event and go away within a month. If the symptoms last longer than a month, it’s considered PTSD.

In both ASD and PTSD, the symptoms must be persistent enough to cause significant distress and impair regular functioning.

The following are common symptoms of acute stress disorder:

  • sleep disturbances
  • angry outbursts or irritability
  • avoidance of stressors/reminders of the event
  • reliving the event (e.g., in dreams, flashbacks, or recurring memories)
  • more negative thoughts than before the event

How Acute Stress Disorder And Addiction Are Connected

By definition, the symptoms of ASD must be causing a significant disturbance in a person’s life for diagnosis.

Stress in general can lead to substance use. This can turn into substance dependence as tolerance grows and withdrawal becomes difficult. Stress also typically makes relapse more likely.

Without treatment, ASD often develops into post-traumatic stress disorder. One large study indicates that 80% of people with ASD will go on to develop PTSD.

Post-Traumatic Stress Disorder (PTSD) And Addiction

PTSD can develop immediately following or even months after a traumatic event, including experiencing or witnessing physical or sexual abuse, an accident, etc.

Substance abuse and PTSD often co-occur. People don’t always know that they have PTSD and may use drugs or alcohol to try to control their symptoms.

Depressants like alcohol or pain-relieving illicit and prescription opioids might seem to work for addressing jittery, distressing emotions like anxiety.

However, as cravings and alcohol dependence or drug abuse develop, the ability to self-regulate deteriorates further.

Symptoms Of PTSD

PTSD symptoms are the same as those of ASD but last longer. See the symptoms listed above for acute stress disorder.

PTSD in children is different from PTSD in adults, but as children grow, their symptoms will begin to match those of adults.

PTSD in children younger than 6 years old: The child might always want to be with their parent(s), act out trauma scenes in their play, or have trouble sleeping.

PTSD in children ages 6 to 11: The child might represent trauma scenes in their play, drawings, or stories; have nightmares; become aggressive; or avoid school or friends.

PTSD in adolescents ages 12 to 18: They might experience depression or anxiety, withdraw from family and friends, and engage in risky behavior like substance abuse.

How PTSD And Addiction Are Connected

In an effort to overcome symptoms of PTSD like sleep disturbances and painful flashbacks, someone might turn to drug or alcohol use.

The use of substances can lead to craving them for their effects, and drug or alcohol abuse symptoms can develop.

Because the underlying issue wasn’t treated, a vicious circle can develop between managing PTSD symptoms and cycling between substance abuse and withdrawal.

PTSD affects every aspect of a person’s life and can be disabling. This can lead to other mental health issues.

For example, when someone with PTSD starts avoiding family and friends, they are more likely to develop depression.

Depression and substance abuse are co-occurring disorders themselves. Anxiety is also likely to happen with PTSD, and anxiety and addiction are also linked.

Can Stress Lead To Addiction?

Research makes a strong link between stress and addiction. In general, the more stress a person has in their life, the more prone they are to substance abuse.

Childhood Trauma

Early stressful life experiences are one indicator that a person will use drugs or alcohol. In people who experienced child abuse, the chances for addiction are particularly high.

Child abuse — in the forms of physical violence, sexual abuse, and emotional neglect — is so common in the U.S. that it is considered a public health problem.

Other common childhood indicators for substance use include the loss of a parent to drugs or another tragedy, divorce or conflict between parents, and isolation.

Studies have shown that the unpredictability of an event and the inability to control it lead to higher stress levels. It’s easy to see how children could often feel this way.

One symptom of stress disorders is memory loss of details of the event. For some, childhood memories resurface years later, after the trauma has taken a toll.

Poor Coping Strategies For Stress

Stress is a normal part of life, but not everyone is taught healthy coping mechanisms for dealing with it.

With these mechanisms in place, people are less likely to turn to drugs or alcohol. Without them, people may come to rely on a substance to avoid any feelings of stress.

Studies show that the more stress is experienced in a person’s life, the greater their chances are of using alcohol or drugs to cope.

Coping mechanisms for dealing with addiction triggers are also helpful for people with co-occurring stress disorders.

Stress And Self-Medication

People experiencing high levels of stress are more likely to use illicit drugs or alcohol in an effort to self-medicate. This can lead to a drug or alcohol addiction.

Pain and chronic stress are also linked. Stress isn’t always the cause of underlying pain, but whatever the cause, being in pain a lot of the time feeds into the stress response.

Additionally, chronic stress can cause tightness and tension, migraines, and muscle spasms. Stress has even been linked to flare-ups of symptoms of arthritis, fibromyalgia, and other health conditions.

Those with chronic pain or pain following injury or surgery might be prescribed opioids, like hydrocodone, or otherwise seek them out. All opioids are very addictive and come with a risk of abuse.

Chronic stress can also lead to financial, relationship, and other life issues that might cause someone to self-medicate with substances.

In addition to stress disorders and substance use disorders, stress can lead to other co-occurring mental health conditions, like anxiety disorders and addiction.

Chronic Stress And Gray Matter

Chronic stress is defined as a feeling of being overwhelmed or pressured for a long period of time. Studies have shown that chronic stress leads to a reduction of gray matter in the brain.

Gray matter is involved in many processes in the brain and body. Among them are sensory perception, cognitive control, stress regulation, and decision-making.

People with less gray matter have increased risk factors for substance abuse.

Cortisol And Substance Abuse Risk

It’s widely acknowledged that higher stress responses (i.e., higher cortisol levels) can increase the risk of substance abuse.

However, some studies have found the opposite to be true: In some people who live with addiction, low cortisol responses actually show an increased risk of substance use and relapse signs.

This may be due to the fact that people who display lower cortisol levels have fewer inhibitions and have a much lower level of fear than the general population.

Others may have dulled senses and turn to stimulants such as crack cocaine and methamphetamine in search of a thrill.

Treating Stress Disorders And Addiction

Like all co-occurring disorders, stress disorder and addiction are best treated when both conditions are identified and diagnosed.

This is especially important because stress is a normal part of life; that is, it’s always going to be a factor.

Long-term outpatient support, recovery groups, and regular therapy can be helpful supports to manage this stress.

Giving people the best treatment and resources for coping with stress as well as with addiction is necessary for their healing and overall well-being.

Some studies have found that inpatient addiction programs work particularly well initially due to the intensity of withdrawal and related substance cravings.

Inpatient programs offer 24/7 care and support, which can be especially helpful with co-occurring disorders.

Outcomes For Stress Disorder And Addiction

One recent healthcare study showed that approximately half of all people seeking substance abuse treatment have co-occurring PTSD.

Although SUD alone is easier to treat than SUD and co-occurring PTSD, treatment options for the dual diagnosis exist.

Evidence-based treatments that are trauma-focused, such as prolonged exposure and cognitive processing therapy (a type of cognitive behavioral therapy), have shown good results.

Interventions related to self-control also show promising results for the treatment of PTSD and co-occurring addiction, since impulsive behaviors can be common.

Getting Help With Stress Disorders And Addiction

If you or a loved one is living with a stress disorder and addiction, know that you are not alone and that it is possible to live a full, healthy life.

The addiction treatment programs at Spring Hill Recovery Center take into account the needs of each individual, giving added attention to dual diagnosis conditions.

Reach out to us today if we can answer any questions you have about our Ashby, Massachusetts treatment programs and care team.

  1. Annals of the New York Academy of Sciences – Chronic Stress, Drug Use, and Vulnerability to Addiction https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1196/annals.1441.030
  2. Frontiers in Behavioral Neuroscience – Association of Fatigue and Stress With Gray Matter Volume https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066525/#:~:text=Discussion-,Stress%20is%20associated%20with%20a%20greater%20risk%20for%20various%20health,means%20to%20objectively%20evaluate%20stress.
  3. International Journal of Psychophysiology – Cortisol secretion patterns in addiction and addiction risk https://www.sciencedirect.com/science/article/abs/pii/S0167876005002631?via%3Dihub
  4. Merck Manual: Consumer Version – Overview of Trauma- and Stress-Related Disorders https://www.merckmanuals.com/home/mental-health-disorders/anxiety-and-stress-related-disorders/overview-of-trauma-and-stress-related-disorders
  5. National Institute on Drug Abuse – Stressful Experiences Affect Likelihood of Remission of Drug Dependence, Continued Drug Use, and Relapse https://nida.nih.gov/news-events/nida-notes/2018/02/stressful-experiences-affect-likelihood-remission-drug-dependence-continued-drug-use-relapse
  6. Substance Abuse and Mental Health Services Administration (SAMHSA) – Posttraumatic stress disorder (PTSD) https://www.samhsa.gov/resource/dbhis/posttraumatic-stress-disorder-ptsd
  7. U.S. Department of Veterans Affairs – PTSD: National Center for PTSD https://www.ptsd.va.gov/index.asp

Written by Spring Hill Recovery Editorial Team

© 2024 Spring Hill Recovery | All Rights Reserved

* This page does not provide medical advice.

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