PTSD and Alcohol Abuse

Why the link exists, and what you can do

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You may have nearly constant feelings of high anxiety, and an almost paranoid need to watch your back. There could be bad memories that won’t go away. Or, maybe you have an occasional fight with your partner and it leads to intense feelings of helplessness.

These are signs of possible post-traumatic stress disorder (PTSD), or of related symptoms called complex PTSD. Many people struggle with these experiences, and often turn to alcohol or substances for needed relief.

However, combining PTSD and alcohol only provides a band-aid to the problem. And, it often makes symptoms worse in the long run. Here’s a look at PTSD and drinking, different types of PTSD, and how you can heal and cope without using alcohol.

Table of Contents

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What Is PTSD?

PTSD is the term mental health professionals use to describe a specific set of symptoms. There’s a commonly accepted myth that PTSD only affects veterans with combat experience. However, it actually has many causes, and can impact anyone.

PTSD begins with a difficult trauma. Common ones are sexual abuse or sexual assault, accidents, physical abuse, military experiences, or the traumatic death of a loved one. However, any situation that makes you feel powerless—as if you won’t survive, can’t save someone else, or can’t protect yourself—could lead to PTSD.

The majority of people who survive a trauma won’t experience PTSD. But studies show that somewhere between 5 to 10 percent will.1 That adds up to millions in the U.S. alone.

shadow of a young man, ptsd and alcohol

PTSD and Alcohol Abuse

Many people who struggle with PTSD also struggle with alcohol. According to the U.S. Department of Veterans Affairs, men and women with PTSD are more than twice as likely to have alcohol use disorder vs those who do not.2 As for substance abuse more generally, over 46 percent of those with PTSD may qualify as having a substance use disorder.

More data is needed on complex PTSD and drinking, but therapists anecdotally report that clients often use alcohol to manage symptoms. This is frequently referred to as self-medication, and is a common reason why people become dependent on alcohol.

While alcohol often seems to help in the moment, it has the ability to make some symptoms of PTSD worse long-term—including depression, anxiety, heightened stress response, and insomnia. But because many people struggle to find other short-term relief from intense symptoms, PTSD and alcohol abuse can sometimes form a vicious cycle.

Symptoms of PTSD

Symptoms of PTSD may include the following:

  • Intrusive memories of the trauma that can pop up with reminders or at unexpected times
  • Attempts, which don’t work for long, to push traumatic memories or reminders away
  • Avoidance of any reminders of the trauma, including places and conversations
  • Depression-like symptoms, which relate to the negative thoughts about yourself and the world
  • Feelings of despair and helplessness
  • Hypervigilance, as if you are in danger—even when you logically know you’re not
  • Feeling on edge, jumpy, or startling easily

Some people experience additional symptoms, including:

  • Flashbacks, where you feel intensely as if the trauma is happening again
  • Dissociation, where you may feel “spaced out” for long periods, or as if you’re not in your body—especially when memories of the trauma are triggered

Complex PTSD

Over the years, trauma specialists have noticed an additional type of response to trauma. Rather than daily symptoms, which often occur with PTSD, these triggers may happen only occasionally. They are often triggered by relationship issues—with significant others, family, or authority figures.

This is often referred to as complex PTSD, or developmental PTSD. Complex PTSD can sometimes refer specifically to ongoing episodes of trauma, such as ongoing sexual or emotional abuse as a child.

These terms are not yet included in the diagnostic manual used by mental health professionals, but the general idea of complex trauma is accepted by many therapists. A specialist in complex trauma, Pete Walker, identifies the following complex trauma symptoms:3

  • Emotional flashbacks
  • Toxic shame
  • Self-abandonment
  • Vicious inner critic
  • Social anxiety

While those with complex trauma may not have the same outward signs of PTSD, such symptoms can cause havoc in all areas of a survivor’s life.

Why Do People Drink to Cope With PTSD?

While the long-term effects of drinking to cope with PTSD can be profoundly negative, there are many reasons why there is a strong connection between PTSD and alcohol abuse.

Drinking alcohol causes the release of chemicals such as dopamine, serotonin, and endorphins in your brain and body. It also binds to some of your GABA receptors, temporarily calming your nervous system. This can flood your body with positive sensations, while providing momentary relief from many PTSD symptoms—including depression, hypervigilance, anxiety, and negative self-talk.

The trouble, however, is that this relief is only temporary. In fact, as the alcohol leaves your system, many PTSD symptoms can become worse. For example, many people experience heightened anxiety after a night of drinking, as well as an increased stress response. This can tempt them to continue drinking to push these feelings away.

Long-term, many people with PTSD develop a dependence on alcohol for this very reason. Alcohol provides temporary relief, while also increasing the likelihood of stress, anxiety, depression, and even insomnia as the effects wear off. In fact, chronic heavy drinking can actually change your brain chemistry, worsening and even causing some of these mental health issues as time goes on. This can make it especially hard to quit drinking, or deal with underlying trauma.

But if you’re struggling with severe PTSD symptoms, what other choices are there? Fortunately, although the problem is complex, a number of safer, healthier treatment options for PTSD have emerged. It can take time to overcome past trauma, but it really is possible to get your life back, without drinking alcohol to cope.

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Treatments for PTSD

There are different views in the mental health field about treating trauma. Some believe symptoms are mainly feeling-related, and stored in the body. Cognitive behavioral therapists, meanwhile, believe PTSD symptoms relate mainly to thoughts. Others believe it’s a combination of both—an interplay between physical sensations and thoughts about trauma.

Recent research has also found specific networks in the brain that help people resolve trauma symptoms and other anxiety triggers.4 It’s possible that, by healing these, some people can experience relief from PTSD symptoms.

Based on the evidence so far, there are a number of treatments that appear to work for PTSD. The following three are among the most popular, proven to help treat PTSD in adults:


EMDR refers to eye movement desensitization and reprocessing.5 This is a therapy that involves revisiting the trauma in your mind, while stimulating both sides of your brain. This can be achieved by watching lights or tapping both sides of your body. The idea is that the stimulation helps activate more parts of the brain, and makes the processing easier.

Skilled EMDR therapists are able to guide the client through multiple past traumas, resolving elements of each one. The therapy can work in a matter of weeks or months.

Prolonged Exposure

The prolonged exposure approach involves attacking the trauma directly.6 After learning some self-soothing techniques, individuals jump into facing traumatic memories head on. Individuals repeatedly tell the story of the trauma to the therapist.

This desensitizes people to the trauma, while allowing them a chance to resolve unprocessed memories and beliefs. This is considered a type of cognitive behavioral therapy (CBT).

Cognitive Processing Therapy

Cognitive processing therapy approaches the trauma more gradually.7 It begins with identifying negative beliefs that relate to the trauma. These often involve guilt and shame.

Many who suffer a trauma mistakenly believe it was their fault. The therapist helps the client challenge each of these beliefs. In some cases, survivors also write and read the story of the trauma, to overcome avoidance and further help with needed processing. This is a type of CBT therapy as well.

Treating Alcohol Abuse Linked To PTSD

For those with a diagnosis of PTSD with alcohol use disorder, it’s often necessary to treat both issues at once. This can be challenging, but with newer approaches to alcohol treatment, it is increasingly easy to accomplish.

Many modern treatment programs now recognize the importance of counseling and recovery coaching in helping people overcome alcohol addiction. In addition, advances in anti-craving medication have made it easier to control some symptoms of addiction, giving people more room to work on underlying trauma.

Finally, it is now possible to get treatment for alcohol use disorder completely online. Programs like Ria Health now give you access to medical and coaching support from your smartphone, as well as prescriptions, support groups, and much more. Holistic care is now just a tap away.

If you struggle with both PTSD and alcohol abuse, get in touch to learn how our team can help you get your drinking under control, and work towards long-term healing.

woman clasping hands, ptsd and alcohol