What are the signs of post traumatic stress disorder?
A wide variety of symptoms may be signs you are experiencing post traumatic stress disorder:
It’s not just the symptoms of post traumatic stress disorder but also how you may react to them that can disrupt your life. You may:
- Frequently avoid places or things that remind you of what happened
- Consistent drinking or use of drugs to numb your feelings *** ***
- Consider harming yourself or others
- Start working all the time to occupy your mind
- Pull away from other people and become isolated
- Feeling upset by things that remind you of what happened
- Having nightmares, vivid memories, or flashbacks of the event that make you feel like it’s happening all over again
- Feeling emotionally cut off from others
- Feeling numb or losing interest in things you used to care about
- Becoming depressed
- Thinking that you are always in danger
- Feeling anxious, jittery, or irritated
- Experiencing a sense of panic that something bad is about to happen
- Having difficulty sleeping
- Having trouble keeping your mind on one thing
- Having a hard time relating to and getting along with your spouse, family, or friends
Relationships Between Post traumatic Stress Disorder and Substance-Use Disorder
Several explanations have been proposed for the high level of PTSD/SUD co-morbidity. First, PTSD can lead to SUD. As one example from a developmental perspective, childhood traumatic stress may challenge maturing self-regulatory mechanisms on both the neurobiological and behavioral levels, thereby increasing the risk for later SUD. Throughout life, it is observed that people with PTSD may ‘self-medicate’ with substances as a way of coping with overwhelming PTSD symptoms. Second, SUD is known to heighten the likelihood of trauma exposure, hence the risk of PTSD (the high-risk hypothesis). Third, SUD can also lead to a higher probability of developing PTSD after trauma exposure, due to a higher psychological and biological vulnerability for the disorder in individuals with chronic substance abuse (the susceptibility hypothesis). Fourth, and finally, the PTSD/SUD relationship may be mediated by a third variable, such as disconstraint, and deficits in coping skills. Although there is no single explanation for the PTSD/SUD relationship and different pathways are not mutually exclusive, the notion that PTSD has an important influence on the development of SUD has received the most empirical support. For example, a series of laboratory studies has found evidence for the impact of trauma-related cues on craving for substances. Participants with PTSD reported higher levels of craving in response to trauma-related cues than to neutral cues. Moreover, alcohol craving and distress in response to trauma images decreased in patients receiving six sessions of trauma-focused imaginable exposure, but did not change in control patients. In other studies of patients with PTSD/SUD, greater use of substances was associated with situations involving unpleasant emotions, physical discomfort and interpersonal conflicts than with situations involving pleasant or neutral situations. Similar associations were found between PTSD status and reasons for relapse in recently abstinent patients. For instance, VA. found that PTSD/SUD patients were more likely to report substance use in response to negative emotions than in response to substance cues, in the first 6 months after treatment. A study by Back et al. reported direct relationships between PTSD symptoms and current substance use in a small sample of cocaine-dependent patients. Eighty-six percent reported an increase in substance use when PTSD symptoms increased and 64% reported a decrease in substance use when symptoms of PTSD improved. In another study, improvement in PTSD symptoms appeared to have a greater impact on alcohol treatment response than the reciprocal relationship. However, it is also clear that substance use can maintain and exacerbate PTSD symptoms.
something to think about:
Ten Years Ago Portugal Decriminalized All Drugs. What Happened Next? Drug related deaths fell by 50%
The government in Portugal has no plans to back down. Although the Netherlands is the European country most associated with liberal drug laws, it has already been ten years since Portugal became the first European nation to take the brave step of decriminalizing possession of all drugs within its borders—from marijuana to heroin, and everything in between. This controversial move went into effect in June of 2001, in response to the country’s spiraling HIV/AIDS statistics. While many critics in the poor and largely conservative country attacked the sea change in drug policy, fearing it would lead to drug tourism while simultaneously worsening the country’s already shockingly high rate of hard drug use, a report published in 2009 by the Cato Institute tells a different story. Glenn Greenwald,the attorney and author who conducted the research, told Time: “Judging by every metric, drug decriminalization in Portugal has been a resounding success. It has enabled the Portuguese government to manage and control the drug problem far better than virtually every other Western country.”
Back in 2001, Portugal had the highest rate of HIV among injecting drug users in the European Union—an incredible 2,000 new cases a year, in a country with a population of just 10 million. Despite the predictable controversy the move stirred up at home and abroad, the Portuguese government felt there was no other way they could effectively quell this ballooning problem. While here in the U.S. calls for full drug decriminalization are still dismissed as something of a fringe concern, the Portuguese decided to do it, and have been quietly getting on with it now for a decade. Surprisingly, most credible reportsappear to show that decriminalization has been a staggering success.
The DEA sees it a bit differently. Portugal, they say, was a disaster, with heroin and HIV rates out of control. “Portugal’s addict population and the problems that go along with addiction continue to increase,” the DEA maintains. “In an effort to reduce the number of addicts in the prison system, the Portuguese government has an enacted some radical policies in the last few years with the eventual decriminalization of all illicit drugs in July of 2001.”
However, as Greenwald concludes: “By freeing its citizens from the fear of prosecution and imprisonment for drug usage, Portugal has dramatically improved its ability to encourage drug addicts to avail themselves of treatment. The resources that were previously devoted to prosecuting and imprisoning drug addicts are now available to provide treatment programs to addicts.” Under the perfect system, treatment would also be voluntary, but as an alternative to jail, mandatory treatment save money. But for now, “the majority of EU states have rates that are double and triple the rate for post-decriminalization Portugal,” Greenwald says.
For those looking for clues about how the U.S. government can tackle its domestic drug problem, the figures are enticing. Following decriminalization, Portugal eventually found itself with the lowest rates of marijuana usage in people over 15 in the EU: about 10%. Compare this to the 40% of people over 12 who regularly smoke pot in the U.S., a country with some of the most punitive drugs laws in the developed world. Drug use of all kinds has declined in Portugal: Lifetime use among seventh to ninth graders fell from 14.01% to 10.6%. Lifetime heroin use among 16-18 year olds fell from 2.5% to 1.8%. And what about those horrific HIV infection rates that prompted the move in the first place? HIV infection rates among drug users fell by an incredible 17%, while drug related deaths were reduced by more than half. “There is no doubt that the phenomenon of addiction is in decline in Portugal,” said Joao Goulao, President of the Institute of Drugs and Drugs Addiction, at a press conference to mark the 10th anniversary of the law.
We’re not holding our breath that the Portuguese example will lead to any kind of abrupt about-face in America’s own drug war, which is still sputtering steadily along at a cost of trillions a year. However, with the medical marijuana movement so far refusing to be strangled out of existence by the DEA, Senators Jim Webb and Arlen Specter recently made a proposal to create a blue ribbon commission to look at prison and drug sentencing reform. And for any pro-legalization presidential hopefuls in 2012, the movement for a common sense drug policy in the United States may be finally moving into the mainstream.