What is trauma anyway, and does it contribute to addiction?
In this post, we’ll be tackling that complicated question. We’ll start by looking into what causes addiction in the first place, and then we’ll take a deep dive into trauma. Along the way, you’ll learn how unresolved trauma can contribute to the development of addiction. You’ll learn how the brain responds to trauma and how that response can change in response to treatment. Finally, we’ll look at PTSD and see how it, too, can contribute to substance abuse.
Let’s get started.
What Causes Addiction?
Addiction is a startlingly complex condition. It’s difficult to distill its cause down to a single factor. Indeed, researchers now believe there are many factors that, combined, contribute to whether a person will develop an addiction. In this section, we’ll explore these in-depth.
First, however, it’s important to understand that anyone who uses drugs is at risk of developing a dependency, and anyone can go on to develop a substance abuse problem. Some drugs, such as nicotine and heroin, are just so addictive that using them excessively can get anyone hooked.
Most people who use drugs do not become addicted. However, certain people have a higher predisposition to addiction than do other people. There are several risk factors that contribute to this. Let’s take a look.
- Genetic predisposition. Family studies comparing twins, adoptees and siblings suggest that up to half of a person’s risk for developing addiction comes down to genetic predisposition.
- Brain characteristics. Certain areas of the brain, such as the ventral tegmental area, the nucleus accumbens and the prefrontal cortex can develop differently from person to person. The aforementioned brain areas are important components of the brain’s reward pathway. If you are born with slight abnormalities in any of these brain regions, you may be more likely to develop an addiction than other people.
- Personality traits. Being born with certain personality traits, like high Impulsivity, novel sensation seeking, anxiety or depression can make you more likely to use drugs. Combined with the next item on this list, this behavior can lead to addiction.
- Brain changes during life. Using stimulants, nicotine, opioids, alcohol or sedatives even casually changes brain function. Eventually, these changes add up, which can lead to full dependency and addiction.
- In particular, experimenting with drugs or alcohol early in life, when the brain is still developing, has been shown to contribute to addiction. Note that having a few of these risk factors does not guarantee that you’ll develop a substance abuse disorder. It does mean, however, the odds that you’ll become addicted to a substance or behavior are higher than they would be otherwise. Naturally, the more risk factors present, the higher the odds you’ll struggle to control your consumption should you choose to use drugs or alcohol.
There’s one more factor we haven’t looked at yet, and that’s the environmental factor. This is a category that we could describe broadly as ‘trauma.’ Under this umbrella, we have:
- Physical or sexual abuse
- Emotional abuse
- Substance use or abuse in the immediate family or household
Two other environmental factors contribute to this:
- Exposure to drug abuse among peers
- Frequent exposure to pop-culture references to drug abuse
These factors serve to normalize the behavior, which can encourage the traumatized individual to experiment with drugs. Self-esteem issues, such as a desire to fit in or be liked, can play a role here.
While the genetic component plays a large role in determining whether a person will develop a substance abuse disorder, trauma alone can contribute heavily as well. Unresolved trauma from childhood can contribute to the development of personality traits, mentioned above, that can lead a person to try drugs in the first place. Then, once drug use has begun, the compounds create changes in the brain that makes repeated drug use more likely.
Trauma and Addiction
A child’s circumstances shape their physical and psychological development. Consequently, researchers have, in recent years, given more scrutiny to drug abuse in the household. They’ve also looked into how certain types of abuse affect personality and brain development. The aim of this work is to find causal relationships between these early life factors and later drug use and abuse.
One result of this research was the discovery that the brain reacts and responds to its environment, through a phenomenon known as neuroplasticity. As the brain develops through childhood and into early adulthood, it forges and strengthens certain neural connections. These connections, taken together, form a neural network between neurons. It’s these neural networks that allow the brain to parse and interpret its environment.
If you could look at the brain of someone who grew up in a wholesome, loving home and the brain of someone who grew up in an abusive home, you would see big differences between them.
In other words, the physical structure of the brain is heavily influenced by experience.
According to the Adverse Childhood Experiences study, which followed 17,000 addicted adults, the stress of trauma can contribute to the development of dependence on chemical substances. In the study, around two-thirds of participants reported at least one childhood experience of either abuse or neglect. Most, however, reported more than one. The study implies that dependence can develop in the absence of genetic factors if trauma is severe enough. It also underscores the fact that prevention plays an important role in reducing addiction rates.
Children In dysfunctional homes are particularly vulnerable to trauma because they rely on family members for support. If parents, siblings or other guardians do not provide that support, the result can be long-term changes in brain structure that can predispose the individual to chemical dependence.
Fortunately, brain plasticity goes both ways. Unhelpful responses can be unlearned over time. More on that in a bit.
What Causes Trauma Anyway?
When someone is exposed to more stress than they can cope with, trauma is the result.
For instance, a young child who is physically abused lacks the frame of reference to realize that abuse is unacceptable. They often blame themselves, reasoning that they must have done something to deserve the abuse. At the same time, the child lacks the ability to escape the treatment, and this overwhelms their ability to cope. The result is trauma.
In response to trauma, the child may begin to act out at home or school, lacking any other alternative. This can, and often does, result in further abuse.
Throughout all of this, and over many years, the child’s brain is developing. The abuse, and the attempt to cope, shapes ultimate brain function.
The inaccurate perception that maltreatment must be their fault can linger into adulthood. When this happens, the person may be more likely to struggle with self-esteem. This in turn makes them more likely to engage in risk-seeking behaviors to get the approval of others and to engage in frequent sexual encounters as a substitute for genuine relationships.
Naturally, it isn’t just physical abuse that can result in trauma. Other types of guardian to child abuse include:
- Neglect
- Repeated abandonment
- Sexual abuse
- Psychological abuse
A Closer Look at Trauma and Its Effects on Youth
Meet Erin. Erin is 30 years old, and she’s struggling with addiction. When she was young, she often had to watch her parents arguing, often while waiting for a meal, a bath or some other necessity she was too young to do for herself.
The arguments Erin witnessed weren’t always limited to the verbal. She often witnessed her father push her mother, and sometimes, her mother pushed back. As Erin got older, she became capable of taking care of herself. First, of course, she learned to bathe herself. Then she learned to cook. Then she learned to study on her own, so she wouldn’t have to rely on her parents to help her.
But always, throughout it all, there was the yelling—the yelling that kept her up late at night. The yelling that caused her to be sleepy during class, and during tests.
Erin was most afraid when her parents drank. She knew that the drink would make the shouting intensify, the shoving to increase in frequency and the walls to cave in. Sometimes, Erin’s mother would cover the holes her father punched into the walls with posters of famous rock stars or nature scenes.
Once, when Erin’s father had been on his second bottle, he threw Erin into the wall, the way he’d throw his fists into the wall in years gone by. That hurt Erin physically, but the emotional pain was worse. The emotional pain never faded. Not really. Shortly thereafter, Erin’s father ‘went away’ for something or other, as her mother put it. Erin never spoke to him again, because he died in prison.
Erin’s mother went through a string of boyfriends. Most of them abused alcohol, but some of them used drugs. It was from them that Erin’s mother learned to use the needle. Many of the men physically abused her mother, and the police became frequent visitors.
When Erin was fourteen, her mother left the state to live with a boyfriend. Erin went to live with her grandmother, which meant going to a new school. At school, Erin became friends with kids who used drugs and alcohol. It wasn’t long before she was using too. Fearing her granddaughter was going down a familiar path, but unsure what to do and at her wit’s end, Erin’s grandmother kicked her out.
Erin moved in with her boyfriend and began experimenting with crystal meth. Over the next few years, Erin was in and out of jail on a variety of petty offenses until she landed a serious charge at the age of 18. By 30, she had done several stints in jail. The result of one of these was an order to seek addiction treatment.
Erin does not exist. She’s a fictional person. But her story contains elements that would be all too familiar to many people struggling with drug addiction.
PTSD
There is another level of trauma that we should address here, and that is PTSD. You can think of PTSD as trauma on steroids, and as we’ll see, people afflicted with PTSD have a higher likelihood of experimenting with drugs.
The perception among the public is that post-traumatic stress disorder is something that only affects veterans. While veterans struggling with PTSD receive the most recognition, PTSD can occur in any individual who has survived a particularly stressful event.
It may surprise you to know, for instance, that PTSD rates are actually highest among women who have survived severe childhood trauma. Around 10 percent of women will experience the symptoms of PTSD at least once in their life. The figure is around 5 percent for men.
Of course, PTSD can occur from a wide range of traumas. In fact, the condition can result from witnessing any of the following:
- Military combat
- Severe accidents or injuries
- The aftermath of natural disasters
- Sexual or physical abuse
- Acts of terrorism
Overall, around one-third of people exposed to severe trauma develop PTSD.
Symptoms of PTSD include:
- Mentally re-living the event as a sudden, intense flashback
- Avoiding situations that remind the person of the traumatic event
- Feeling numb or apathetic
- Feeling disconnected from family and friends who ‘just don’t get it’
- Persistent, general anxiety
- Higher rates of substance abuse than the general public.
Once the symptoms of PTSD emerge, they typically don’t resolve on their own. However, recent breakthroughs in exposure therapy provide hope that treatment providers can put the condition into remission.
PTSD may form as the result of unresolved trauma, but once present, it changes the way the brain functions. In fact, its impact on brain function is quite similar to what occurs in drug abuse. Indeed, PTSD and drug dependence can occur simultaneously, and they can feed off of each other.
In other words, the trauma that led to PTSD can also trigger substance abuse disorder. This is why, sadly, if an affected person doesn’t seek treatment for both PTSD and addiction at the same time, they may relapse. Compounding matters further is the fact that those with PTSD are prone to panic attacks. These attacks, which may manifest as aggressive outbursts, are difficult for family members to cope with.
This may lead the person with PTSD to experiment with drugs and alcohol. Once the brain identifies the substance as a way to cope with stress, decadency can quickly develop.
Recovering from Addiction
If you see yourself in any of the above, know that help is out there.
Childhood trauma may have increased your vulnerability to addiction, but you can, right now, decide to take the first step in breaking free. Will it be easy? No, it won’t. Will you have to deal with mental and emotional baggage you’d rather allow to collect dust in the more shadowy recesses of your mind? Yep. Will it hurt? Yes.
You should do it anyway.
Anyone can be a victim. Anyone can allow circumstance to mold them, to shape their actions. But not everyone can say enough. Not everyone will take action to proactively shape their destiny.
The first step in getting clean is, of course detox. This won’t be fun. But going through detox in a qualified rehab facility, as an inpatient, ensures that you get through it. The worst thing you can do is go at it halfheartedly. This is one reason an in-treatment facility is generally the better option if you can afford it. If you want to stop using but just can’t, an outpatient facility might not do the trick.
But detox isn’t even half the battle.
You have deep seated issues that you must address in order to gain control over your thoughts and actions. Trauma-informed services, which utilize proven therapy modalities such as cognitive behavioral therapy, can help you gain control. For instance, CBT familiarizes you with your most common thought distortions. Thought distortions are inaccurate or exaggerated thoughts. We all have these thoughts from time to time, but individuals who have lived through trauma tend to have them more often.
If you’ve ever caught yourself thinking things like the following, then you’re familiar with thought distortions:
- No one else gets it
- This is as good as it gets
- I’ll have to live with this for the rest of my life
- I’ll always be a slave to my drug use
These are thought distortions because they’re not based in reality. The above thoughts are representative of several thought distortions, namely:
- Catastrophizing
- Overgeneralization
- Emotional reasoning
- Other blaming
- Self blaming
- Fortune telling
- …and many more
These thought distortions are dangerous because, if left unchecked, they will influence your actions. A quality rehab facility with trauma-informed services can help you learn to challenge these thought distortions as they arise, enabling you to lessen their influence on your behavior.
In addition, a trauma-informed facility has the following core values:
- Trustworthiness. These facilities operate with transparency. Learn to gain control over your addiction in a supportive, nurturing environment. You’re no longer on your own.
- Collaboration. They’ll tell you what’s expected of you. Tasks are clear. It’s up to you to do the work. If you follow through, they’ll do their part to help you gain control over your addiction.
- These programs focus on empowering you to gain control. You’ll learn powerful skills to manage your addiction once out in the world at large.
- Safety. These facilities put an emphasis on ensuring physical and emotional safety at all times.
If you’re struggling with addiction, there’s no doubt that a quality rehab facility can help you. But you must be prepared to work hard. Remember, the brain can change over time. One of the advantages of CBT, if you do it consistently, is that it can teach the brain to operate in new, more beneficial ways. Over time, you’ll cope more readily with cravings, and you’ll learn to avoid potential relapse triggers.
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