Alcohol has some strong effects on people with PTSD and those effects turn out to not be what we expected.
Recently I came across a couple of studies about the interaction of alcohol and PTSD. There may be more studies about this and I will keep looking. But here are some things we think we know.
The way in which memories are stored will depend on the level of alcohol in the bloodstream when the traumatic event occurs. Alcohol consumption is related to trauma; more than one study has indicated that people who perpetrate violence are more likely to be intoxicated.
I know that this does not mean that drinking makes you violent. Millions of people have a drink every day and do not go out and perpetrate violence. But among those who do get violent a great many are under the influence of drugs or alcohol. It is easy to see that when someone is drunk they have reduced control of their behavior and having lowered inhibitions they are more likely to engage in violent behavior.
What we also find is that victims of violence are frequently under the influence of drugs and alcohol. Being intoxicated reduces you self-protective behavior and you are more likely to put yourself in a dangerous situation, more likely to look like an easy target to someone with a violent intent and intoxicated people are more likely to “not take it anymore” and engage in argumentative and assertive behavior.
So why would drinking by someone who had been the victim of a violent trauma make the PTSD symptoms worse?
A small amount of alcohol in someone’s system may increase PTSD symptoms rather than anesthetize them for several reasons. Maintaining control of thoughts and emotions especially the intrusive memories from PTSD requires sustained effort. Alcohol reduces the ability to ward off those emotions.
Bisby in his study found that intrusive memories in PTSD were most likely to be suppressed at the extremes of blood alcohol content. So with no alcohol in the blood stream the memories could be shut off by the person’s effort. As the level rose they were less able to control those intrusive, memories until the blood alcohol levels reached the legally drunk point. While this study stopped with a blood alcohol level of .08, the definition of legally drunk, it is likely that the memories would have continued to decline as the person became progressively more intoxicated (Bisby et al. 2009.)
Now this study did find that memory for facts, the verbal memory portion was impaired and the more alcohol in the blood stream the less accurately the person remembered precisely what had happened.
What they did remember more of when under the influence was the emotional feelings associated with the traumatic experience.
Additionally I suspect that some of this increased recall of trauma with a low level of alcohol in the blood stream is the result of state dependent learning. The presence of alcohol in the blood stream opened up the memories that had been stored away and sealed off when sober.
Further this study concluded that people with small amounts of alcohol were more likely to develop PTSD as a result of a traumatic event. As I mentioned in a previous post the presence of alcohol in the blood stream increases the storing of the emotions of the event while surprising the factual memories.
Having alcohol in the system during stressful events may not calm your nerves and improve your coping skills. It is more likely to reduce the ability to cope and increase the risk of developing a PTSD response to being the victim of trauma.
So for any number of reasons consuming a small amount of alcohol is not a good idea for someone who has experienced a trauma. A small amount will increase traumatic memories and it will take highly intoxicating levels of alcohol to shut those memories off.
The result is that people with PTSD who drink any alcohol are at high risk to develop a severe case of alcoholism.
This is one more case where the use of chemicals to avoid pain can in fact result in increased pain when the chemicals drop below intoxicating levels.
For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page . For information about my other writing work beyond this blog there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com .