Understanding PTSD and Alcoholism in Veterans

"There's a group of people coming to kill all of us right now." In his powerful talk about dealing with PTSD following his 2009 deployment to Afghanistan, Brandon describes the terrifying realization he faced during his initial combat experiences. This traumatic event left him with emotional wounds that turned everyday situations into triggers for intense emotional reactions.

Sadly, Brandon's experience reflects a common reality for many veterans, often leading to substance abuse. What connects military service to alcoholism? And does the VA recognize alcoholism as a disability? Let's explore these important questions.

The Hidden Scars: Alcoholism in Veterans

Most civilians can't comprehend the horrors of warfare. Yet for thousands who served, extreme fear, pain, and death were daily realities. These experiences leave lasting marks—not just physical injuries, but invisible psychological wounds as well.

Veteran alcohol abuse frequently stems from trauma that persists long after the battlefield falls silent. While civilian life moves forward, the mind remains trapped in past horrors, struggling to process what happened.

What Is PTSD?

In his book "The Evil Hours: A Biography of Post-Traumatic Stress Disorder," David Morris describes PTSD's devastating impact: "Trauma destroys the fabric of time. In normal time you move from one moment to the next... After trauma, you may move in circles, find yourself being sucked backwards..."

Psychologically, post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing traumatic events. It manifests differently in each person and often contributes to alcoholism among veterans and other trauma survivors.

What Causes PTSD?

As New York Times columnist David Brooks notes in "The Moral Injury," people typically don't develop high rates of PTSD after natural disasters. Instead, it follows moral atrocities. Soldiers exposed to combat's depravity experience unique symptoms—what Brooks calls "an expulsive cataclysm of the soul."

For veterans, traumatic triggers include combat exposure, military sexual trauma, or losing comrades.

Recognizing PTSD Symptoms

PTSD's defining feature is persistent memories that intrude on daily life, making it difficult to move forward. Common symptoms include:

• Flashbacks: Sudden, vivid reliving of traumatic events triggered by memories, conversations, news, or even smells
• Nightmares: Trauma replaying in dreams, adding daytime stress and disrupting sleep
• Hypervigilance: Constant alertness, as Judith Lewis Herman describes in "Trauma and Recovery"—the nervous system remains permanently prepared for danger
• Avoidance: Steering clear of trauma reminders, which can become counterproductive
• Mood and Cognitive Changes: Shifts in energy, mood stability, and task performance, with increased irritability or emotional outbursts

How Common Are PTSD and Substance Use in Veterans?

Research shows alcohol use disorder (AUD) is prevalent among veterans. Demographics play a role—AUD is more common in males, and about 90% of veterans receiving VA AUD treatment are male, matching the veteran population's gender distribution.

According to NIH data, 65% of veterans seeking substance use disorder treatment report alcohol as their primary substance, though some may underreport other drug use due to stigma or career concerns.

At least 7% of veterans experience PTSD, though this is likely underestimated. Among veterans of Operations Iraqi Freedom and Enduring Freedom, 15% experienced PTSD in the past year, and 29% will face it during their lifetime. Deployed veterans are three times more likely to develop PTSD than non-deployed personnel.

Rates are higher among women veterans—19% of female VA users have PTSD diagnoses compared to 10% of males, partly due to higher rates of military sexual trauma (reported by 1 in 3 women versus 1 in 50 men receiving VA services).

With over 2.5 million soldiers deployed since 9/11, PTSD has reached epidemic proportions among veterans. The consequences are devastating: the UNC School of Medicine's Institute for Trauma Recovery reports one veteran dies by suicide every 80 minutes in the U.S.

VA Disability Ratings for Alcohol-Related Issues

The VA uses percentage-based ratings to classify combat-related disabilities, with higher percentages indicating greater impairment and compensation eligibility.

While alcoholism itself isn't considered a primary VA disability, its health consequences—and the underlying PTSD—are recognized. For example, a veteran with a 50% PTSD rating might see it increase to 70% due to alcohol-related health impacts.

The Connection Between Alcohol Misuse and PTSD

Studies reveal a strong link between PTSD and alcoholism in veterans. Those with PTSD are more likely to develop alcohol use disorder than those without. This relationship involves several factors:

1. Impaired Coping Skills

Combat-related PTSD often brings overwhelming guilt. As David Brooks explains, many veterans "feel guilty because they lived while others died... The self-condemnation can be crippling."

Added to guilt are fear, anger, and hopelessness. Intrusive memories and hyperarousal make managing these emotions seem impossible. Without adequate psychological support, alcohol can appear as a quick solution—though it only provides temporary relief before emotions return more intensely.

2. Neurobiological Factors

As veteran Jake Wood describes in "Among You," combat and PTSD alter emotional biology: "You are no longer human, with all those depths and highs... My mind has now locked all this down."

This emotional numbness reflects dopamine depletion common in both PTSD and alcoholism. Trauma changes the brain's reward system, making joy difficult to experience. Alcohol temporarily boosts dopamine and endorphins, but chronic use leads to reduced natural production, deepening both conditions.

3. Social Isolation

Perhaps the most crippling effect of combat memories is the profound loneliness. As Wood writes, "I feel no emotional connection to these outwardly human gestures. I am not there, because I never left Afghanistan."

This isolation creates a downward spiral—retreating from life rather than seeking connection. When alcohol enters the picture, the spiral accelerates: drinking to cope increases isolation, which fuels more drinking.

Pathways to Recovery from PTSD and AUD

While PTSD and alcohol use disorder can feel like inescapable traps, recovery is possible. Many have found their way to healing through these approaches:

• Seek Professional Help: Asking for support demonstrates strength, not weakness. As Joan Beder notes, we should treat mental healthcare as routine—comparable to physical checkups—especially since lives are at stake.
• Find Community: Both conditions thrive in isolation. Support groups through organizations like the Veterans Health Administration and Veterans of Foreign Wars provide resources and community, reminding you that you're not alone.
• Rebuild Life Gradually: Rediscover old interests, take classes, or explore podcasts and audiobooks. Begin with small daily steps toward activities that bring meaning and enrichment.

Hope Beyond PTSD and AUD

Remember that both PTSD and alcohol use disorder are medical conditions. While addressing them requires personal commitment, developing these struggles is never your fault. You don't have to face them alone—recovery is achievable, and Quitemate is here to support your journey toward hope and renewed joy.