Understanding PTSD: Causes, Risks, and Healthy Coping Strategies

For many people, weekday mornings aren't exactly something to look forward to. Still, we manage to get up, grab some coffee, and head to work (or our home office), even if we do so reluctantly. That's just how life goes for most of us. But for some, mornings bring a much heavier burden.

Imagine waking up every day with yesterday's nightmares still weighing on your mind. Even simple tasks like grocery shopping or making a phone call can trigger painful memories from past trauma. For those living with post-traumatic stress disorder (PTSD), this isn't something they have to imagine—it's their daily reality. PTSD turns life into an ongoing struggle to find stability while traumatic memories persist.

What Is Post-Traumatic Stress Disorder?

The American Psychiatric Association defines PTSD as a psychiatric disorder that can develop after someone experiences or witnesses one or more traumatic events. These events might include:

• Natural disasters
• Serious accidents
• Terrorist acts
• War or combat
• Rape or sexual assault
• Intimate partner violence
• Bullying

Traumatic events can be emotionally or physically harmful, or even life-threatening. Exposure to trauma can affect mental, physical, social, and spiritual well-being.

How Common Is PTSD?

While about 70% of adults in the United States will experience at least one traumatic event in their lifetime, only 20% will develop PTSD. This difference might be due to the severity of trauma or stigma around seeking help, which can hide the true scope of the problem.

Overall, approximately 3.6% of U.S. adults—about 9.25 million people—have PTSD in any given year. Women are twice as likely as men to develop the disorder, with 1 in 9 women experiencing PTSD at some point in their lives.

PTSD Symptoms

People with PTSD experience various symptoms, including:

• Nightmares
• Anxiety
• Depression
• Headaches
• Gastrointestinal problems

Flashbacks are among the most common and well-known symptoms. These aren't just bad memories—they're vivid experiences where parts of the traumatic event feel like they're happening again in the present moment.

How Is PTSD Diagnosed?

Not everyone with PTSD experiences all symptoms, and not everyone with these symptoms has PTSD. The Diagnostic and Statistical Manual for Mental Disorders (DSM-V) outlines key diagnostic criteria:

• Exposure to actual or threatened death, serious injury, or sexual violence
• Intrusive symptoms like distressing memories, dreams, or flashbacks
• Persistent avoidance of trauma-related triggers
• Negative changes in thoughts and mood
• Loss of interest in significant activities
• Changes in arousal and reactivity (irritability, reckless behavior, hypervigilance)
• Symptoms lasting more than one month
• Significant distress or impairment in functioning
• Symptoms not due to substance use or other medical conditions

PTSD Risk Factors

The main risk factor is exposure to trauma, but not everyone who experiences trauma develops PTSD. Vulnerability depends on trauma type, duration, and individual factors. Higher-risk groups include:

• Women
• Children who experienced abuse or neglect
• Those with family history of PTSD
• Combat veterans
• First responders
• Sexual assault victims
• People with history of alcohol or substance abuse
• Natural disaster survivors
• Crime victims or witnesses
• Individuals with lower income and education

Many people with PTSD suffer silently due to stigma or fear of being misunderstood, which can prevent them from getting treatment. Celebrities like Lady Gaga and Prince Harry have helped raise awareness by sharing their own experiences.

Alcohol's Role in PTSD

While many people drink to relax or socialize, some use alcohol as a coping mechanism or form of self-medication. For those with PTSD, alcohol might seem to offer temporary relief from pain.

Alcohol is a depressant that slows brain signals, reducing reaction time, impairing coordination and judgment, and creating a sense of relaxation. However, these effects are short-lived. The National Institute on Alcohol Abuse and Alcoholism explains that the brain quickly adjusts to alcohol's effects, often leaving people feeling more restless and anxious afterward.

The Connection Between PTSD and Alcohol Abuse

Research spanning 40 years consistently shows that alcohol use disorder (AUD) is much higher among people with PTSD than those without symptoms. The connection suggests that many people use alcohol to self-medicate.

While alcohol might temporarily numb traumatic memories, it doesn't help people cope in the long run. Instead, the combination of PTSD and alcohol abuse can be harmful.

Consequences of Combining Alcohol and PTSD

Using alcohol to cope with PTSD often worsens symptoms. Increased reactivity from PTSD can lead to panic attacks when combined with alcohol. While panic attacks themselves aren't dangerous, they can trigger intense fear, anxiety, and flashbacks in people with PTSD.

Many people with PTSD experience blackouts, which can also result from excessive drinking. PTSD-alcohol blackouts might involve intense flashbacks or dissociation from reality.

According to the U.S. Department of Veterans Affairs, up to half of adults with both PTSD and drinking problems also have other serious issues, including:

• Panic disorder
• Mood problems like depression
• Attention problems
• Harmful behavior toward others
• Drug addiction or abuse
• Chronic physical illnesses
• Ongoing physical pain

Without treatment, people can fall into a destructive cycle where PTSD symptoms lead to drinking for relief, which then worsens PTSD symptoms.

Treatment Options for PTSD and Alcohol Abuse

Recent research from Veterans Affairs and the Department of Defense has updated treatment strategies for PTSD related to alcohol misuse. Trauma-focused therapies show significant benefits:

• Cognitive Processing Therapy (CPT)
• Prolonged Exposure Therapy (PE)
• Eye Movement, Desensitization, and Restructuring (EMDR)

Medication can supplement therapy but isn't effective alone. Common prescriptions include antidepressants, anxiolytics, and antipsychotics, with strong evidence supporting sertraline (Zoloft), paroxetine (Paxil), and venlafaxine (Effexor).

Healthy Ways to Cope With PTSD

Healthy coping mechanisms provide alternative paths to relief from PTSD symptoms. From mindfulness to therapeutic interventions, healing involves reclaiming the normalcy that trauma disrupts.

• Mindful journaling: Keep a daily journal to explore emotions and identify triggers.
• Strong support systems: Connect with understanding friends, family, or support groups.
• Quitting or cutting back on alcohol: Drink mindfully, set limits, and recognize when it becomes a coping mechanism.
• Physical activity: Regular exercise benefits mental health and helps manage symptoms.
• Artistic expression: Use creative outlets like painting, writing, or music to process emotions.
• Professional guidance: Seek help from mental health specialists in trauma and addiction.
• The Quitemate app: This mindful drinking app offers a holistic approach to well-being with daily readings, 24/7 community support, one-on-one coaching, daily Zoom meetings, courses, and challenges.

Moving Forward

If you're experiencing PTSD, you're not alone. Many resources can help you develop coping skills to move forward and thrive.

If you're in a mental health crisis, dial 988 in the United States to connect with local resources. Outside the U.S., contact your local mental health crisis line.