How Unresolved Trauma Can Lead to Addiction

Severe trauma requires to be addressed appropriately, with professional help. Some trauma sufferers are unable or unwilling to do this.  If they respond by self-medicating, they risk addiction to mood-altering substances, thereby compounding their problems.

When people seek to explore the causes of addiction they talk of nature and nurture, meaning the causes are broadly both genetic factors and/or experiential issues to do with upbringing (or sometimes both). In the latter case of upbringing, when a person’s childhood has seen traumatic events, the risk of that person turning to addiction becomes increased. This is particularly so where the trauma remains unresolved because it is not addressed through appropriate means such as counselling. The risk of depression and suicide is also increased in such cases.

What is trauma?

Trauma (the Greek word for ‘wound’) is used in psychology to describe the emotional experience of a terrible event either personally or as a witness. Such events can be, for example, sexual assault, other physical violence, emotional abuse, accidents, loss or relationship breakdown. Such events often cause acute emotional pain that the brain cannot process at the time, leaving the person with psychological damage that may be either undetected or displayed through symptoms such as depression, anxiety or post-traumatic stress disorder (PTSD).

Perception of trauma

The effect of trauma varies according to the person’s perception of the event. Thus, one person may consider a serious road traffic accident as deeply shocking while another may view it as ‘predictable but could have been worse’. Traumatic events to children are nearly always more emotionally damaging than those to adults.

Brain responses to trauma

Extreme moments of trauma provoke primitive brain responses of freeze, fight or flee which translate into feelings of terror, panic and helplessness. The brain does not forget these moments and people often continue for years to struggle with similar feelings (flashbacks), often triggered by reminders such as seeing a person involved in the original event, that make them relive the trauma again and again.

Coping with trauma

Trauma always needs to be addressed fully and promptly so that the person affected can return to normal life with minimal emotional damage. Professional advice and appropriate treatment should be sought whenever possible. However, some who struggle to cope with their experiences may either be unable or unwilling to access professional help and instead turn to self-medication with drugs and alcohol to suppress their emotional pain. This kind of maladaptive response is always dangerous. In the USA, a study by the Substance Abuse and Mental Health Services Administration (SAMHSA) has shown that, as the number of traumatic events experienced during childhood increases, the risk for addiction, depression and suicide attempts also increase.

Self-medication for trauma issues

The short-term relief from the experience of a traumatic event provided by mood-altering substances has a doubly negative effect. Not only does it block the person from dealing with the trauma in a more appropriate manner with professional help, but it also risks establishing a self-defeating pattern of behaviour which may lead to the additional problem of substance use disorder.

How does trauma affect self image?

The effect of trauma can be to change how a person thinks, feels and acts, giving rise to issues of low self-esteem and distrust of other people and the world in general. In addition, people who have suffered trauma will often experience feelings of anger, anxiety, insecurity, fear and shame. Such feelings can have a devastating effect on a person’s wellbeing, to the extent that they feel unable to cope. Yet these types of feelings are also those commonly found in people with substance addiction problems. The combination of unresolved trauma and substance misuse is thus highly likely to produce dangerously negative mental conditions such as severe depression or suicidal ideation.

Why do trauma victims not seek professional help?

The reasons why so many fail to obtain appropriate help to deal emotionally with their traumatic experience are often centred around the ignorance of the healing process and fear of the stigma attached to any kind of mental health therapy. Some commonly mistaken attitudes include the following:

  • ‘It is a sign of weakness to seek help’. Some people are brought up to believe that showing emotion makes them vulnerable. Others (especially men) are led to believe that ‘strong people don’t show feelings’ or that showing emotional pain is a form of ‘excuse’ for poor performance. In reality, recognising the need for help and taking appropriate steps to receive it are signs of maturity.
  • ‘The traumatic event happened exactly the way I remember it and there is no benefit in discussing it further’. It is our perception of the event that dictates the severity, not the event itself. A person’s emotional pain should always be respected, but although hard, a revisiting of the event and new insights into what happened and why, can eventually be crucial in helping a victim to come to terms with the issue.
  • ‘I just need to let time heal the past.’ It is true that the passing of time can ease certain types of pain and give new perspectives, but time alone cannot heal severe emotional trauma. The body’s memory of emotional wounds can last for a lifetime and time may never bring closure. A sensitive process of therapy where the person concerned can express feelings as they work through painful experiences with the help of specialist techniques such as EMDR (eye movement desensitisation and reprocessing).
  • ‘They will blame or stigmatise me if I talk about my trauma.’ Some people are fearful even of telling their doctor about their experiences for fear of a negative reaction. In general, attitudes towards any kind of mental health difficulties have greatly improved and there are a number of organisations besides the medical profession who offer totally non-judgmental help, such as Samaritans, Mind and Victim Support.

Risk factors for developing a substance abuse disorder after trauma

Trauma and the resulting emotional distress can lead to self-medication and thus to addiction. However, the reverse is also true – people who are involved in addictive behaviours, especially substance abuse, are more likely to experience traumatic events. This is partly because they may indulge in risky behaviour such as drink-driving or unsafe sex, and also because they may become prone to intense mood swings into depression and suicidal ideation.

Although everyone responds to trauma differently, people in certain categories are more at risk of turning to substance use following a traumatic event, including:

  • People who work in emergency services such as police officers and paramedics
  • People in conflict-related jobs such as military personnel
  • People who are unemployed, have special educational needs or are unable to access sources of help such as the NHS.


Severe trauma can often result in PTSD, a condition that when not properly treated, can put people under extreme emotional stress so that their behaviour becomes unpredictable and difficult to manage. In such cases, self-medication can have disastrous results. Those most at risk of developing PTSD are:

  • Victims of sexual assault
  • Childhood victims of physical and emotional abuse
  • Those experiencing grief, loss and abandonment
  • Victims of violent crime and accidents
  • Victims of war and natural disasters.

Treatment for co-morbid trauma and substance abuse disorder

Treatment for trauma and substance abuse can and should be integrated and concurrent. Severe and unresolved trauma requires sensitive treatment of a specialised nature. This may be difficult to achieve in a day-care setting and therefore, residential treatment is always recommended. Here, the patient has access to medical as well as therapeutic care round the clock as well as a safe place in which to address their painful experiences.

Treatment at Castle Craig Hospital

At Castle Craig, we have successfully treated many people suffering from co-occurring trauma and substance abuse. Patients work through our core trauma therapy programme under the guidance of a personal therapist while addressing their trauma issues in sessions with specialist staff members. Techniques such as PTSD and relaxation therapy are available as needed. Each person’s treatment plan is approved by the psychiatrist in charge. Our treatment staff are always ready to talk and advise on the best response to your problems.

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