From Hurt to Healing: Understanding the Link Between Trauma, Mental Health, and Addiction

Trauma, mental health, and addiction are each huge topics in their own right. When we consider the extent of each respective spectrum, along with the fact research shows they tend to overlap, the challenge facing health professionals becomes clearer. 

It has long been understood that childhood trauma can lead to mental health disorders in later life, and this 2021 meta-analysis revealed a significant association between the two. Moreover, while it still remains uncertain how many adults with substance use disorders have experienced trauma, many studies have documented a conclusive correlation. For example, surveys of adolescents receiving treatment for substance abuse report that more than 70% of patients had a history of trauma exposure. This becomes even more complex when we include the rate of dual diagnosis (the condition of having a mental illness and a co-occurring substance use disorder). According to this 2022 study:

Adults with dual diagnosis were estimated to constitute 25.8% of those with any psychiatric disorder; 36.5% of those with any SUD and 17.8% of the 75.8 million adults with either disorder.”

Given its scope, doing sufficient justice to this tridirectional relationship is impossible. However, in many cases, it is trauma that creates the conditions for mental disorders, SUDs, or their co-occurrence to emerge. While there are different instances of this relationship, a common progression is as follows: trauma can lead to a mental health condition, which may precipitate an addiction as a coping mechanism. 

What is trauma?

Given the unique and multifaceted way it affects each person, trauma is difficult to neatly define. 

Addiction expert, Gabor Maté summarizes it as “a psychic wound that hardens you psychologically… then interferes with your ability to grow and develop.” 

In simple terms, trauma is an emotional response to an intensely distressing event or series of events that overwhelm your ability to cope. Among its innumerable manifestations are feelings of helplessness, a diminished sense of self, and an inability to feel a full range of emotions. 

These can result from a single incident (acute trauma), ongoing, repeated experiences (chronic trauma), or multiple, prolonged traumatic events occurring during developmental years (complex trauma). 

Examples of trauma can include:

  • Physical or emotional abuse
  • Sexual violence
  • Natural disasters
  • War or terrorism
  • Serious accidents or injuries
  • Witnessing violence or death
  • Loss of a loved one
  • Neglect or abandonment
  • Life-threatening medical diagnoses

While there are salient commonalities, the impact of trauma is as varied as human individuality. It depends on factors such as the nature of the traumatic event(s), genetics, personal history, available support systems, and capacity for resilience. 

The physiological and psychological effects of trauma range from the short-term to the long-term. They can include anxiety, depression, post-traumatic stress disorder (PTSD), difficulties in relationships, and issues with daily functioning.

Ultimately, trauma is a subjective experience, and what may be traumatic for you or me may not be for another. Therefore, understanding and addressing trauma requires a sensitive, personalized approach that carefully considers your unique experience and needs.

The connection between trauma and mental health

In ancient Greece, the famous physician Hippocrates noted symptoms in soldiers that we would now call post-traumatic stress disorder (PTSD). However, it would take millennia until it became fully recognized as a distinct mental health condition in 1980. Since then, the study of trauma has grown exponentially, and its relationship with mental health disorders is widely acknowledged.

Today, research shows those with severe mental illnesses report childhood trauma at a much higher rate than the general population. For example, a large cross-sectional survey of child physical abuse in a representative sample of the U.S. population found significantly increased adjusted odds ratios for a broad range of DSM-IV disorders, with a dose-response relationship between frequency of abuse and several adult psychiatric disorders.

crying child beside alcoholic father

When looked at closely, we see that trauma and mental illness aren’t mutually exclusive—they are interwoven. What often occurs is that, after receiving an official diagnosis, trauma tends to be seen through the lens of a specific mental health disorder. 

Due to unconscious repression, you may not even realize the extent trauma is affecting you and can function reasonably well day-to-day. However, over time, if it isn’t properly tended to, unresolved trauma can come to the fore, disrupting your sense of safety, well-being, and control. The resultant emotional and cognitive responses can lead to mental health disorders. Below are some of the key contributory factors:

Biological changes

The experience of trauma can cause changes in your stress response system. Such exposure can lead to the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which is responsible for regulating your body’s response to stress. This dysregulation can result in an overactive stress response and increased cortisol levels, contributing to the development of mental health issues such as anxiety and depression.

Cognitive and emotional responses 

It is common for those who suffer from trauma to have negative beliefs about themselves, others, and the world. These can contribute to feelings of helplessness, hopelessness, and worthlessness—all common symptoms of depression. Moreover, you may experience persistent feelings of fear, worry, and anxiety, as well as intrusive thoughts or memories, which can result in the development of anxiety disorders and PTSD.

Social factors

group of friends and woman using cellphone

There’s a reason social support is a key component of recovery treatment plans: it is essential for healing and well-being. Unfortunately, due to aspects like social isolation, stigma, and a lack of understanding from others, trauma can disrupt your social support system. It can also make it difficult for you to form and maintain healthy relationships, which can lead to mental health conditions or a worsening of symptoms. 

Coping strategies 

In an attempt to manage the emotional distress caused by trauma, you might develop maladaptive coping strategies, such as avoidance, emotional numbing, or substance use. 

While these seem to provide temporary relief, they exacerbate mental health issues in the long run and can prevent you from processing and healing from trauma. According to the National Survey on Drug Use and Health,13.5% of young adults aged 18 to 25 had both a substance use disorder and any mental illness in the past year. Bear in mind that, due to many going undiagnosed, this number may be significantly higher. 

Addiction as a coping mechanism

Central to the relationship between mental illness and addiction is the concept of self-medication. For myriad reasons, those who struggle with trauma or mental illness often don’t receive adequate care. They may have been underserved by health professionals, don’t have access to a trusted support network, or feel too scared or ashamed to seek help

In response to debilitating symptoms, many people may turn to addictive substances or behaviors for relief. Unfortunately, this relief is often short-lived. As your brain and body grow accustomed to the addiction, its effects weaken, and you could end up using more just to reach a baseline. 

Inversely, addictions can contribute to the development or exacerbation of mental health issues. Prolonged drug or alcohol use can have a significant impact on your brain chemistry, causing or worsening symptoms of mental illness. 

The presence of underlying risk factors can also make you more susceptible to both addiction and mental illness. If you have a family history of mental illness or addiction, you might be more likely to experience these challenges yourself. Trauma or prolonged exposure to stressful environments can increase your vulnerability to both conditions.

If you continue using substances as a means to cope, you might find that your emotional well-being becomes increasingly unstable, making it more challenging to break free from the cycle of addiction. What begins as a way to cope with symptoms of trauma or mental illness, can end up adding fuel to the fire, as you now have to contend with the added symptoms of your addiction.

The path to healing

Woman and therapist hugging after sharing recovery progress with aa meeting group

Throughout history, medical categorization has proven extremely helpful. It’s enabled doctors and psychiatrists to better navigate health, prescribing treatments according to established diagnostic models. 

However, humans are extremely complex. Everyone has their own unique tapestry of neurochemistry, psychology, genetics, and physical health. If we don’t attempt to understand how these elements intersect and take a holistic, personalized approach to a person’s needs, we’re in danger of misdiagnosing, misprescribing, and ultimately failing in our duty to help. 

To effectively address the connection between trauma, mental health, and addiction, it’s crucial to seek comprehensive treatment that considers all three issues simultaneously. This approach, known as integrated treatment, focuses on treating the whole person rather than addressing their conditions as separate entities. By participating in therapy, support groups, and other evidence-based treatments, you’ll have the opportunity to build healthier coping strategies and develop a stronger foundation for lasting recovery.

The journey from hurt to healing is a deeply personal and transformative process. Recognizing the connections between trauma, mental health, and addiction is an essential step in understanding the challenges you or a loved one may face during recovery. 

While labels can be helpful, they can also be limiting. Therefore it’s crucial you seek out a comprehensive, integrated program that treats you as a human being; one with potential far exceeding any isolated diagnosis. Ultimately, it is only through addressing the complex interplay of these issues that we ensure the best chance for lasting recovery.

How can Tikvah Lake help?

At Tikvah Lake, we’re dedicated to providing expert, compassionate care that empowers you to move beyond the pain of your past and embrace a healthier, more fulfilling future. 

Our experienced team of professionals understands the unique challenges posed by the intersection of trauma, mental health, and addiction, and we’re committed to helping you build the resilience needed to overcome these obstacles. 

Our personalized treatment program provides you with invaluable knowledge and coping strategies, fostering the self-belief you need to create a healthier, sober life. 

If you’d like to talk to us about the relationship between trauma, mental illness, and addiction, or find out how we can help, please contact us.

About Adam Nesenoff

Adam Nesenoff has been working in recovery for over ten years.

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