SeriousKarma

I'm throwing this out there to the Sober Recovery universe to see if any of you have any interesting thoughts to add:

As many of you know my STBXAH is prior military, and has been diagnosed with, among other things, PTSD. Quite frankly this kind of irritates me. It's not that I don't think he has PTSD, I'm sure he does. It's just that I know he had major issues with alcohol long before the PTSD, and it's my understanding that PTSD can't be properly diagnosed in someone with an existing substance abuse issue.

I've spoken to countless other military spouses, at places such as Alanon, and find this to be alarmingly common. When I mention that my qualifier was an alcoholic years before the PTSD, that seems to be the norm, not the exception. In fact, I can't think of anyone that I spoke with where it wasn't the case.

I'm not questioning that substance abuse issues can grow out of trauma. That, of course, makes perfect sense. I'm just concerned that the military may be inadvertently making a situation worse.

I'd be interested to hear what any of you think on this subject. I've searched for articles, but all I find have to do with substance abuse that occurs after the PTSD.

NYCDoglvr

I know someone who has both PTSD (she was in one of the towers on 9/11) and is sober 13 years. Her experience at ground zero resulted in her getting sober. She has a therapist for PTSD and goes to AA for alcoholism. It's very common for alcoholics to suffer from other mental illnesses such as depression and bipolar disorder so PTSD/alcoholism isn't surprising. I've been treated for major depression most of my life and am sober 23 years.
The American Medical Association classifies alcoholism as a mental illness as it does PTSD, depression and bipolar disorder.

The HBO series "Addiction" is full of great information. Here's a link to a doctor who talks about what it is and dual diagnosis.

http://www.hbo.com/addiction/thefilm...ra_volkow.html

Note: alcoholism is an addiction. My drug of choice was alcohol.......other than that, there's no difference

ladyscribbler

My ex certainly had alcohol issues prior to his PTSD. He started drinking as a teenager and didn't deploy until he was in his twenties. Of course he uses his doc to self medicate, but the alcoholism was definitely a pre-existing condition.
I think alcohol abuse will exaggerate many symptoms of PTSD, especially the mood swings and explosive anger outbursts, and symptoms that might be manageable with proper therapy and coping techniques get out of control when the sufferer is drinking.
I think it is impossible to reliably determine the extent of any mental illness when someone is an active alcoholic. My ex also suffered TBIs (yours did too, if I'm remembering) and I always wondered how much his drinking effected his cognitive/memory abilities when they were testing him at the VA trying to determine the extent of the damage.
Such a waste.

dandylion

SeriousKarma....I think that alcoholism almost always sits under the radar from years and years regardless if the person went to military service or not. It does not get recognized and "labeled" as such until way down the road when symptoms start to cause disruption of some sort.

Certainly...the alcoholic is the last one to hold up a sign...LOL! They deny and hide it until the cows come home. So, naturally, when they enter the military....it is not going to be in their records. It is like, if it has never been said..it never existed.

People sit in front of therapists all the time...and the therapist never suspects. Because...the patient is never going to tell. If the person shows up "sober" and is shiny clean with a haircut and blazer...who is to know?

Soo...add the trauma of military action to subterranean alcoholism....you have the perfect storm. Alcoholics have trouble processing all emotions, anyway....so imagine the ungodly emotions that would be triggered in the military?

I think you are correct..but you are going to have to cut through a wall of denial with a machete!

These are some of my thoughts....

dandylion

SeriousKarma

Exactly.

Yes, my X does have a TBI. That's verifiable. Though I'm not sure he didn't get it falling out of bed after a bender.

I live in an Army town, and I ask a lot of questions. So far I've yet to meet anyone who says their significant other didn't have the drinking problem first. My fear is that in over emphasizing/diagnosing PTSD the military is steering the focus away from the real problem. Thus, in the long run, actually harming military members and their families.

Ladyscribbler, I think you and I had already determined that the Army is massively codependent. Maybe someone ought to send Co-Dependent No More to the Chairman of the Joint Chiefs of Staff.

SeriousKarma

You're right Dandylion. It's very tricky.

Which came first the chicken or the egg.

What I see happening is very unfortunate. We here at SR know that in order the help our addicted loved ones we need to let them help themselves. However, in the case of this particular problem, I think the addict sometimes uses the PTSD diagnosis to prop up that addiction. The military may be unwittingly enabling them.

dandylion

Serious Karma...Of Course they do! The alcoholic uses any tool at their disposal to prop up their addiction. Anything that they can get someone to buy.

I don't think that the military has ever been a instrument in psychological enlightment.

I'm just saying.....

dandylion

Oh, by the way...I know which came first...it was the chicken...definitely, the chicken.

ladyscribbler

I know for a fact my ex has suffered several more head injuries since returning from the last deployment. He once had to get a dozen staples in his head because he fell down in the concrete floored basement and cut his scalp open so badly it was hanging there like a flap.
And he still didn't think he needed medical attention! When he got home from the hospital he was angry with me for calling 911 because they did a BAC test in the ER, "So now everyone thinks I have a drinking problem." DUH, because normal people always have near death experiences when they're drinking.

I don't think that the military has ever been a instrument in psychological enlightenment.

LOL Dandylion. I used to work in psychological warfare so you'll get no argument from me on that one. There were a couple of times when I wanted to walk by my bleeding ex, throw down an Ace of Spades death card and let the animals eat his corpse. But then they might have gotten alcohol poisoning.

SeriousKarma

If you say so... I mean, you're usually right. No reason to doubt your authority when it comes to poultry.

At least we got that sorted out today.

pixilation

That's ex, his PTSD symptons were always much worse while he was actively drinking. And he was in the earlier stages of alcoholism(bingeing on weekends mostly) when his qualifying event happened.

allforcnm

I was just posting about dual diagnosis.. comorbidity in the secular family fourm.... this is one link from National Institute of Drug abuse on the topic.. its got quite a few pages but I found it all very helpful.

Letter From the Director | National Institute on Drug Abuse (NIDA)

SeriousKarma

Allforcnm, Thanks for the link. It had a lot of interesting info. I've pulled out a couple things that jumped out at me:

Correct diagnosis is critical to ensuring appropriate and effective treatment. Ignorance of or failure to treat a comorbid disorder can jeopardize a patient’s chance of recovery.

(yep)

This next paragraph deals specifically with PTSD:

Physically or emotionally traumatized people are at much higher risk of abusing licit, illicit, and prescription drugs. This linkage is of particular concern for returning veterans since nearly 1 in 5 military service members back from Iraq and Afghanistan have reported symptoms of post-traumatic stress disorder (PTSD) or major depression. Recent epidemiological studies suggest that as many as half of all veterans diagnosed with PTSD also have a co-occurring substance use disorder (SUD), which could pose an enormous challenge for our health care system. Many PTSD programs do not accept individuals with active SUDs, and traditional SUD clinics defer treatment of trauma-related issues. Nevertheless, there are treatments at different stages of clinical validation for comorbid PTSD and SUD; these include various combinations of psychosocial (e.g., exposure therapy) and pharmacologic (e.g., mood stabilizers, anxiolytics, and antidepressants) interventions. However, research is urgently needed to identify the best treatment strategies for addressing PTSD/SUD comorbidities, and to explore whether different treatments might be needed in response to civilian versus combat PTSD.

For all that I do sometimes like to bash the Army, I do recognize that, in many ways, they have unwittingly been put on the front lines of a mental health war. If they ever do figure out how best to deal with these issues both military and civilian will benefit.

SeriousKarma

NYCDoglvr,

Thanks for the clip. I finally got around to watching it. Full of interesting info. I'm not sure if I totally agree with her advice to families, however. I see where she was coming from, but I could see her advice justifying some codie enabling behavior. Would have been nice if she had suggested that the family members get themselves support asap. Of course her emphasis was on the addict so I understand.

I hope your friend is doing better. My husband was with the Old Guard at Arlington, near the Pentagon, on 9/11. The plane flew right over the heads of some of his coworkers doing a funeral. Many of my neighbors worked in the Pentagon. It was crazy. No one could get in or out of post for days. The entire area came to a grinding halt. We all sat outside waiting to hear if our neighbors were ok. Thank God they all were. That was one messed up day.

allforcnm

Just an FYI... if you dig into the Addiction website created by HBO.. supported by National Institute of Drug abuse... Nora Volkov is the director of NIDA... they support the use of the CRAFT method... community reinforcement and family training... as its a two pronged approach.. they believe we can take care of ourselves while also advocating and actively supporting.. helping our loved ones. I hesitated to share this link earlier, but the quotes are from the experts in addiction and mental health.. not really myself.. although I do agree based on my own experiences.

http://www.soberrecovery.com/forums/...treatment.html