Understanding the complexities around trauma and addiction: the need for comprehensive treatment approaches

Trauma – whether from the loss of a loved one in a tragic accident or enduring a violent event – leaves deep and lasting scars on the human psyche. These mental health impacts are profound and pervasive, often manifesting in complex ways that challenge both the individual and those around them. There is a myriad of events that can lead to an individual developing trauma and the enduring psychological distress that accompanies. Surviving a violent road traffic accident or witnessing loved ones lose their life from such, natural disasters, domestic violence, childhood abuse, and acts of terrorism can all contribute to the growing prevalence of trauma-related mental health issues.

Trauma does not discriminate; it can affect anyone, regardless of their socioeconomic status, age, or background. The consequences often go beyond the immediate pain, leading to long-term mental health challenges, including depression, anxiety, PTSD, and substance use disorders.

Understanding how trauma can manifest in these ways – and why it has the impacts that it does – is crucial for providing effective, comprehensive care. At Harbor, we advocate for a personalised, whole-person approach to treatment, ensuring that each individual’s unique experiences and needs are fully addressed, laying the foundation for true healing.

Psychological impacts of trauma

Whether originating from a sudden loss, violence, or a severe accident, trauma leaves profound psychological imprints on those affected that can be vast and complex .This often leads to conditions such as PTSD, anxiety, depression, and other mental health challenges. Survivors of road traffic accidents or those who have lost loved ones in violent events may face enduring psychological effects that disrupt their ability to function in everyday life.

Trauma induces significant biological changes within the brain^1-4, particularly affecting the limbic system, which governs emotional responses^1-2. When a traumatic event occurs, the amygdala – often referred to as the “fear centre” of the brain – becomes hyperactive, storing intense emotional responses associated with the event². This hyperactivity can interfere with the hippocampus – the brain region responsible for memory recall – resulting in fragmented memories that are often disjointed and difficult to process². This is why survivors may struggle to recall events chronologically or experience overwhelming emotions when reminded of the trauma. Memories are also encoded differently during a traumatic event³. The brain does not encode memories in chronological order and there are gaps³. Whatever the “fear circuitry” in the brain focused attention on during the trauma is more likely to be remembered rather than periphery details³.

In the immediate aftermath of a traumatic event, survivors often exhibit a range of reactions, including exhaustion, confusion, anxiety, and dissociation¹. Other common symptoms include hyperarousal – where the individual remains in a heightened state of alertness – and excessive guilt or survivor’s guilt, where they irrationally blame themselves for the trauma¹. While many individuals demonstrate resilience, using social supports to cope, a significant percentage may develop long-term psychological disorders. For some, trauma can trigger self-harm as a means of coping with the overwhelming emotions or to regain a sense of control⁵. Apprehension about the traumatic event happening again and reexperiencing distress can also result in anxiety to the same level as if the trauma were happening in the moment^6-7. The prevalence of PTSD is particularly noteworthy, as it is the most commonly diagnosed trauma-related disorder – with an estimated 1 in 3 people who experience trauma developing this condition⁸.

Finally, substance use disorders are frequently linked with trauma, as individuals may turn to alcohol or drugs to self-medicate and manage their symptoms. However, this often exacerbates any underlying mental health issues, creating a vicious cycle that can complicate recovery without professional intervention¹.

Mechanisms linking trauma and addiction

The link between trauma and substance dependency is profound and multifaceted, with trauma frequently serving as a precursor to addiction. Trauma survivors frequently turn to substances such as alcohol, opioids, marijuana, and cocaine as coping mechanisms. These substances are not only relatively easily accessible, but also potent in their ability to numb emotional pain and temporarily alleviate the distress caused by traumatic memories¹.

Trauma, particularly when experienced during childhood, can have enduring effects on an individual’s neurobiology; something that directly influences the likelihood of developing substance use disorders^9-11. The impact of trauma on the brain is nuanced and complex¹¹, and involves interactions between genetic predispositions, the type and duration of trauma, and the presence or absence of supportive caretakers¹⁰. However, one of the main outcomes of trauma is the dysregulation of the stress response system, particularly the hypothalamic-pituitary-adrenal axis¹². This system, which is responsible for our ‘fight or flight’ response, can become chronically activated in trauma survivors, leading to elevated stress hormones and a state of hyperarousal¹³.

This chronic activation plays a pivotal role in the development of substance use disorders. Individuals with dysregulated stress systems often turn to substances as a way to self-medicate. This is since using substances change the way people feel – producing pleasure and reducing dysphoria¹⁴. Drugs such as alcohol, benzodiazepines, opioids, and cannabis products are particularly appealing because of their calming effects, which can temporarily reduce the anxiety and hyperarousal associated with trauma¹¹. These substances work by slowing down the central nervous system, providing a reprieve from the relentless state of heightened alertness that many trauma survivors experience.

Conversely, some individuals respond to trauma with dissociation or depersonalisation, a protective mechanism that leaves them feeling numb, disengaged, and emotionally detached¹¹. For these individuals, stimulants like cocaine, amphetamines, synthetic drugs, and nicotine often become the substances of choice. These drugs offer energy, alertness, and a temporary escape from the pervasive sense of emptiness¹¹.

Interestingly, research has also identified a correlation between specific types of trauma and particular addictions¹⁵. For example, survivors of sexual assault are at a higher risk of developing alcohol use disorder, with a prevalence of 15.4% compared to 12.1% among those exposed to combat-related trauma. In cases of combat-related trauma, indirect exposure was more strongly associated with pornography addiction. These findings highlight the intricate and varied ways in which trauma influences the development of substance dependency, underscoring the need for tailored, trauma-informed approaches to treatment.

The whole person approach to treatment

At Harbor, our whole person approach to treatment is at the core of our philosophy when addressing trauma and co-occurring substance use disorders. Based in the heart of London, we provide a world-class, welcoming environment where clients and their families can feel safe and supported. Our unique one-patient-at-a-time model ensures that from the moment an individual enters our care, every aspect of the treatment plan is meticulously crafted around their specific needs. This bespoke approach allows everyone to embark on the most appropriate journey towards optimal health and wellbeing. And, unlike many rehabilitation centres that are isolated from everyday life, our residencies are situated within the vibrant cityscape of London. We believe that the familiarity of the urban environment, combined with the support and challenges it offers, contributes to more robust and long-lasting results.

Effective treatment requires addressing both trauma and addiction simultaneously, ensuring that practitioners do not merely treat the symptoms but also the underlying issues. Our approach is to offer a comprehensive range of evidence-based therapies, meticulously curated to craft a personalised treatment plan to meet each client’s unique needs. Our treatment protocols encompass physical, emotional, and spiritual wellbeing that reflects our commitment to treating the whole person.

For those living with trauma, these often include trauma-informed therapies like cognitive-behavioural therapy (CBT), and Eye Movement Desensitisation and Reprocessing (EMDR). CBT helps clients reframe negative thought patterns, develop introspection, and build resilience. EMDR is recognised by the World Health Organisation, reprocesses traumatic memories, reducing their psychological impact. Each treatment is individually tailored, ensuring that your journey to recovery is both effective and deeply personal.

The importance of seeking help and available resources

Addressing trauma and addiction requires timely professional intervention. The longer such issues go untreated, the deeper their impact can become. This can lead to more severe psychological and physical consequences. Seeking help is not just a step towards recovery; it is a crucial move towards reclaiming one’s life from the grips of trauma and substance dependencies. And healthcare professionals play a pivotal role in recognising these signs of trauma and development of substance use disorders as a coping mechanism. The ability to refer patients to the appropriate resources can make a significant difference in each individuals’ recovery journey.

At Harbor, we offer specialised, 24/7 wrapped around mental health care and addiction rehabilitation that is meticulously designed to address these complex issues through a comprehensive approach. Our curated treatment plans are crafted to meet the unique needs and wants of each client, ensuring that no aspect of care is overlooked.

We encourage healthcare professionals to refer patients that may benefit from our services, and we invite anyone seeking support to contact us for more information or to schedule a consultation.

Let’s pave the way for lasting recovery.

References

• https://www.ncbi.nlm.nih.gov/books/NBK207191/
• http://stacarecenter.org/wp-content/uploads/2015/09/The-Care-Center-Neurobiology-of-Trauma-Nov-2016.pdf
• https://www.unco.edu/assault-survivors-advocacy-program/learn_more/neurobiology_of_trauma.aspx
• https://pubmed.ncbi.nlm.nih.gov/32840220/
• https://pubmed.ncbi.nlm.nih.gov/9806085/
• https://www.healthline.com/health/anxiety/whats-the-relationship-between-trauma-and-anxiety
• https://www.sciencedirect.com/science/article/pii/S2213158218301190
• https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/
• https://pubmed.ncbi.nlm.nih.gov/33735776/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968319/
• https://www.psychologytoday.com/gb/blog/understanding-addiction/202109/why-trauma-can-lead-to-addiction
• https://link.springer.com/article/10.1007/S12144-018-9973-9
• https://www.mymentor.uk.com/wp-content/uploads/2019/01/Childhood-Disrupted.pdf
• https://www.tandfonline.com/doi/full/10.1080/14659890500114359
• https://www.sciencedirect.com/science/article/abs/pii/S0306460321000745