At some point in time, we’ve all likely experienced, or seen, a traumatic event. A car accident, an unexpected breakup or divorce, the death of someone close to us, or losing a job or a house – whatever the trauma, we may have been affected deeply, and responded in appropriate ways: we’re fatigued, depressed, irritable, fearful, and find it difficult to move on from moment to moment. In time, we grow from the experience and retake control of our life.
For some victims of trauma, however, the process is not as smooth, and their experiences lead them down a dark road of substance abuse and drug dependency. The relationship between the various forms of trauma and addiction is a complicated one, and what happens in a person’s formative years can have a lasting impact on how they live their life decades later.
What Is Trauma?
“Trauma” is a word that is used – and perhaps overused – very flippantly, but what does it actually mean? The American Psychological Association explains that trauma is an emotional response to an event that makes a person genuinely scared for their life or their well-being.[1] In the short term, trauma manifests as shock, mental disorientation, or denial that something bad happened. In the long term, trauma can result in an inability to concentrate on day-to-day activities, nightmares, unbidden and intrusive recollections of the event, difficulty in maintaining social and professional obligations, or depression and substance abuse. Collectively, these are symptoms of post-traumatic stress disorder (PTSD).[2]
Psychology Today goes on to explain that the concept of “personal vulnerability” is key when understanding how trauma affects people.[3] Someone doesn’t have to be involved in a car accident in order to feel traumatized by the event; if they perceive that the accident made them feel personally vulnerable – perhaps by virtue of their physical proximity to the accident, or if they were supposed to have been in one of the vehicles, but weren’t – then they can be as traumatized by the event as someone who was actively involved in the accident. A soldier who sees his colleagues killed or injured – while remaining physically unharmed himself – will be at risk for suffering the nightmares, flashbacks, avoidance behaviors and chronic stress and depression of post-traumatic stress disorder.
Perhaps the most fundamental example of this is how a child – vulnerable and susceptible at a very young age – can be traumatized by seeing a sibling or parent abused, even if the child himself is not on the receiving end of the abuse. Because children are typically helpless and defenseless, and do not know how to properly process traumatic experiences or events, they are more prone to developing an anxiety disorder, or post-traumatic stress disorder. In fact, children who grow up exposed to trauma have brains that are chemically and neurologically different than children who grow up in safe and secure environments.[4]
A study done by researchers at the University of Texas, and published in the Neuropsychopharmacology journal, discovered that teenagers who had experienced trauma as a child – suffering any form of substantial abuse or neglect, surviving a life-threatening sickness, seeing domestic violence, or having a parent die before the age of 10 – showed “connectivity problems” in several brain areas: one responsible for planning behavior; another that connects the brain’s emotional processing regions to thought, allowing the patient to regulate their response to emotional stress.
Emotional abuse and trauma are harder to quantify, primarily because they often go unrecognized, undiagnosed, and unreported. Playground bullying, for example, is gaining widespread attention for the layers of humiliation and pain it can heap upon a defenseless child or teenager; however, in previous generations, the suggestion of bullying seeding long-lasting negative effects on a person’s psyche might have been laughed out of the room. Such attitudes still exist today, especially when the bullying occurs closer to home.
Conclusion
Summarizing the University of Texas study, TIME magazine posited that “addiction susceptibility may be linked to an inability to regulate emotions” – that is, the trauma may rob a victim of the ability to deal with the trauma in a healthy and positive way, making them instead feel depressed, isolated, and fearful, and priming them for a substance abuse problem that may rise to the surface decades after the last traumatic experience.[5]Abuse and Addiction
As PsychCentral puts it, neglect or abuse (sexual, physical or emotional) during childhood is a common thread among people receiving treatment for alcoholism, and such neglect and abuse may play a role in the future development of substance abuse issues.[6] Quoting a study published in Alcoholism: Clinical and Experimental Research, the PsychCentral blog breaks down the numbers:
- The general population has physical abuse rates of 8.4 percent; for alcoholic men, this rate is 24 percent, and for alcoholic women, it is 33 percent.
- The general population has sexual abuse rates of six percent; for alcoholic men, this rate is 12 percent, and for alcoholic women, it is 49 percent.
In June 2013, TIME magazine reviewed a study published in the journal Pediatrics that said bullying – whether at the hands of a sibling or kids in the schoolyard – was “linked to worse mental-health outcomes for kids and adolescents.”[7] Even children who underwent seemingly innocuous experiences, like having toys broken by an older brother or sister, had greater levels of depression, anxiety, and anger than children who had no such experiences. Roughly 33 percent of children who received physical (hitting, pulling hair) and verbal (taunting, mocking, name-calling) abuse from siblings (or even their own parents) grew up to display more mental health symptoms than children who were not belittled or made to feel scared.
If the parents of these children do not recognize the signs of severe bullying to the point where it becomes traumatic, the untreated depression that such behavior can foster could likely lead to a substance abuse problem – one that can manifest even decades later.[8]
19 Times More Likely
One example of this comes from recent history. The September 11th attacks left an indelible mark on the American psyche, and children were among the most potently affected groups of people. One study conducted on children who had witnessed the attacks (and reported in the journal Disasters), lost a loved one in the attacks, or had to evacuated from the general ground zero area of the attacks found that teens with one of these factors were five times more likely to increase their intake of drugs and alcohol. Teens who had experienced three or more of the factors were 19 times more likely to increase their intake of drugs and alcohol.[9] Simply put, the more trauma these children and teens experienced, the more likely they were to abuse controlled substances. Furthermore, not only did these teens abuse drugs and alcohol, their substance abuse also negatively affected their schoolwork, their social behavior, and their grades – criteria that a study in the journal Addiction identified as the threshold between drug abuse and drug addiction.[10]
As The Fix put it, “Childhood abuse [or trauma] massively increases the risk of people turning to drugs or alcohol.”[11] Further research, like a study done in the Depression and Anxiety journal, found that high rates of substance abuse among the study population (39 percent alcohol, 34.1 percent cocaine, and 44.8 percent marijuana) correlated with physical, sexual and emotional abuse during childhood.[12]
The ACE Study
One of the watersheds of research involving childhood trauma and addiction is the Adverse Childhood Experiences (ACE) study. The two-year-long study conducted by the Kaiser Permanente health maintenance organization and the Centers for Disease Control surveyed 17,337 patients and found correlations between extreme stress in childhood and various forms of addiction and other social impairments later in life. The criteria for the childhood trauma were:- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Domestic violence
- Substance abuse in the house
- Mental illness in the house
- Parental divorce
- Incarcerated member of the household
Women, Trauma and Food Addiction
Of course, children are not the only group of people at risk for their trauma developing into an addiction; and neither are drugs and alcohol the only mechanisms of addiction. Women – who, as a population, are twice more likely to develop post-traumatic stress disorder than men[14] because of a “heightened fear response”[15] – are at the risk of developing a food addiction as a result of their PTSD. Researchers writing in the journal JAMA Psychiatry surveyed 49,000 female nurses, and asked them if they had ever experienced a traumatic event. Almost 18 percent of women, who had six to seven symptoms of PTSD as a result of childhood abuse or a traumatic event, reported that they also experienced symptoms of a food addiction, such as eating when they were not hungry, hiding their eating habits from others, and experiencing withdrawal symptoms when trying to cut down on food intake.[16] The researchers concluded that the study results bore out their hypothesis: that there is a tendency to use food as self-medication against traumatic stress symptoms, in the way that other survivors of trauma and abuse use alcohol or drugs to insulate themselves against the feelings of stress or depression that are born from their experiences. Crossing over with the findings of the ACE study, the International Journal of Obesity noted that “abuse in childhood is associated with adult obesity.”[17]
Traumatic Brain Injuries and Addiction
Trauma can also be physically violent. Athletes in particularly dangerous contact sports – professional football, ice hockey, boxing and wrestling, for example – are at risk for traumatic brain injury, which describes a medical condition that arises as the result of a sudden, forceful impact to the head. When this happens, the brain itself is pushed up against the side of the skull, causing nerve fibers to tear.[18] According to the Centers for Disease Control, between 1.6 million to 3.8 million people suffer head injuries as a result of a collision with a stationary or moving object, either because of sporting or recreational activities, car accidents or acts of violence.
Surveying the topic of “Substance Abuse and Traumatic Brain Injury,” Brainline.org quoted studies that found between 10 and 20 percent of people with traumatic brain injury develop a substance abuse problem after their injury.[19] One of those studies, which was published in the Journal of Learning Disabilities, found that people who drank before a traumatic head injury initially reduced their levels of alcohol intake following the injury, but gradually returned to pre-injury levels of drinking.[20] This suggests that people who were exposed to physical violence as children may not be able to shake their self-medication coping strategies, even after experiencing a head injury that causes significant brain trauma – and that a traumatic head injury may even exacerbate their compulsion to abuse drugs and alcohol.
Part of that relationship is explained in an article published in the Journal of Neurotrauma; traumatic brain injuries can increase the possibility of a substance abuse problem by “disrupting incentive motivation neurocircuitry.”[21] The article’s authors explain that pathways in the brain that are responsible for delivering the neurotransmitters that make us feel good and rewarded, which are forcibly rewired by substance abuse, are similarly disrupted because of the effect of traumatic brain injuries. In addition, the study found that repeated injuries to a specific part of the brain could cause a personality disorder that is conducive to substance abuse and addiction.