How Substance Use Disorder Masked My Complex PTSD
When I finally arrived in recovery, at 32 years old, I quickly discovered that the depression I’d had for years didn’t go away when I stopped drinking. The relief I felt was only temporary. I couldn’t understand why, unlike my peers, I was so exhausted in recovery — why I couldn’t settle, and why I felt like I experienced a rollercoaster of emotions almost every day.
It turned out that my substance use disorder had been masking an underlying condition: Complex trauma.
I attended AA for five years. I did all of the things suggested: I got a sponsor, I worked the steps (several times in NA and AA), and I worked service positions. I returned to work shortly after getting sober and I spent my life working, doing step work, and going to meetings. And I felt terrible.
I had zero energy. My body craved carbohydrates to the point that I couldn’t control it. I would get home from work and meetings, then binge until I passed out. This wasn’t what I anticipated life in recovery to be like. I felt just as depressed. The only difference was that I was depressed without a numbing agent.
Life in early recovery was only marginally better than the alternative — that is, until I hit the five-year mark.
After leaving AA and visiting a naturopath, who referred me to a great therapist, I was diagnosed with complex PTSD.
When I was five years sober, I relocated to the US (from the UK) and I began a full-time writing career. The stress of relocating, on my own, without a stable form of income or anywhere to live, was a jolt to my system. I felt like I was jumping out of a plane every single day. I knew this was part of the process, but this was the hardest thing I have ever done. And I’m so glad I did it.
That level of dysregulation in my body was hard to handle. I felt exhausted a lot of the time. I was managing my energy levels with several naps throughout the day and a lot of coffee. I was hyper-aware of what was happening around me at all times and I felt like I would just fly off the handle at something that, on reflection, was minor. In addition, my body ached and I would get weird infections and markers in my blood for autoimmune conditions.
I decided to seek help from a naturopath, who looked at my health and symptoms holistically. This helped to provide a lot of answers to the sickness I’d experienced. She also referred me to a great therapist. It was this therapist who introduced the concept that I had a history of complex trauma and met the diagnosis for complex PTSD. The more I learned about complex PTSD I began to connect the dots about my health.
What is the difference between PTSD and complex PTSD?
Most traumatic events are one-off or time-limited, such as a car accident, an assault, or a natural disaster. Complex PTSD, however, is different. In fact, while 92 percent of those with complex PTSD meet the diagnostic criteria for PTSD, they also exhibit additional symptoms that affect their self-concept and how they deal with stressful events.
According to the National Center for PTSD, people with complex PTSD experience episodes of chronic trauma that continues or repeats for months or years at a time. These types of trauma may include domestic abuse, physical and sexual abuse as a child, sex trafficking, and being in a prisoner-of-war camp.
Symptoms include difficulties with emotional regulation, consciousness, self-perception, distorted perceptions of the perpetrator, relations with others, and a sense of meaning in life.
On a base level, experiencing substance use disorder is itself traumatic.
You might be asking yourself: What was the traumatic experience? And the answer is as simple as experiencing a traumatic childhood, involving moving to the UK as a child from an abusive family, mental illness and substance use disorder in my family, and my own experiences with substance use disorder and in traumatic relationships.
On a base level, experiencing substance use disorder is itself traumatic. No one chooses to obliterate their reality with substances, to lie, cheat, steal, and put themselves in dangerous situations. A life of active addiction is most definitely an episode of trauma.
A complex PTSD diagnosis and recovery.
The diagnosis made so much sense to me. Looking back, I can see that all along I’d been using drugs and alcohol to self-medicate some pretty unusual experiences. I didn’t feel safe in my body, or anywhere else for that matter. I always slept closest to the door. If I was in a room, I could tell you within a few minutes where the exits were. Loud noises make me jump. Raised voices or someone acting violently makes me freeze. For the most part of my recovery, if you were to ask me how I felt in my body, my answer would be: Numb and uncomfortable.
In his book The Body Keeps the Score, renowned trauma specialist Bessel A. van der Kolk says:
“Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from themselves.”
The discovery of my complex PTSD diagnosis and subsequent therapy has been the greatest gift to my recovery. Most of all, it has brought me home to my body and given me tools to cope with the stresses of life as well as the triggered state of complex trauma.
Some of the ways I have learned to cope include:
Somatic experiencing therapy
Talk therapy
Meditation
Mindfulness
Learning how to feel safe in my body
Managing anxiety
Grounding techniques
Massage
Yoga, especially yin and restorative
Acupuncture
Stress reduction
Relaxation
Regular exercise
Implementing and maintaining boundaries
Walking away from situations that cause me to feel stressed
Saying no
Creating a healthy work/life balance
Red light therapy
Creative expression: drawing, painting, and crafting
Learning to express my feelings in safe environments
Asking for my needs to be met by others
Empowering myself to take control of my recovery
Re-energizing in nature
Taking regular naps
A healthy sleep routine
Ditching coffee
Eating nutritious food regularly and prioritizing sustenance rather than reaching for chocolate or processed foods when I’m overly stressed and hungry
A trauma diagnosis doesn’t mean you are broken. For me, it simply meant that I needed to take a breath and learn some better coping mechanisms. Today, I feel better than I have in my whole life. Trauma recovery takes time, but it’s absolutely worth it for my sustained recovery.