PTSD
Anxiety
Co-occurring
Treatment Options
What Co-occurs
100

Intrusion

These symptoms are related to intrusive thoughts and memories of the traumatic event.

  • Reoccurring, involuntary, and intrusive upsetting memories of the event
  • Repeated upsetting dreams related to the event
  • Dissociation (for example, flashbacks, feeling as though the event is happening again)
  • Strong and persistent distress to cues connected to the event that are either inside or outside of the body
  • Strong bodily reactions (for example, increased heart rate) when reminded of the event
100

What Is Anxiety?

Anxiety disorders are characterized by excessive and persistent worry and fear about everyday situations.

100

Why Addiction and Mental Illness Co-Occur

  • Drug abuse can cause people to experience one or more symptoms of another mental illness. For example, there is an increased risk of psychosis in some marijuana users.
  • Mental disorders can lead to drug or alcohol abuse because some people use substances to self-medicate. For instance, the nicotine in tobacco products sometimes lessen certain symptoms of schizophrenia and may improve cognition.
  • the age at which the symptoms appear. During the teen years, people are still developing, maturing, and growing. As a result, significant changes in the brain occur during adolescence.
  • people who are physically or emotionally traumatized are at a much higher risk of substance use disorders. This connection is particularly concerning for veterans returning to the country. In fact, one in five military servicemen and women coming back from Iraq and Afghanistan have reported symptoms of post-traumatic stress disorder (PTSD) or major depression.
100

the individual will experience physical and mental withdrawal symptoms. During this, the individual will be provided with medical and psychological support until stabilized.

DETOX

100

Depression  

alcoholism

200

Avoidance

People with PTSD may avoid people, places, conversations, activities, objects, or situations that bring up memories of the event. They may also avoid thoughts, feelings, or physical sensations that recall the event.

200

Anxiety Symptoms

The mental symptoms of anxiety can include:45

  • Worry
  • Fear
  • Tension
  • Irritability 
  • Trouble concentrating
  • Restlessness
  • Nervousness
  • Low mood and depression
  • Reassurance-seeking
  • Dissociation (depersonalization and/or derealization) 


Physical symptoms of anxiety can include:45

  • Sweating and flushing 
  • Dizziness and lightheadedness 
  • Fast heartbeat and breathing 
  • Chest tightness or pain
  • Tingling or “pins and needles” feelings 
  • Trembling
  • Nausea
  • Trouble sleeping
  • General pain or frequent headaches or stomachaches without a clear cause


Anxiety symptoms can affect your life by making it harder for you to:

  • Go to work or school
  • Take care of yourself
  • Do chores, errands, and other tasks
  • Maintain relationships with loved ones

This is not an exhaustive list, but these are some common symptoms of anxiety disorders:

  • Excessive fear and worry
  • Dry mouth
  • Muscle tension
  • Nausea
  • Irregular heartbeat
  • Difficulty sleeping
  • Cautious, avoidant behavior
  • Panic attacks
200

Why It Is Difficult to Diagnose Both Conditions

Co-occurring disorders are sometimes difficult to diagnose. One reason is that the symptoms are often complex and can vary in severity. As a result, it is not uncommon for people to receive treatment for one disorder while the other disorder remains untreated. Sometimes this happens because the symptoms are so similar or overlap. In other words, both mental health issues and addiction can have similar biological, psychological, and social components.

200

dialectical behavior therapy, cognitive behavioral therapy, prolonged exposure therapy, contingency management, and psychodynamic therapy.

EVIDENCE-BASED PSYCHOTHERAPY

200

Bipolar Disorder 

Alcohol Addiction

300

Negative Changes in Thoughts and Mood

People with PTSD may experience a pervasive negative emotional state (for example, shame, anger, or fear). Other symptoms in this category include?

  • Inability to remember an important aspect of the event
  • Persistent and elevated negative evaluations about oneself, others, or the world (for example, "I am unlovable," or "The world is an evil place")
  • Elevated self-blame or blame of others about the cause or consequence of the event5
  • Loss of interest in previously enjoyable activities
  • Feeling detached from others
  • Inability to experience positive emotions (for example, happiness, love, joy)
300

Types of Anxiety Disorders

Various types of anxiety disorders include the following:


  • Generalized anxiety disorder
  • Social anxiety disorder
  • Panic disorder
  • Other anxiety disorders (separation anxiety, specific phobias, agoraphobia, selective mutism)


Obsessive-compulsive disorder and post-traumatic stress disorder (PTSD) (a type of trauma and stressor-related disorder) were formerly classified as anxiety disorders but now have different classifications. Each involves symptoms that include anxiety.

300

Treatment When Co-occurring disorders Exists

DETOX

EVIDENCE-BASED PSYCHOTHERAPY

GROUPS

MEDICATION

RECOVERY SUPPORT

ADJUNCTIVE THERAPIES AND RECREATION

300

These gatherings promote peer support during rehabilitation, providing a safe space to share personal stories and discuss challenges in recovery.

GROUPS THERAPY 

300

Social Anxiety 

Marijuana Misuse

400

Changes in Arousal and Reactivity

People with PTSD often feel constantly "on guard" or like danger is lurking around every corner (also known as hypervigilance). Related symptoms include?

  • Difficulty concentrating
  • Heightened startle response
  • Impulsive or self-destructive behavior6
  • Irritability or aggressive behavior
  • Problems sleeping
400

Complications of Anxiety and Anxiety Disorders

Anxiety that’s not managed and anxiety disorders that go untreated can lead to complications. The effects that anxiety can have on someone’s life can be severe. Here are just a few examples of the complications of anxiety:


  • Poor mental health (depression, anxiety)
  • Social isolation (avoiding others, being afraid to leave home)
  • Struggles at school or work (trouble keeping a job, being unable to complete homework) 
  • Sleep problems (sleeping too much or not enough)
  • Financial issues (such as overspending or not being able to earn enough due to missed work)
  • Chronic physical health problems (like pain or symptoms that do not seem to have a clear cause)
  • Low self-esteem
  • Problems forming and maintaining relationships
  • Substance misuse
  • Suicidal thoughts or behaviors 


If not treated, anxiety symptoms can change or get worse over time.

400

Mental illness and addiction often overlap. In fact, nearly _________ people have a co-occurring disorder

 9 million people

400

target the specific mental health disorder may be utilized in treatment and beyond rehab. These include antidepressants, benzodiazepines, antipsychotic medications, and mood stabilizers.

MEDICATION

400

Anxiety Disorder

Benzodiazepine Addiction

- such as Xanax, Ativan, or Valium

500

In order to be diagnosed with PTSD, What following criteria should be met according to the DSM-5?

  • Exposure to the traumatic event
  • One (or more) intrusion symptom(s)
  • One (or more) symptom(s) of avoidance
  • Two (or more) symptoms of negative changes in feelings and mood
  • Two (or more) symptoms of changes in arousal or reactivity

These symptoms also must:

  • Last for longer than one month
  • Bring about considerable distress and/or interfere greatly with a number of different areas of life
  • Not be due to a medical condition or substance use
500

When to See a Healthcare Provider

if your worry becomes ongoing and disproportionate to the situation, reach out to a healthcare provider.


People with anxiety disorders feel so much fear and anxiety that makes it harder for them to get through their daily lives. For example, they may fear going out in public, find themselves unable to return phone calls, avoid meeting with friends, cancel performances or presentations, and have chronic symptoms like nausea and changes in sleep.


If you feel that your anxiety is preventing you from living a full life, know that there is help. You don’t have to face these challenges alone.

500

Only _______ of these individuals get treatment for both conditions. And nearly _______ receive no treatment at all.

Only 7 percent of these individuals get treatment for both conditions. And nearly 60 percent receive no treatment at all.


500

Twelve-step programs, or alternatives like SMART Recovery, are often integrated into the rehabilitation program. These programs feature a distinct set of recovery steps or goals to achieve, as well as providing recovery meetings in the community.

RECOVERY SUPPORT

500

PTSD 

Alcoholism, Opioid, or Heroin Addiction