Substance Abuse: A Common Co-Occurring Disorder in Caregiving Professions

I’ve said it before in previous blogs, as well as in each of the books in the PTSD Recovery series, but it’s worth repeating.

Drug and alcohol abuse make sense in the context of PTSD. Criterion C of PTSD is avoidance, and drinking and drugging help us avoid our feelings. Criterion D is all about changes in the way we think and feel, and alcohol and drugs can play a major role in this.

Self-medicating is a term used to describe individuals who turn to drugs or alcohol to cope with overwhelming emotions and feelings that they are not ready or able to confront.

This can take various forms, such as excessive use of alcohol, tobacco, or painkillers.

According to the National Center for Injury Prevention and Control, CDC, people in high-stress jobs, like first responders and healthcare workers, are more prone to self-medication. The constant pressure and exposure to traumatic events can lead to cumulative trauma and mental health issues like acute stress disorder, depression, and post-traumatic stress disorder (PTSD). Unfortunately, many individuals in these professions also develop co-occurring substance use disorders (SUDs) to relieve their symptoms.

While dealing with job stress is a contributing factor in substance use disorders (SUDs), those in caregiving professions may also turn to alcohol for other reasons. Sometimes, a cold beer (or a few) at the end of a tough day eases the tension. Social drinking is good for bonding with your peers. You’ve been through hell with your brothers and sisters, and it would be a shame to miss some quality relaxation time with your team once the shift ends. A work culture where social drinking and bonding with peers is normal, but it's also an easy place for problems related to substance abuse to go unnoticed. For others, maybe they need to take the edge off of their physical pain from injury or muscle strain and they grab their bottle of painkillers. No one likes to be in pain, whether mental or physical, so numbing it is one answer. And an easy habit to fall into.

But what starts as a social norm or coping mechanism can quickly spiral into addiction. Many people don't even realize they have an SUD until they try to cut down or face negative consequences from their self-medicating.

However, the good news is that SUDs are treatable.

Seeking professional help is a necessary step towards healing. Unfortunately, there is still a stigma surrounding seeking help for mental health and addiction issues. Many view it as a weakness or something to be ashamed of.

It's time to break this stigma. As caregivers, our own mental and physical well-being should be just as important as the mental and physical health of those we care for.

When the demands of the job take a toll on our health, seeking help is not only necessary, it's the bravest thing you can do.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Secondary Trauma vs Compassion Fatigue

 

Secondary Trauma, also known as Vicarious Trauma, is a serious issue that can affect individuals who work in caregiving professions. It is often used interchangeably with compassion fatigue, but there is a key difference between the two.

Compassion fatigue is a gradual process of emotional and physical exhaustion caused by prolonged exposure to trauma while caring for others. This can lead to symptoms such as dissociation, lack of concentration, irritability, and feelings of helplessness and hopelessness. These symptoms don't just stay at work. They can have a negative impact on personal relationships as well. Over time, compassion fatigue can be exacerbated by stress within the organization one works for, lack of support or recognition, and negative outcomes when working with traumatized individuals. This can put caregivers at a higher risk for mental health issues like depression, burnout, and even PTSD.

On the other hand, Secondary Trauma or Vicarious Trauma involves profound negative changes in an individual's worldview due to their exposure to traumatic content from those they are helping. 

If you are experiencing the following problems, Secondary Trauma / Vicarious Trauma may have developed:

• Fear in non-threatening situations
• Physical symptoms include headaches, shortness of breath, and a racing heart
• Feeling others’ trauma as if you experienced it yourself
• Constantly feeling on guard or jumpy
• Excessive fear that yourself, your colleagues, or loved ones may get hurt
• Persistent intrusive thoughts involving the trauma of others 

During a TED Talk in 2017, Patricia Smith, the founder of the Compassion Fatigue Awareness Project, had this to say: 

“Caregivers are not good at asking for help. Asking for help is hard, no matter who you are. For nurses, doctors, teachers and more, the idea of leaving work can seem like an impossibility.

You may feel guilty or that you are abandoning your patients or students. But if you are struggling with drug or alcohol use, you need help too. Your clients, patients and students will be happy for you.”

Compassion fatigue and Vicarious Trauma may be a common occurrence in caregiving professions, but it doesn't have to take control of your life. By taking care of yourself and being aware of the warning signs, you can continue to provide excellent care without sacrificing your own well-being. Remember, only when you take care of yourself can you truly take care of others.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Compassion Fatigue in Caregivers

 

According to Charles Figley, who first coined the term, compassion fatigue refers to the negative psychological symptoms experienced by caregivers who are exposed to direct traumatic events or secondary trauma in the course of their work. This can include first responders or mental and/or healthcare workers, and other professionals who are frequently exposed to traumatized individuals.

The stress and impact of this exposure on caregivers' mental and physical health cannot be underestimated. It often stems from a combination of prolonged exposure to trauma, as well as the inability to emotionally disengage from the suffering of others.

Some common signs of compassion fatigue include exhaustion, anger and irritability, negative coping behaviors such as alcohol or drug abuse, emotional detachment or numbness, burnout, and impaired decision-making abilities.

So how can you prevent compassion fatigue from taking over your life? Here are some key things to keep in mind:

1. Take care of your own well-being: As a caregiver, it's natural to put others' needs before your own. However, it's crucial to prioritize your own mental and physical health to avoid reaching a breaking point.

2. Acknowledge your limitations: You're only human, and there's only so much you can do. Don't be afraid to ask for help when you need it or delegate tasks if possible.

3. Practice self-care: Make time for activities that bring you joy and help you relax. Whether it's exercising, reading a book, or spending time with loved ones, self-care is essential for recharging your emotional batteries.

4. Don't ignore warning signs:

• Depression
• Frustration
• Feelings of uselessness
• Cynicism
• Feeling disconnected from others
• Worries you’re failing at your job
• Constantly feeling exhausted or tired
• Feeling the need to drink alcohol or do drugs

If you notice any of the warning signs mentioned above, don't brush them off. Address them and seek help before they escalate. Seek help from resources like supervisors, peer-support groups, or clinical practitioners before it becomes too overwhelming.

Compassion fatigue may be a common occurrence in caregiving professions, but it doesn't have to take control of your life. By taking care of yourself and being aware of the warning signs, you can continue to provide excellent care without sacrificing your own well-being. Remember, only when you take care of yourself can you truly take care of others.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD