With an estimated 40 million Americans suffering from an anxiety disorder and over 20 million diagnosed with substance use disorder, both anxiety and addiction are widespread.
The conditions are also inextricably linked. ADDA (Anxiety and Depression Association of America) data shows that 20% of Americans with an anxiety disorder or mood disorder also have a co-occurring alcohol use disorder or substance use disorder.
Many people diagnosed with GAD (generalized anxiety disorder) turn to drink or drugs in an attempt to self-medicate symptoms, this theme of mental illness and overarching drug or alcohol addiction is a common problem This might provide fleeting and short-term relief, but it does nothing to address the underlying issue. Also, abusing substances can inflame the symptoms of anxiety you are attempting to soothe.
For others, abusing substances can trigger an anxiety disorder or inflame the symptoms of an existing anxiety disorder.
When an anxiety disorder co-occurs with alcohol abuse or an addiction to drugs, this is known as a dual diagnosis or co-occurring disorder.
Why, then, is anxiety and addiction such a big deal?
Anxiety and Addiction: Understanding the Problem
There are several categories of anxiety disorders, each presenting different symptoms. Regardless of the condition, most anxiety disorders are characterized by irrational fear or worry lasting for at least six months.
The main types of anxiety disorder are:
- GAD (generalized anxiety disorder): GAD is characterized by persistent symptoms of constant worrying resulting in stress and tension despite no obvious underlying cause
- PTSD (post-traumatic stress disorder): PTSD can occur after exposure to a traumatic event, like war, terrorist acts, natural disasters, or serious accidents
- OCD (obsessive-compulsive disorder): OCD sufferers are afflicted by recurring thoughts and often engage in repetitive behaviors like hand washing or cleaning the house. These behaviors provide temporary relief from the obsessive thoughts
- Panic disorder: If you experience recurring episodes of extreme fear coupled with physical symptoms like dizziness, heavy breathing, and increased heart rate, you might have a panic disorder
- Social anxiety disorder: SAD (social anxiety disorder) is sometimes known as social phobia. This condition is characterized by extreme anxiety in combination with intense self-consciousness, even under normal and stress-free circumstances
What, then, causes anxiety and addiction?
Causes of Addiction and Anxiety
Your likelihood of developing an anxiety disorder, an addiction, or both involves a mixture of the following variables:
- Genetics
- Psychological factors
- Environmental factors
Most people diagnosed with an anxiety disorder react differently and unhealthily to stress, largely for genetic reasons. The part of the brain responsible for processing fear is intensely sensitive in those with anxiety disorders.
There is also a link between neurotransmitters in the brain like serotonin and cortisol and feelings of anxiety and depression.
Of all these factors, genetics and family history are among the most important. Roughly 50% of those with panic disorder and 40% of those with generalized anxiety disorder have a family history of these disorders.
Substance abuse can also trigger anxiety disorders. We can deduce this from the fact that substance use disorders and anxiety co-occur at rates higher than normal.
Gender and age also impact your risk profile for anxiety disorders. Women are more than twice as likely to suffer from anxiety disorders as men. The symptoms of phobias, separation anxiety, and OCD often develop during youth and adolescence. Social phobia and panic disorder symptoms tend to manifest during teenage years.
Among those diagnosed with generalized anxiety disorder and a co-occurring substance use disorder, the most commonly abused substances include:
- Alcohol
- Cocaine
- Benzodiazepines
- Opioids
- Marijuana
- Stimulants
Substance abuse can dramatically worsen the psychological symptoms of anxiety. If tolerance builds and addiction takes hold at the same time the symptoms of anxiety disorder are deteriorating, this makes for an unhealthy mixture.
For someone with an anxiety disorder, the euphoria provided by drugs can seem to counteract the stress, dread, and fear they’ve been experiencing. Unfortunately, the euphoria doesn’t last. Your body starts metabolizing the substances, while dopamine is reabsorbed by your brain.
By this point, you may keep using the substance to stop that amazing euphoric feeling from fading, and so the vicious cycle continues.
What’s happening here is that your body is craving higher and higher levels of dopamine and you’re turning to drugs to obtain what is no longer being produced by your body naturally.
A smarter approach is to find ways to raise your dopamine levels without drugs.
Anxiety and drug addiction fuel one another in menacing ways. Psychology Today calls it a “cycle of self-medication and rebound anxiety”.
Ironically, it becomes a Catch-22 situation, because the drugs that are bringing a brief moment of relief (even if it’s just nicotine or caffeine) can also cause anxiety. In this way, you’re simply trading one addiction for another.
To fix this, your brain needs to be rewired. Addiction treatment is the most effective method achieving this recalibration.
How Does Anxiety Lead to Substance Abuse?
People suffering from generalized anxiety disorder are much more likely to develop an alcohol use disorder or substance use disorder than those without an anxiety disorder.
If an anxiety disorder is untreated and the symptoms worsen, people commonly self-medicate with drink or drugs. In the short-term, self-medication can provide temporary happiness and relief from the symptoms of anxiety. Over time, though, this substance abuse will do nothing to address the root cause of your anxiety, and you’ll likely exacerbate the symptoms. By this stage, addiction may have set in and you could be dealing with anxiety and weed addiction rather than anxiety in isolation.
How about anxiety with the legal but potentially damaging alcohol use disorder, though?
Anxiety and Alcohol Addiction
Suffering from anxiety disorder is distressing in its own right. The same is true of alcohol use disorder. When these conditions co-occur, though, it can be especially troublesome.
Anxiety is a disorder that impacts your CNS (central nervous system). The condition can lead to an accelerated heart rate, increased blood flow, and intense neural activity.
Typically, the symptoms of extreme anxiety are treated with benzodiazepines, but this medication is strongly habit-forming and should only be used short-term and exactly as prescribed. Alcohol, like benzos, is a CNS depressant, and as such many people self-medicate seeking these same soothing effects but without the addictive potential of benzodiazepines.
Many people turn to alcohol as a means of alleviating the symptoms of undiagnosed anxiety disorder. With no idea why they are feeling this way, blotting out the feeling sometimes feels easier than dealing with it. Sadly, the issues both become complicated and ultimately require dual diagnosis treatment.
Anxiety and Addiction Recovery
Now, while anxiety disorders and substance use disorders won’t go away untreated, with the right integrated treatment, you can get to the bottom of both issues. After all, self-medicating the symptoms of anxiety will do nothing long-term except make them worse, so why not unpack the mental health condition and substance use disorder at the same time?
By diving deep and exploring the underlying issues that cause your anxiety or depression, you’ll be much better placed to fight back. Whether you need the support and structure of residential rehab, or you prefer the flexibility and affordability of outpatient treatment, there is no barrier to treatment you cannot overcome if you’re committed enough.
According to ADAA (the Anxiety and Depression Association of America) anxiety is treatable using a combination of:
- Anti-anxiety medications
- Behavioral modification strategies
- Psychotherapy
CBT (cognitive behavioral therapy) is one of the most effective modalities for treating both anxiety disorders and alcohol and drug abuse.
In CBT sessions, you’ll identify the triggers for self-defeating thought patterns and poor behaviors. Crucially, you’ll also discover how to modify these ways of thinking and behaving for superior, healthier outcomes.
If you have a dual diagnosis, you may find CBT beneficial for minimizing your chances of abusing substances and relapsing, and you might also find it useful for coping with stressful situations without being consumed by fear and anxiety.
CBT is delivered in both individual and group settings as appropriate. Medication can also be used to effectively treat anxiety disorders in combination with psychotherapy.
SSRIs (selective serotonin reuptake inhibitors) are often used to alleviate the symptoms of anxiety as well as being used to treat depression. Drugs in this class are considered safe and proven effective. These medications work by maximizing the amount of serotonin available to your brain and so reducing the negative thoughts and continual worries triggered by anxiety disorders.
Dual Diagnosis Treatment for Anxiety
If you’re struggling with both anxiety disorder and substance use disorder or alcohol use disorder, commonly referred to as a dual diagnosis, the best and most effective treatment is delivered using an integrated model.
You’ll typically need to detox and withdraw from the substance in question, depending on whether you’re addicted to alcohol, illegal drugs, or prescription medication.
Once your body is purged of toxins, you’ll address both issues simultaneously using a combination of medication-assisted treatment if appropriate and psychotherapy.
Some of the most common antidepressants and anti-anxiety medications used include:
- Zoloft
- Xanax
- Celexa
- Lexapro
- Buspar
- Pristiq
These medications can be used both short-term and long-term. Xanax is the exception here. As a benzodiazepine, this medication is highly effective, but it’s also highly addictive and unsuitable for ongoing use.
Whenever you’re taking any form of medication, you should maintain clear and frank lines of communication with your treatment provider. Only use the medications precisely as prescribed. Be certain that you’re aware of the addictive potential of any medication if you’re suffering from co-occurring anxiety and addiction. Be open about any substance abuse issues so your healthcare provider is better placed to prescribe appropriate and non-addictive treatment solutions when possible.
The District Recovery: Anxiety and Addiction Treatment
Here at The District Recovery Community, our dual diagnosis treatment program and addiction therapy will help you attack your alcohol use disorder or substance use disorder at the same time as your underlying anxiety disorder.
Remember: constant worry and fear are not something you should struggle with alone. You shouldn’t need to turn to drink or drug use just to feel normal. You don’t need to feel this way, then, but you do need to put in some work to get back on track. Here at TDRC, we’ll make that easier for you by helping you conquer your addiction and mental heath disorder with a variety of treatment options.
We have a variety of highly effective outpatient treatment programs at varying levels of intensity, including PHPs (partial hospitalization programs) and IOPs (intensive outpatient programs). These offer the same core services of medication-assisted treatment and psychotherapy with varying degrees of care and time commitment as appropriate.
