Anxiety and Addiction

Anxiety and addiction are an increasingly common dual diagnosis. At Avenues Recovery, we offer a range of therapy options to address anxiety issues alongside substance abuse. In this article, we’ll define the different types of anxiety, explore their connection to addiction, and discover effective treatment options for a wholesome recovery.

Prevalence of Co-occurring Anxiety and Addiction

Anxiety often precedes addiction, leading individuals to self-medicate and develop substance dependence over time. Addiction can also trigger anxiety, by causing heightened senses, obsessive fears, and irritability. This, in turn, exacerbates the cycle - an addict may up their drug dose to escape these anxiety-like symptoms. 

Comprehensive studies on anxiety and substance abuse have proven the following statistics:

• The odds of drug dependence in individuals with generalized anxiety disorder are 9.5 times higher than those without anxiety.
• Adults with PTSD (post-traumatic stress disorder) are 2-4 times more likely to have a substance use disorder than adults without PTSD.
• Individuals with social anxiety disorder are 2-3 times more likely to develop alcohol use disorder.
• Drug dependence is 9.2 times more likely in individuals with panic disorder with agoraphobia.

Anxiety vs. Anxiety Disorder

Anxiety is a feeling of uneasiness, such as worry, fear, or dread, usually regarding an upcoming event or an event with an unknown outcome, such as a job interview, medical test, or exam. Anxiety is a natural response when one feels under threat, and it can be experienced through our thoughts, feelings, and physical sensations. Surprisingly to many, anxiety isn’t necessarily a negative thing; it can help you stay alert and cautious, help you remain aware of danger or risks, and prompt you to act when faced with danger or a challenging situation. Anxiety occurs when the amygdala – an area in the brain that percepts emotions - senses trouble, and subsequently releases stress hormones and adrenaline to make the body respond quickly and powerfully.

If anxiety interferes or disrupts your quality of life (i.e. it is ongoing, intense, or out of proportion with your challenge) you may be diagnosed with anxiety disorder. 

Signs of Anxiety Disorders

A person with an anxiety disorder will experience the following chronic symptoms:

• Restlessness
• Physical weakness
• Feeling on edge
• Irritability
• Sweaty hands
• Tense muscles
• Constant worry
• Difficulty concentrating
• Easily fatigued
• Sleeping difficulties

Types of Anxiety Disorders and Their Symptoms

• Generalized anxiety disorder (GAD): This is the most common form of anxiety. Generalized anxiety disorder is long-term anxiety. Here the sufferer feels anxious constantly, despite there being no genuine reason to worry. The person will worry about everyday issues such as financial situations, relationships, or health.
• Social anxiety disorder (SAD): This is also known as ‘social phobia,’ where the person suffering will have an irrational fear or dread of interacting with others or being in a social setting. It’s a relentless fear of being judged or embarrassed, and sufferers will go to great lengths to avoid any social interactions. This condition affects close to 15 million U.S. adults and is not to be confused with ordinary shyness.
• Panic disorder: With panic disorder, the person will have sudden panic attacks for no legitimate reason. They will experience a pounding heart, sweat profusely, tremble, feel weak and dizzy, and have difficulty breathing. The sufferer will also have an intense fear of having another panic attack and will therefore avoid situations that might trigger one.
• Post-traumatic stress disorder (PTSD): This is anxiety that arises after having experienced trauma. An estimated 8 million Americans who suffered a trauma will show symptoms of PTSD. Flashbacks to the event, insomnia, nightmares, and paranoia are symptoms of this disorder.
• Phobia: This is an overwhelming, debilitating fear of specific objects, places, animals, situations, or feelings. People with phobias will go out of their way to avoid the object of their fear, despite it interfering with their daily lives. Common phobias include:
  • Claustrophobia - fear of enclosed space
  • Agoraphobia - fear of crowded places
  • Aviophobia - fear of flying
  • Acrophobia - fear of heights

There are many specific phobias out there, each with a designated name. For a comprehensive list, click here.

Addiction and Anxiety - Dual Diagnosis

Individuals who suffer from anxiety will often use drugs or alcohol to help relieve their symptoms and feel more at ease in social settings. The problem is that anxiety gets in the way of being responsible with drug intake. The sufferer won’t recognize that they have an anxiety disorder that must be treated professionally, not by abusing drugs and alcohol. This creates a vicious cycle since the misuse of drugs and alcohol can cause similar symptoms to anxiety, such as uneasiness, agitation, irritability, and obsessive fears. This will lead to further substance abuse, increased substance-induced anxiety, and so on.

Causes of Co-occurring Substance Abuse and Anxiety

When a person suffers from both addiction and anxiety disorder (or any other mental illness) together, it is referred to as a ‘co-occurring disorder,’ or ‘dual diagnosis.’ Here are several reasons why anxiety can trigger substance abuse or vice versa:

• Self-managing symptoms - The person with the anxiety disorder will rely on alcohol or drugs to help them manage their symptom, whether physical or psychological. In other words, alcohol and drugs are used as a coping mechanism or even a form of self-medication.
• Biochemical factors - Chemical imbalances in the brain affect both anxiety and substance use disorders.
• Genetic predisposition - It’s been proven that anxiety and substance abuse have a genetic component. Therefore, people who are susceptible to anxiety may also be prone to substance abuse if both are common in family members.
• Effects of substance abuse or withdrawal - Abusing drugs will lead to symptoms that are identical to those of anxiety. Upon withdrawal, the person will experience anxiety as the brain tries to revert to its initial state.

Identifying Co-occurring Anxiety and SUD

Here are some behaviors that can act as signs to determine whether one has a co-occurring disorder:

• Using drugs or alcohol to cope with: negative emotions, situations that tend to frighten, pain, bad moods, or focus maintenance
• Noticing a relationship between anxiety and substance abuse, e.g. realizing that alcohol consumption is always the solution to anxiety
• Feeling anxious despite being sober
• After being treated for substance abuse, the treatment failed due to mental health issues, or vice versa 

Anxiety and Addiction Treatment

The first step towards anxiety and addiction recovery is a thorough assessment to uncover all symptoms and behaviors. Then, both conditions are treated simultaneously to effectively recover. If only addiction is treated, the individual will likely return to substance abuse since he still suffers from anxiety. Conversely, if just anxiety is addressed, the continued substance abuse will lead to anxiety.

In cases where the person is heavily dependent on substance abuse, medical detox is the initial phase of treatment. The withdrawal symptoms can be very difficult to deal with; hence, a treatment facility is the best option to help the body learn how to function without drugs or alcohol in a calm, clean, and supportive atmosphere. Stabilizing medications, such as opioid agonists, might be administered by a doctor to help relieve the difficult symptoms, which are often related to anxiety. To help manage anxiety in the longer- term, SSRI medications (paroxetine or escitalopram) or SNRIs (duloxetine or venlafaxine) will be prescribed.

Rehab Treatment Options for Anxiety and Addiction

Outlined below are commonly used rehab treatments:

• Therapy and counseling- Dialectical behavioral therapy (DBT) or cognitive behavioral therapy (CBT) is the most effective form of therapy for anxiety and addiction. Here one is guided on how to identify negative thoughts, develop coping mechanisms, and manage anxiety and cravings.
• Holistic practices - This includes meditation, yoga, exercise, and art therapy. These activities can promote self-care, stress reduction, and emotional regulation, as well as serve as healthy outlets for managing anxiety and lessening the likelihood of relapse.
• Group therapy - This allows the patient to connect with others who are in the same position and gain peer support and reassurance. It also reduces the feelings of isolation which are typically associated with anxiety disorders and addiction.

Help for Anxiety and Drug Abuse

Someone suffering from anxiety and substance abuse will likely find it difficult to reach out for help since they’re both sensitive and personal topics. Upon being approached about one’s condition, the individual will likely respond in denial and become offensive. It might be helpful to have more than one person intervening, preferably a close family member or friend who can be non-judgmental and compassionate. Without intervention, the addiction will get worse and lead to deteriorating health conditions, injury, or even death.

If you or someone you know suffers from co-occurring substance abuse and anxiety disorders and desires an improved quality of life, contact us at Avenues Recovery to learn how we can help you reach this goal. Our staff are highly trained and are experts at helping people battle their addictions and turn their lives around.