Addiction often co-occurs alongside mental health issues. One of the most common mental health disorders that afflicts those with an addiction is anxiety. There are several different types of anxiety disorders, and these include the following.
Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) is a disorder hallmarked by chronic anxiety and excessive worry and tension, although there is little or nothing to aggravate it.
Panic disorder is characterized by unpredictable and repeated episodes of intense fear accompanied by physical symptoms that may include dizziness, chest pain, heart palpitations, shortness of breath, or stomach/digestive distress.
Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) is an anxiety disorder that is marked by recurrent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions). Repetitive behaviors, such as hand washing, cleaning, counting, or checking, are often performed with the hope of preventing obsessive thoughts or making them go away. However, performing these rituals offers only temporary relief, and not engaging in them only serves to increase anxiety.
Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a condition that may develop after a person has been exposed to a terrifying event or circumstance in which severe physical harm was incurred or threatened. Traumatic events that may cause PTSD include assaults, natural or humanmade disasters, accidents, or military combat.
Social Anxiety Disorder (Social Phobia)
Social anxiety disorder is characterized by fear and anxiety and excessive self-consciousness in average, everyday social situations. Social phobia can be restricted to only one type of situation or, in its most severe form, may be so broad that individuals experience symptoms almost anytime they are around other people.
A specific phobia is the irrational, debilitating fear of a particular object, person, animal, or situation. Individuals with this form of anxiety will go out of their way to avoid the object of fear, even if this avoidance interferes with their daily lives. Among the most common specific phobias include claustrophobia (the fear of enclosed spaces), aviophobia (the fear of flying), and acrophobia (the fear of heights).
In general, unlike the normal, healthy responses that people everyone experiences in response to stressful or dangerous circumstances, clinical anxiety is marked by persistent, often unfounded fears that can interfere with interpersonal relationships, work, school, or social activities. Anxiety symptoms can be both physical and psychoemotional, and addressing these symptoms often necessitates a multifaceted approach to treatment.
Anxiety and Its Relationship to Substance Abuse
In an effort to deal with their symptoms, it is not uncommon for individuals who experience anxiety disorders to engage in substance abuse. The National Institute on Drug Abuse (NIDA) estimates that people with anxiety are twice as likely to suffer from substance abuse as the rest of the population. Unfortunately, attempts at self-medication often backfire by making the effects of this psychiatric disorder more severe.
Moreover, alcohol and drug use can exacerbate the psychoemotional and physical symptoms of anxiety, reinforcing the need to use ever-increasing amounts of these substances to function correctly. The result is an escalating pattern of substance abuse resulting in physical dependence and addiction.
Anxiety can also have a direct impact on the body. As noted, people with anxiety may have strong physical reactions to situations or objects that do not seem intrinsically dangerous or threatening and may include, but are not limited to, the following:
- Shortness of breath
- Sweating or clamminess
- Rapid heartbeat
- Sleep disturbances
- Chest and stomach pain
- Choking sensations
To meet the diagnostic criteria for a full-fledged anxiety disorder, the person must experience symptoms on most days for six months or longer. However, individuals whose lives are affected by incapacitating fear should not hesitate to seek professional help. With the right combination of therapeutic interventions, anxiety can effectively be addressed.
Although there are many suggested theories regarding the root causes of anxiety, investigators are still exploring the causes of these complicated disorders. In many instances, an anxiety disorder may develop as a result of multiple factors, including the following:
- Family history
- History of trauma
- Substance abuse
- Overexposure to stress
- Other mental health issues
Anxiety and Substance Abuse
Substance abuse is more common in individuals with anxiety disorders than in the general population. The existence of a substance use disorder in conjunction with an anxiety disorder or other mental health problem is known as a dual diagnosis or co-occurring conditions. There are several reasons why anxiety could trigger the need to abuse substances, or vice versa.
Self-Medication of Symptoms – One of the most commonly accepted theories about the relationship between anxiety and substance abuse posits that individuals with anxiety disorders resort to the abuse of alcohol or drugs in an effort to control their physical and emotional symptoms. A person with social anxiety disorder may use alcohol to cope with stressful interpersonal encounters, placing them at risk of physical dependence and addiction.
Biochemical Factors – Both substance use disorders and anxiety may be related to chemical brain imbalances. For example, low serotonin, a neurotransmitter responsible for the regulation of mood, energy levels, sleep, metabolism, and other functions, has been linked with alcohol dependence and mental health issues.
Genetic Predisposition – There is some evidence that both substance abuse and anxiety-related conditions have genetic components. Persons vulnerable to anxiety may also be susceptible to substance abuse and addiction if both conditions were commonly found in their families.
Drug or Alcohol Withdrawal – Drug or alcohol abuse can provoke symptoms that directly increase anxiety, such as nervousness, agitation, irritability, and sleepless disturbances. When withdrawing from the effects of substance abuse, individuals may experience symptoms such as these as the brain attempts to restabilize chemical balance.
Anxiety is highly treatable using a combination of therapy, behavioral modifications, and certain medications. Cognitive-behavioral therapy (CBT) is one of the most effective therapeutic services for both the treatment of anxiety and drug or alcohol dependence. In CBT, individuals learn to identify and alter self-defeating thought patterns that make them feel anxious and fearful.
Clients who have anxiety and substance abuse disorders can use CBT to acquire new coping mechanism that will help promote recovery goals, even when encountering triggers and stressful situations. CBT can be applied in individual and group therapy settings.
When combined with psychological and social therapies, medication can also be a valuable tool in overcoming anxiety. Medicines in the SSRI category (selective serotonin reuptake inhibitors) are frequently prescribed to treat anxiety symptoms and help these individuals forge healthier and more satisfying lives.
Individuals with a dual diagnosis often benefit the most from specialized treatment that addresses both issues in combination. A comprehensive recovery program for co-occurring substance abuse and anxiety includes several levels of care, beginning with detox and continuing through residential rehab, outpatient treatment, and aftercare. Family therapy, group support meetings, and methodologies such as equine-assisted therapy also assist in the recovery process by bolstering the individual’s support system and reinforcing self-worth.
Integrated Treatment Solutions
Constant worry, stress, and and fear are not just personality quirks. They are sometimes debilitating symptoms of a psychiatric condition that can be treated with a combination of evidence-based therapies. When anxiety is complicated by addiction, the need for effective recovery solutions becomes even more important.
The answer to anxiety and substance abuse often lies in comprehensive recovery programs that integrate mental health services and addiction services. While therapeutic interventions for addiction treatment were once kept separate from anxiety, studies now show that the most effective way to help persons with dual diagnoses is to provide integrated services that address both conditions simultaneously.