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Anxiety and Substance Use Disorder

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Dealing with Anxiety and Substance Use Disorder

Substance use disorder (SUD), also known as drug addiction, is a chronic and relapsing condition characterized by the compulsive and harmful use of substances such as alcohol, prescription drugs, or illegal drugs.

Navigation: Anxiety and Substance Use Disorder: Can They Co-Occur?, Anxiety Disorders: What Are the Different Types?, Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, Other Types of Anxiety Disorder, What is a Dual Diagnosis and How is it Treated?, Taking Care of Your Mental Health When You Have Anxiety, Rehab Is Your Best Chance


Having a drink or two at a party is usually not a concern for many people. However, some people have to deal with a substance use disorder, which creates several health problems.

Substance use disorder (SUD), also known as drug addiction, is a chronic and relapsing condition characterized by the compulsive and harmful use of substances such as alcohol, prescription drugs, or illegal drugs.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), an estimated 20.4 million people aged 12 or older in the US had a substance use disorder in 2019.

Individuals with SUD have difficulty controlling their substance use, often taking larger amounts or using for longer periods than intended. They may have unsuccessful attempts to cut down or stop using.

An addicted person will keep using the substance even when they are already suffering from its consequences. They may also engage in dangerous behaviors while under the influence, such as driving under the influence or having unprotected sex.

Their substance abuse will not only affect their physical health, but also their mental health, their relationships, and most other aspects of their life.

SUD can affect anyone, regardless of age, gender, or background. It is influenced by a combination of genetic, environmental, and psychological factors. Some individuals may be more vulnerable to developing SUD due to genetic predisposition, while environmental factors like exposure to drugs, trauma, or peer influence can also contribute.

While SUD is considered a mental health disorder in its own right, it can also co-occur with other mental health disorders, particularly anxiety disorders and depression.

Those with anxiety disorders may find that taking drugs or drinking alcohol can make the symptoms of anxiety worse. In fact, about 20 percent of people in the US who have an anxiety or mood disorder also have a substance use disorder. On the other hand, about 20 percent of people with a substance use disorder also have an anxiety disorder.

Here we will explore the relationship between substance use disorders and mental health disorders like anxiety.


Anxiety and Substance Use Disorder: Can They Co-Occur?

Anxiety and substance use disorder can definitely co-occur, but the relationship between the two is complex.

Many people with anxiety disorders may turn to various substances as a way to self-medicate and alleviate the symptoms of their mental health disorder temporarily. Prescription drugs, alcohol, and even illicit drugs can provide temporary relief from anxiety, leading to a cycle of reliance and substance abuse. This has the potential to turn into a full-blown addiction.

People with anxiety disorders may use substances such as alcohol, marijuana, or prescription drugs to feel more comfortable in social situations, for example. Even though the effects are short-lived, they use these substances to manage their anxiety.

When someone experiences both anxiety disorder and substance use disorder at the same time, it is called a dual diagnosis or co-occurring disorder. The presence of both conditions can complicate treatment and recovery, as they often interact and exacerbate each other’s symptoms.

While anxiety does not necessarily cause substance abuse, people who have this mental condition are at an increased risk compared to the general population. The underlying factors that contribute to anxiety also make a person more vulnerable to substance misuse.

It can also go the other way around. Some substances like cocaine and amphetamines can contribute to the development of anxiety. In fact, some of these drugs can directly induce anxiety or panic attacks. In some cases, people who quit drugs or reduce their intake go through withdrawal, and anxiety is one of the most common withdrawal symptoms.

Anxiety and substance use disorders share some common neurobiological mechanisms. Both conditions involve dysregulation of brain circuits related to reward, motivation, and stress response. This overlap can contribute to the co-occurrence of these disorders and the potential for one to worsen the other.

If you or someone you know is struggling with anxiety and substance use, it is essential to seek professional help from healthcare providers experienced in treating co-occurring disorders. They can provide an accurate diagnosis and develop an appropriate treatment plan tailored to individual needs.

It is not enough to tackle mental disorders without also providing substance abuse treatment. Healthcare providers will have to address both the mental illness and the drug use simultaneously in order to provide long-lasting benefits.


Anxiety Disorders: What Are the Different Types?

Many people think that anxiety is just one thing, but there are actually many different types. The symptoms of anxiety can make substance use disorder worse for some individuals. This is why it is important to know what the different types of anxiety disorder are.

Anxiety disorders are a group of mental health conditions characterized by excessive and persistent worry, fear, and anxiety. Let’s take a look at some of the common types of anxiety disorders.

Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) involves excessive and uncontrollable worry and anxiety about everyday life events, such as work, health, relationships, and other concerns. GAD is different from normal, everyday worries that people may experience. In fact, the worry is often disproportionate to the actual situation and can interfere with daily functioning.

People with GAD often find it challenging to control their worrying, and their anxiety may interfere with their daily activities and functioning. They may worry about a wide range of issues, even when there is little or no reason for concern. Their worries may feel intrusive and overwhelming.

GAD can even manifest through various physical symptoms, such as restlessness, fatigue, muscle tension, irritability, difficulty sleeping, and problems with concentration.

To be diagnosed with GAD, the excessive worry and anxiety must persist for at least six months.

Panic Disorder

Panic disorder is characterized by recurrent and unexpected panic attacks. Panic attacks are sudden episodes of intense fear and discomfort accompanied by physical symptoms such as rapid heartbeat, shortness of breath, dizziness, chest pain, and a sense of impending doom.

Individuals with panic disorder often worry about future panic attacks and may develop agoraphobia, which is a fear of being in situations where escape may be difficult.

For people with a substance abuse disorder, particularly those who struggle with alcohol abuse, panic attacks may cause them to relapse.

Social Anxiety Disorder

Social anxiety disorder involves an intense fear and avoidance of social situations due to the fear of being judged, embarrassed, or humiliated.

People with social anxiety may have extreme self-consciousness and may experience physical symptoms such as blushing, sweating, trembling, and difficulty speaking in social situations.

Substance use disorders often co-occur with social anxiety disorder because people with this disorder tend to use alcohol or drugs to lessen their social anxiety. This is why alcohol abuse usually develops after the onset of this disorder. It is interesting to note that sometimes these substances can actually make their anxiety worse.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder or OCD is characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce anxiety or prevent feared outcomes.

Common obsessions include concerns about cleanliness, symmetry, or harm, while compulsions involve repetitive behaviors like hand washing, checking, or counting.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop in individuals who have experienced or witnessed a traumatic event. It is characterized by a range of symptoms that can significantly impact a person’s daily life and overall well-being, such as intrusive memories or flashbacks, nightmares, hypervigilance, and changes in mood and cognition.

Common causes of PTSD include experiences such as military combat, sexual assault, physical abuse, natural disasters, accidents, or any other event that involves a threat to one’s life or safety. It’s important to note that not everyone who experiences a traumatic event will develop PTSD, as the condition’s development depends on various factors, including individual resilience and support systems.

Just like other types of anxiety, PTSD often co-occurs with substance abuse. People with this disorder use alcohol or drugs to try to ease their anxiety, however, this often just exacerbates their symptoms.

Other Types of Anxiety Disorder

There are other types of anxiety disorders such as separation anxiety disorder. It is characterized by excessive fear or worry about being separated from attachment figures, typically occurring in children. It can result in significant distress and impairment in daily functioning.

Specific phobias are also considered a form of anxiety disorder. These are characterized by intense fear and avoidance of specific objects or situations, such as heights, spiders, flying, or enclosed spaces. The fear is excessive and disproportionate to the actual threat posed by the stimulus.

It’s important to note that anxiety disorders can coexist with each other or with other mental health conditions, and each individual’s experience may vary. If you or someone you know is experiencing symptoms of an anxiety disorder, it’s advisable to seek professional help for accurate diagnosis and appropriate treatment.

What is a Dual Diagnosis and How is it Treated?

Treating substance abuse will not eliminate an anxiety disorder, although it may help. If a person has both conditions, they usually have to be treated simultaneously. This is called dual diagnosis treatment.

As we mentioned earlier, a dual diagnosis refers to the co-occurrence of a substance use disorder and a mental health disorder in an individual. It means that someone is dealing with both addiction or substance abuse and another mental health condition at the same time. It doesn’t matter what type of mental illness co-occurs with the substance use disorder. It can be an anxiety disorder or any other mental health disorder such as depression, bipolar disorder, schizophrenia, or others.

The treatment of dual diagnosis typically involves an integrated approach that addresses both problems concurrently. A person receiving dual diagnosis treatment will typically go through a thorough assessment which is conducted by a healthcare professional.

This evaluation will help treatment providers understand the person’s condition and symptoms, allowing them to create a personalized treatment plan based on their  specific needs. The healthcare provider will take a look at the person’s symptoms, medical history, and other relevant factors.

A dual diagnosis treatment program understands that these conditions cannot be treated separately. The complex nature of addiction and mental illness can prevent a person from making a full recovery if only one aspect of the problem is addressed. Therefore a dual diagnosis rehab center may use a combination of therapies, medications, and support services.

Medications may also be prescribed to manage the symptoms of the co-occurring disorders. By addressing the physical and mental health effects of their condition, patients are able to focus on their recovery.

Antidepressants, anti-anxiety medications, mood stabilizers, or antipsychotics may be used, depending on the patient’s specific condition.

While in rehab, the person will participate in individual and group therapy sessions that will help them explore the underlying issues of their dual diagnosis. Therapy will help them recognize their triggers, learn healthy coping mechanisms, and develop new habits to manage their substance abuse and mental health symptoms.

Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and motivational interviewing are commonly used therapeutic approaches.

Meanwhile, group therapy provides a supportive environment where patients can share their experiences, learn from one another, and develop a sense of community. They can benefit from the fact that the people around them understand exactly what they are going through. This can help in reducing feelings of isolation and building a support network.

Additional support services may include case management, vocational rehabilitation, housing assistance, family therapy, and peer support. These services aim to promote overall well-being and sobriety.

Finally, dual diagnosis treatment also focuses on relapse prevention. The recovery journey does not end when you leave rehab. Relapse prevention strategies are crucial because it teaches patients to maintain their sobriety for the long term. This will prepare them for the outside world and help them readjust to the drug-free or alcohol-free lifestyle.

Treatment should be tailored to address their unique circumstances and may involve a combination of different therapies and interventions.

A multidisciplinary team, including psychiatrists, psychologists, addiction specialists, and other professionals, often collaborates to provide comprehensive care for dual diagnosis individuals. With proper treatment, patients can overcome their anxiety and substance abuse.

Taking Care of Your Mental Health When You Have Anxiety

Taking care of your mental health is essential, especially when you’re dealing with anxiety. Here are some strategies that can help you manage anxiety and promote overall well-being:

Practice Relaxation Techniques: Incorporate relaxation techniques into your daily routine to reduce anxiety symptoms. Deep breathing exercises, progressive muscle relaxation, meditation, and mindfulness can help calm your mind and body.

Stay Active: Engage in regular physical exercise as it releases endorphins, which are natural mood enhancers. Activities like walking, jogging, yoga, or dancing can be beneficial for managing anxiety. Aim for at least 30 minutes of exercise most days of the week.

Prioritize Self-Care: Make self-care a priority in your life. Get sufficient sleep, maintain a balanced diet, and establish a consistent daily routine. Engage in activities you enjoy, such as hobbies, reading, or spending time in nature.

Limit Stressors: Identify and minimize sources of stress in your life. Learn to say no to additional responsibilities when you feel overwhelmed. Establish healthy boundaries and prioritize self-care.

Challenge Negative Thoughts: Practice cognitive restructuring to challenge negative thoughts and replace them with more realistic and positive ones. Keep a journal to track your thoughts and identify patterns that trigger anxiety.

Build a Support System: Surround yourself with supportive and understanding individuals. Share your feelings with trusted friends or family members who can provide empathy and encouragement.

Practice Mindfulness: Incorporate mindfulness techniques into your daily life. Focus on the present moment, without judgment, and engage your senses to ground yourself when anxiety strikes.

Limit Caffeine and Alcohol: Both caffeine and alcohol can exacerbate anxiety symptoms. Limit or avoid these substances, as they can disrupt sleep patterns and increase feelings of restlessness.

Take Breaks and Rest: Give yourself permission to take breaks and rest when needed. Overworking or pushing yourself excessively can worsen anxiety symptoms. Allow yourself downtime to recharge.

Consider Support Groups: Joining a support group for individuals with anxiety can provide a sense of community and help you realize you’re not alone in your experiences. It can also offer additional coping strategies and insights.

Seek Professional Help: Consult with a mental health professional such as a therapist or counselor who specializes in anxiety. They can provide you with valuable guidance, support, and techniques to manage your anxiety effectively.

Remember, everyone’s journey with anxiety is unique. It may take time to find the strategies and techniques that work best for you. Be patient, kind to yourself, and reach out for professional help when needed.

Effective treatment for co-occurring anxiety and substance use disorders often involves an integrated approach. Look for a rehab near you today if you have either or both of these conditions. Your road to recovery begins today.

Rehab is Your Best Chance

Treatment is an addicted individualʼs best option if they want to recover. Beating an addiction not only requires eliminating the physical dependence, but also addressing the behavioral factors that prevent them from wanting to get better. Simply quitting may not change the psychological aspect of addiction. Some people quit for a while, and then take drugs or alcohol again, only to overdose because they did not detox properly. Recovery involves changing the way the patient feels, thinks, and behaves.


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Fel Clinical Director of Content
Felisa Laboro has been working with addiction and substance abuse businesses since early 2014. She has authored and published over 1,000 articles in the space. As a result of her work, over 1,500 people have been able to find treatment. She is passionate about helping people break free from alcohol or drug addiction and living a healthy life.

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