Anxiety and addiction are, on their own, each disorders that can cause significant suffering in a person’s life. Together, they can cause untold heartache for the person struggling with anxiety and addiction and for the friends and family watching their loved one suffer. And yet, anxiety and addiction are commonly found in the same individual. In some cases, people with anxiety abuse drugs or alcohol in an attempt to self-medicate. Other times, the substance abuse itself triggers anxiety. Regardless of the root cause, it is important to treat both issues in order to give people struggling with anxiety and addiction the best chance of recovery.
Anxiety Disorder Definition
Most people know what it means to be anxious, to worry about an upcoming meeting, or feel nervous about meeting someone for the first time. But, anxiety is not the same thing as an anxiety disorder. Anxiety disorders are a set of clinical diagnoses encompassing several distinct mental illnesses that share common traits. Anxiety disorders are characterized by feelings of fear or dread that are unfounded.These fears can present both physical and psychological symptoms and may interfere with an individual’s work life, social life, and personal relationships. As much as 18% of the American population suffers from anxiety disorders, making it the most common form of mental illness. Specific anxiety disorders include:
- General Anxiety Disorder (GAD): People with GAD worry all the time, for no real reason. Their fears continue no matter what the situation is. If one worry is allayed, another takes its place. People with GAD frequently struggle with depression as well.
- Social Anxiety Disorder (SAD): People with SAD experience severe anxiety in social situations, such as interacting with large groups of people, speaking in public, or other social situations. While many people feel nervous under these conditions, people with SAD experience such anxiety that they may experience physical symptoms of stress or avoid these occasions altogether.
- Post-Traumatic Stress Disorder (PTSD): People who have experienced severe trauma, such as sexual assault, violent crime, military combat, or a natural disaster may develop PTSD. People with PTSD experience flashbacks, nightmares, irritability, anger, insomnia, and paranoia.
- Panic Disorder: People with panic disorder experience unfounded terror that can result in a panic attack. In a panic attack, people may feel that they are about to die. They experience physical symptoms including increased heart rate, hyperventilation, dizziness, sweating, nausea, vomiting, chest pain, or a feeling of choking.
There is no one root cause of anxiety disorders. People may develop anxiety disorders because of a genetic predisposition, brain chemistry, and their personal life history. Whatever the cause, people with anxiety disorders are at greater risk of depression and addiction than people without anxiety.
Addiction to drugs and alcohol is a medical diagnosis that requires medical treatment. Addiction to either drugs or alcohol is defined by developing a tolerance to and a dependence upon either drugs or alcohol. Being tolerant to a substance means that, through repeated exposure to the substance, the same dose no longer produces the same effect. The individual will need to take a larger dose each time to create the desired effect. Being dependent on a substance means that the body has become accustomed to its presence and requires it in order to function normally. When the individual stops taking the substance, he or she will experience symptoms of withdrawal. People who are addicted to drugs or alcohol may desire to quit using them but undergo withdrawal and intense cravings for the substance when they stop using it.
Anxiety and Addiction
A dual diagnosis of anxiety and addiction is not uncommon. In fact, about 20% of people with an anxiety disorder or another mood disorder struggle with addiction. Likewise, about 20% of people with an addiction to drugs or alcohol also have a diagnosis of an anxiety disorder. Some people with an anxiety disorder attempt to alleviate their symptoms by using drugs or alcohol. Other times, anxiety can be triggered through drug or alcohol abuse. Certain drugs are known to induce anxiety disorders, including alcohol, marijuana, phencyclidine (PCP), hallucinogens, inhalants, and stimulants including cocaine. In fact, cocaine has been documented to trigger anxiety disorders in individuals who did not previously struggle with anxiety and to worsen the symptoms of people who already have anxiety. Other drugs can cause anxiety disorders during withdrawal from them, including benzodiazepines, alcohol, and opioids.
Treatment for Anxiety and Addiction
Because anxiety and addiction are both medical conditions, it is important to treat them both to give the individual the best chances of a complete recovery. It doesn’t really matter which condition came first or whether one triggered the other. Both need to be effectively treated in order to avoid sinking back into a vicious cycle in which one condition triggers the other. In fact, people with anxiety and addiction who seek treatment for addiction alone are more likely to experience further medical problems, suicide, or early death. A combination of medical treatment, therapy, and support effectively treat both conditions.
Treating anxiety often involves antidepressant medications combined with therapy. Common antidepressants used include selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft and selective norepinephrine inhibitors (SNRIs) such as Effexor and Cymbalta. Therapeutic techniques for anxiety involve learning to handle anxiety when symptoms begin and to reduce triggers in the first place. Some therapies used include:
- Relaxation Training: The individual learns to physically relax the body through breathing, yoga, meditation, or visualization techniques.
- Exposure Therapy: If a particular situation or object induces anxiety in the individual, he or she is gradually exposed to it. By learning to manage their anxiety with exposure over time, they can overcome their anxiety.
Medications for drug and alcohol abuse depend on the substance in question. Options include Antabuse (disulfiram) and Campral (acamprosate) to treat alcohol abuse and naltrexone, methadone and buprenorphine to treat opioid addiction. While these medications are helpful in treating addiction, supplemental therapy is a key factor in effective treatment. Therapeutic approaches include:
- Cognitive Behavioral Therapy: The individual will learn how to change their behavior by identifying challenging situations and anticipating how to handle them. For example, they might identify situations in which they will be tempted to abuse drugs or alcohol and plan ahead on how to avoid or respond to the temptation.
- Motivational Interviewing: The therapist will work with the individual to assess and enhance their motivation to change.
- Contingency Management: Positive rewards, such as gift cards, are given to the individual as feedback for demonstrated abstinence from drugs or alcohol, such as from a negative drug screen. These rewards provide an external motivation to change.
Blu By the Sea
While a dual diagnosis of anxiety and addiction can be difficult to overcome, it is not a life sentence. With appropriate medication, therapy, and counseling, people can overcome their addiction and manage their anxiety for a successful lifetime of recovery. In-patient rehab can provide all of these services in a healthy, supportive environment. The medical staff at Blu By the Sea have years of experience helping people struggling with anxiety and addiction to move beyond these diagnoses into a healthy lifestyle. If you or someone you love struggles with anxiety and addiction, call us today. Help is available.