anxiety disorderSometimes substance abuse co-occurs with other mental health disorders, and these cases of co-occurring disorders can complicate the symptoms and consequences of both conditions. Anxiety disorders are some of the most common co-occurring disorders with substance abuse and addiction.

Oftentimes, the symptoms of anxiety disorders lead to behaviors like self-medication that, over time, can develop into substance abuse. Anxiety symptoms can also occur as a result of addiction to or withdrawal from some drugs.

The combination of anxiety and drug abuse can sometimes make it challenging to deliver treatment. Sometimes the person or treatment professionals may not even be aware initially that the co-occurring disorder is present. For a person who is struggling with drug or alcohol abuse and also dealing with co-occurring anxiety, it can help to understand more about anxiety, how it contributes to substance abuse, and what types of treatment are available.

General Overview of Anxiety Disorders

Anxiety is a broad term covering a number of different mental health disorders of varying degrees. According to the Anxiety and Depression Association of America, anxiety includes several different categories of disorders, including:

  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Agoraphobia
  • Other specific phobias
  • Social anxiety
  • Separation anxiety

Other disorders are related to or frequently occur with anxiety disorders, including obsessive-compulsive disorder, post-traumatic stress disorder, and depression.

Of course, everyone feels fear, worry, or anxiety from time to time. However, anxiety disorders result in a person having these feelings regarding everyday situations, on a constant basis, for seemingly no rational reason. These disorders can make fear and worry interfere with daily life, and they can sometimes lead to other problems, including substance abuse.

Anxiety disorders and substance abuse frequently occur at the same time. According to a study in Alcohol Research and Health, about 18 percent of people who had a substance use disorder also had a co-occurring, independent anxiety disorder of any type. This does not include those who may have had an anxiety disorder that resulted from substance abuse, which is less common but also occurs.

There are several reasons that this may happen. One of the most common reasons is that some substances that ease anxiety symptoms may be used to manage these symptoms without consulting a doctor – this is known as self-medication. These self-medicating behaviors can result in a high risk of developing a substance use disorder, as demonstrated through research in the Journal of Clinical Psychology.

For example, a person struggling with anxiety might use alcohol to alleviate symptoms of tension, irritability, and insomnia. Continued self-medication of this kind over a long period of time may lead to the person needing more of the substance to achieve the same effect, which is known as tolerance. This causes the person to drink more, or more often, which then leads to abuse and a potential addiction to alcohol.

According to Mayo Clinic, people who are at risk for generalized anxiety disorder include those who:

  • Have a family history of anxiety
  • Have a timid or shy personality
  • Generally avoid anything that may be considered dangerous

Other risk factors contribute to other anxiety disorders, such as life experience (such as witnessing an extremely frightening event), brain chemistry, and gender (females tend to be diagnosed with anxiety more often than men).

Because anxiety disorders can lead to substance abuse, having an anxiety disorder is considered to be a major risk factor for substance abuse. According to the National Institute on Drug Abuse, other risk factors include:

  • Family history of substance abuse
  • Peer pressure
  • Other mental health disorders, such as depression or bipolar disorder
  • Past chaotic family or home circumstances
  • High stress levels
  • General risk-taking behavior

Recognizing Anxiety Disorders and Substance Abuse

According to the National Institute of Mental Health, symptoms of anxiety disorders can vary depending on the type of disorder. For example, a person struggling with panic disorder may have the severe physical symptoms of a panic attack, including shortness of breath, rapid heartbeat, sweating, and dizziness, along with a constant fear or worry about being in public places and having a panic attack. On the other hand, someone with GAD might have less obvious symptoms, such as insomnia, an inability to relax, or muscle tension. The main symptom of all anxiety disorders, however, is a sense of fear, dread, or worry that persists for six months or more.

If an anxiety disorder is suspected, and it is accompanied by symptoms of substance abuse, it is important to get help from professionals who are experienced with dual diagnoses or co-occurring disorders. Symptoms of substance abuse include:

  • Increased drug-seeking behavior, to the degree that other interests are abandoned
  • Trouble with personal relationships due to substance abuse
  • Problems at work or school
  • Extreme mood swings
  • Secretiveness or attempts to hide substance use

These and other symptoms can sometimes be masked by symptoms of anxiety, or substance abuse can sometimes mask symptoms of anxiety. These co-occurring symptoms may it more difficult to recognize either disorder. In order to obtain proper diagnoses, seek help from a professional.

Most Commonly Abused Drugs with Anxiety Disorders

Alcohol has been found to be one of the most commonly abused substances for people with anxiety disorders, according to another part of the study in Alcohol Research & Health. Alcohol is easily accessed, and the fact that it interferes with the body’s natural stress and fear response can lead to people using it to self-medicate anxiety symptoms.

Benzodiazepine drugs, such as Xanax (alprazolam), Valium (diazepam), and other prescribed anti-anxiety medications, are also frequently abused by those with anxiety disorders. When taken as prescribed and for short periods of time, these substances can ease anxiety without leading to addiction. However, benzodiazepines are often abused or used for too long, which can result in tolerance to the drugs and then addiction.

Opiate drugs, such as prescription painkillers and illicit drugs like heroin, are also commonly abused by people dealing with anxiety disorders. As with alcohol and benzos, opiate drugs can interfere with the body’s anxiety response, bringing a sense of calm, as described in research from the Journal of Psychopharmacology.

Treatment for Anxiety and Substance Abuse

getting help Experts agree that the most positive outcomes for treatment of substance abuse with co-occurring anxiety result from integrated treatment of both conditions together, rather than trying to treat either condition separately. Integrated treatment is important because it provides a degree of continuity in care, taking into account the effects that each condition has on the other.

Research from the journal Social Work in Public Health demonstrates that behavioral therapies provide a positive benefit for treating co-occurring anxiety and substance abuse. Combinations that have shown success include:

  • Panic-Focused Psychodynamic Psychotherapy (PFPP) for panic disorder
  • Cognitive Behavioral Therapy for social anxiety disorder and obsessive-compulsive disorder
  • Affect-Focused Body Psychotherapy for GAD

These therapies are most helpful in treating co-occurring anxiety and substance abuse when they are performed by a professional who is familiar with both disorders. A rehab center that specializes in dual diagnosis and that provides personalized, integrated therapy can help those in need to effectively manage both conditions.