Anxiety and Substance Abuse

Everyone experiences anxiety from time to time. In many cases, anxiety is a natural response to stress that can help people be alert to potential dangers in their surroundings.¹ However, when fear or anxiety become excessive or  persist far longer than more common stress-induced anxiousness, and in doing so become disruptive to your life, it may be time for further evaluation for a possible anxiety use disorder.²

Anxiety disorders are some of the most common mental health disorders, and almost 30% of American adults will experience an anxiety disorder at some point in their lifetime.¹

Read on to learn more about anxiety disorders, the link between and other forms of addiction, risk factors for co-occurring disorders, and how to help someone who struggles with both anxiety and alcohol addiction

What is an Anxiety Disorder?

Anxiety disorders include several mental health issues characterized by overwhelming fear, anxiety, or panic, often with symptoms that last longer than is typical for the circumstance and interfere with day-to-day life.^1,2

When someone has an anxiety disorder, they may experience unusually heightened levels of situational fear, anticipatory anxiety, related physiological changes such as increased vigilance and muscle tension, and commonly go out of their way to avoid situations that trigger or exacerbate anxiety symptoms.^{1, 2}

While anxiety is a typical and expected response to stressors such as public speaking or a scary situation, an anxiety disorder doesn’t go away once the immediate threat or trigger has passed—and could worsen over time.^{1, 3} Anxiety disorders can make it difficult to function at work, take care of responsibilities, and interact in social situations.

Symptoms of Anxiety Disorders

There are several types of anxiety disorders, which have common features of high levels of fear, anxiety, and associated changes in behavior.²  However, some symptoms can vary greatly depending on the specific type of disorder.²  Some common anxiety disorders include:³

Social anxiety disorder. Social anxiety is marked by excessive fear or anxiety in social settings. Hallmarks of this disorder include excessive worry about judgment, negative perceptions, and rejection, leading to avoidance of social situations.² People with a social anxiety disorder may experience physical symptoms, such as blushing, sweating, shaking, increased heart rate, or stomachaches.³ About 7% of American adults experience social anxiety disorder each year.¹

Generalized anxiety disorder. Generalized anxiety disorder (GAD) involves a excessive and overwhelming anticipatory anxiety or worry about various concerns, such as work, family, health, or certain activities, and can interfere with the ability to function, occurring much of the time for at least six months.^{1, 2} The levels of anxiety experienced with GAD may be out of proportion to the actual likelihood or impact of the anticipated triggers.² This disorder affects an estimated 2% of American adults each year.¹ Symptoms of generalized anxiety disorder can include:²

• Restlessness or feeling persistently on edge.
• Getting fatigued easily.
• Finding it hard to concentrate or having your mind go blank.
• Muscle tension.
• Difficulty falling or staying asleep or not getting restful sleep.

Panic disorder is a form of anxiety that involves recurring panic attacks combined with ongoing anxiety about having more panic attacks and changes in behavior to avoid having more panic attacks.^{2, 3} Around 2-3% of American adults experience panic disorder yearly.¹ Symptoms of panic attacks are typically short-lived and can include:^{1, 2, 3}

• Chest pain, heart palpitations, or racing heart.
• Dizziness.
• Nausea or stomach pain.
• Numbness or tingling.
• Shaking.
• Shortness of breath.
• Sweating.
• Derealization or depersonalization (feeling detached from oneself or reality).
• Worries about impending doom or losing control.

Co-occurring Anxiety and Drug or Alcohol Addiction

The term co-occurring disorders refers to a situation wherein a person has one or more substance use disorders (SUD) in addition to one or more mental health disorders.⁴ Co-occurring disorders have historically also been referred to as dual diagnoses, and the terms are often used interchangeably. According to a nationwide survey conducted in 2020:⁵

• 17 million Americans aged 18 and older were diagnosed with co-occurring disorders.
• People with a mental health disorder were more likely to use substances, including marijuana, opioids, and alcohol, than people without a mental health diagnosis.⁵
• Co-occurring substance use disorders are particularly prevalent among people with anxiety disorders.⁶

Risk Factors for Co-occurring Anxiety Disorder and Addiction

You may be wondering, “does anxiety cause addiction?” However, research shows that anxiety and substance use disorders result from a combination of factors, and one doesn’t necessarily cause the other.⁶ However, overlapping factors of anxiety and substance use disorder can increase your likelihood of developing co-occurring conditions and may increase the risk of struggling with other issues.⁶
Risk factors for anxiety disorders can include:

• Family history of anxiety disorders.
• Environmental factors, including difficult and stressful events.
• Exposure to trauma or abuse.
• Certain personality characteristics, including shyness or distress in unfamiliar situations, especially during childhood.
• Overuse of caffeine or other stimulants.
• Medical conditions, especially those that affect the thyroid or heart rhythm.

Common risk factors for comorbid mental illness and addiction can include:⁶

• Genetic and epigenetic vulnerabilities.
• Similarly involved brain regions.
• Environmental factors, including early exposure to stress or trauma.

Anxiety and Substance Use Disorders

There is a link between anxiety and addiction.⁴ An anxiety or substance use disorder significantly increases the risk of developing the other.⁷

• Past studies have indicated that nearly 18% of peopler with a past-year SUD also had a co-occurring anxiety disorder.⁷
• Similar estimates have indicated that approximately 15% of people with a past-year anxiety disorder also had at least one co-occurring SUD.
• It has been estimated that up to half of the people in treatment for alcohol use have at least one anxiety disorder.^7,8
• People with generalized anxiety disorder and SUDs are more likely to be heavy drinkers.⁴

How to Help Someone with Anxiety and Substance Use Disorder

Whether you are struggling with co-occurring disorders or love someone who is, it can be challenging to know how to help. It can be overwhelming to figure out where to start, and you may feel scared or alone. The best way to help someone with anxiety and substance use disorder is to take some time to educate yourself about these conditions. Other tips include:

• Plan what you want to say and write it down. Avoid using stigmatizing language, like “drunk” or “addict,” and avoid shaming and blaming.
• Choose a neutral time and place to have a conversation with your loved one when they are not using drugs or alcohol or under the influence.
• Remain open to hearing what they say and offer to help however you can. This can include helping your loved one research treatment facilities or going to doctor appointments.
• Set and maintain boundaries. For instance, do not allow drugs or alcohol in the home.
• Reach out for help from trusted friends or family. Getting into individual, couples, or family therapy can also be beneficial.
• Practice self-care. This can be something as simple as journaling or spending time with friends.

Treating Anxiety and Addiction

Treatment approaches that integrate the management of both anxiety and substance use disorders may be particularly effective for recovery from co-occurring disorders.⁹ Since these conditions are closely intertwined, the most effective treatment addresses both simultaneously.^{4, 9} Left unmanaged or under-managed, anxiety symptoms could additionally complicate relapse prevention efforts as well as the overall management of a substance use disorder; conversely, ongoing compulsive substance use could adversely impact the course of an anxiety disorder.^4,7

Fortunately, effective co-occurring disorders  treatments are available that can help you get on the road to recovery and empower you to live the life you deserve. Integrated treatment plans can involve any combination of behavioral therapies, depending on your unique needs, including: cognitive-behavioral therapy, dialectical behavior therapy, motivational interviewing, and peer and group support.⁴Additionally, FDA-approved medications may also be used as part of treatment to help manage withdrawal symptoms, mental health conditions, and ease cravings.⁴

There are varying levels of care that can support your recovery, depending on your unique needs. These include:

• Detox, a safe place for you to withdraw and get substances out of your system while under medical supervision.⁹ It’s important to remember that detox is just the first step in the recovery process, and it doesn’t address the underlying factors that contribute to addiction. Detox should be followed by additional treatment to help you get a good start on the road to recovery.⁹
• Inpatient addiction treatment, where you stay at the facility for treatment and attend group and individual therapy sessions.⁹ Medical and counseling staff is available around the clock to help support and encourage you.
• Outpatient addiction treatment in Mississippi,  where you live at home and participate in your usual daily routine while attending scheduled counseling appointments.⁹

Recovery from co-occurring disorders is possible, and we can help. The team at our drug and and alcohol rehab in Mississippi has decades of experience helping people overcome co-occurring disorders. You can reach our helpful admissions navigators 24/7 on our free hotline at . They can help you learn more about rehab admissions, help you check your insurance coverage for rehab, discuss rehab payment options, and answer any questions you may have.