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Substance Abuse and Anxiety

Medically Reviewed by: Charley Allen

Table of Contents

When people think of addiction, they often think of drugs or alcohol. However, any behavior that is so frequent or intense it causes problems in a person’s life can be considered an unhealthy habit. People with mental illnesses like anxiety are at higher risk of developing addictions because their brains have been altered by the stressors in their lives. There is also a higher prevalence of substance abuse among people with serious mental illness than the general population. Anxiety disorder and substance abuse often go hand-in-hand. Both can lead to feelings of hopelessness, isolation, and low self-esteem, all of which increase the likelihood of developing the other condition.

What is Anxiety?

Anxiety is a feeling of worry, nervousness, and unease. It is a normal reaction to stress, so everyone experiences it, but some have more intense feelings than others. People with anxiety disorders have feelings of extreme anxiety that are more persistent and interfere with everyday life. Anxiety is caused by fear. It is a feeling that something bad is going to happen. When you are anxious, you are afraid of what might happen. Your body responds to anxiety by releasing chemicals called hormones. These hormones can make you feel jittery, sweaty, and your heart might race. There are different types of anxiety disorders. Generalized anxiety disorder is the most common type. Panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder are also anxiety disorders.

Risk Factors for Anxiety Disorder

A risk factor is something that increases the likelihood of getting a disease. For example, if you have a relative with a certain disease, you have a higher risk for getting that disease. Risk factors for anxiety disorder include:

  • Genetics: Family members with anxiety disorders may have increased the risk for you.
  • Brain chemistry: Research shows that people with anxiety disorders have lower levels of serotonin, a chemical that helps regulate mood.
  • Environment: Traumatic experiences can also trigger an anxiety disorder.
  • Gender: Women experience anxiety disorders more often than men.
  • Substance abuse: Abusing drugs, alcohol, and medications can lead to both anxiety and depression.

Types of Anxiety Disorders

Anxiety disorders are a group of mental disorders that are characterized by feelings of extreme anxiety and worry that are out of proportion to real dangers. People experiencing an anxiety disorder may have trouble controlling their worries. They often have trouble sleeping, feel tense, and have muscle spasms. Generalized anxiety disorder is the most common type of anxiety disorder. It is when someone experiences constant worry or anxiety over a long period of time. Panic disorder is when you have sudden and repeated attacks of intense fear and anxiety. You may also have physical symptoms like shortness of breath or feeling like your heart is racing out of control. Obsessive-compulsive disorder is when you experience recurring and uncontrollable thoughts and behaviors. Post-traumatic stress disorder is when you have disturbing memories and nightmares after experiencing a traumatic event. Social phobia is another common type of anxiety disorder; this condition causes people to feel nervous in social situations.

Generalized Anxiety Disorder Symptoms

Anxiety disorders are a group of mental illnesses characterized by feelings of fear and worry that are out of proportion to real dangers. Anxiety disorders are one of the most common mental illnesses in the U.S. People with anxiety often feel tense and restless, have trouble sleeping, and may feel tired and irritable. They often have trouble controlling their worry. Some people with anxiety disorders also have another mental illness at the same time. Anxiety disorder symptoms include:

  • Feeling tense and restless
  • Having trouble sleeping
  • Feeling tired and irritable
  • Having difficulty concentrating
  • Having a feeling of impending doom
  • Experiencing muscle spasms
  • Having frequent headaches
  • Having trouble swallowing

Treatment Options for Anxiety Disorders

Certain types of anxiety disorders respond well to medication and therapy. Some anxiety disorders may clear on their own with time. Treatment options for anxiety disorders include:

  • Medication: If you get a diagnosis of anxiety disorder, your doctor may prescribe anti-anxiety medications, antidepressants, or beta-blockers.
  • Therapy: Psychotherapy helps you reduce the symptoms of, and get rid of, an anxiety disorder. Your treatment plan may incorporate cognitive-behavioral therapy, which has been shown to help treat anxiety. However, it is ultimately up to the discretion of your mental health professional to determine which method will help your recovery best.
  • Self-help: There are many books and apps that can give you relief by helping you manage anxiety.
  • Support groups: Talking to others who have anxiety can be very helpful.
  • Relaxation techniques: Meditation, mindfulness, deep breathing, and other relaxation techniques can help you reduce stress, anxiety, and muscle tension by giving you a stronger sense of your body and making you more aware of the present moment.

What Are the Causes of Anxiety Disorder?

Anxiety disorders are highly treatable, but it is important to know what is causing them. This can help you better manage your symptoms. Causes of an anxiety disorder include:

  • Negative thinking: Some people have a negative outlook on life. This can make them more likely to develop an anxiety disorder.
  • Traumatic events: Experiencing a traumatic event can change how your brain works. This can make you more likely to develop an anxiety disorder.
  • Brain chemistry: Anxiety disorders are often linked to having lower levels of serotonin, a chemical that helps regulate behavior.
  • Stress: Chronic stress can trigger an anxiety disorder in some people.
  • Alcohol abuse – Alcohol dependence can lead to a rise in stress hormones, and it can also cause poor decision-making. As addiction becomes stronger, adverse effects on a person’s social interactions, financial situation, and family life can lead to anxiety, PTSD, and other mood disorders.

Self-Medicating for Anxiety Disorder

Anxiety is a very common mental disorder, with 31.1% of people experiencing it in the United States at some point in their lives, according to the National Institute of Mental Health. Anxiety disorders affect the way people think, behave and feel, causing them to feel stressed or fearful even when there is no real danger. These disorders are highly treatable, but many people with anxiety do not seek help because they are embarrassed by their feelings or do not recognize the problem. Anxiety disorders also do not discriminate: They can affect people of any age, ethnicity or background. There are several ways anxiety can be treated, but it may take some time to find a therapy that works well for an individual. People with anxiety disorders may also turn to drugs or alcohol as a way of self-medicating, which can lead to a substance use disorder. Researchers have found that people with anxiety disorders are more likely to abuse drugs and alcohol than those without anxiety. Anxiety disorders can also make a person more likely to become addicted to drugs and alcohol.

Does Substance Abuse Cause Anxiety?

Though research on this is still unclear, there is some evidence that people with anxiety may be more likely to abuse substances than those without anxiety. Experts hypothesize that anxiety is a risk factor for substance abuse because people with anxiety may be more likely to try drugs or alcohol as a way of self-medicating. People with anxiety disorders may also be more likely to abuse drugs or alcohol because these substances produce effects that are similar to anxiety. People with anxiety disorders may be more likely to try drugs or alcohol because these substances can produce feelings of intense excitement or dizziness. People with anxiety disorders may also be more likely to use drugs or alcohol excessively because anxiety disorders can interfere with their ability to control their behavior.

Using Alcohol to Cope with Social Anxiety

If you have social anxiety, you may find yourself frequently turning to alcohol to cope. After a few drinks, you may temporarily feel less anxious and more confident. But, in the long run, alcohol abuse can exacerbate your anxiety and make it harder to overcome. If you want to avoid social anxiety, it’s important to avoid alcohol. While it may seem easier to just avoid the things you’re afraid of, research shows that social anxiety disorder is much easier to treat without the use of alcohol. Cognitive behavioral therapy (CBT) can be used to treat social anxiety disorder. This type of therapy helps you understand your anxiety and change your reactions to it.

Does Marijuana Cause Panic Attacks?

The relationship between marijuana and panic attacks is complicated. While one study showed that smoking marijuana before exposure therapy could increase the likelihood of panic attacks, another showed that Cannabidiol (CBD), a non-psychoactive ingredient in marijuana, could reduce the symptoms of panic attacks. It’s worth noting that these were very small studies; most research on panic attacks and marijuana has been inconclusive. While there isn’t strong evidence that marijuana causes panic attacks, it is possible that there is a connection between the two. People with panic disorder may turn to marijuana for a few reasons. Individuals who smoke marijuana may feel relaxed or calm after using the drug. This sensation can ease the symptoms of panic, especially panic attacks that involve a lot of nervousness or excessive worrying.

Benzodiazepine Abuse and Addiction

Benzodiazepine drugs are commonly prescribed to treat anxiety as well as sleep disorders and muscle spasms. When used correctly, these medications are extremely helpful for managing anxiety. However, when misused, they can produce feelings of euphoria and relaxation that can lead to benzodiazepine abuse. Benzodiazepines can cause physical dependence, meaning that you develop withdrawal symptoms when you suddenly stop taking the drug. Symptoms of withdrawal can include anxiety, nausea, muscle cramps, and insomnia. When used properly, benzodiazepines are safe and effective medications. However, they can cause physical dependence, which means that you experience withdrawal symptoms if you stop taking the drugs while taking too much of the drug is considered an overdose. If you regularly take any prescribed medications, it’s important to consult your doctor about any side effects and the correct dosage.

What Other Mental Disorders Does Substance Abuse Cause?

Substance abuse can also cause other mental disorders. One example is mood disorders, like depression and bipolar disorder. People who are abusing drugs or alcohol are more likely to experience symptoms of depression. In addition, people who have depression may be more likely to abuse drugs or alcohol. This could be because both disorders share some of the same risk factors, like genetics or stressful life experiences. There is also some evidence that antidepressants can reduce the symptoms of cravings and withdrawal. Another mental disorder that can be caused by substance abuse is an eating disorder. Eating disorders are more common among people with substance abuse disorders. One reason for this could be that people with eating disorders are more likely to use drugs or alcohol.

Is Anxiety a Withdrawal Symptom?

When someone is addicted to a substance, their brain begins to crave the substance. If they don’t get their usual dose of the substance, they will experience withdrawal symptoms. Anxiety is a common symptom of withdrawal from drugs like alcohol or benzodiazepines like Xanax or Klonopin. Anxiety is a common symptom of withdrawal from substances like alcohol or stimulants like methamphetamine. During withdrawal, the body and brain try to rebalance themselves after experiencing a substance’s effects. This can cause drastic mood changes and intense feelings of anxiety. Anxiety can also be triggered by the process of quitting drugs or alcohol. Coming off alcohol or drugs is often a long, difficult process that can be very stressful.

What is the relationship between anxiety and addiction?

Anxiety and alcohol use disorder are often linked because both conditions can cause feelings of distress and exacerbation of symptoms. These conditions can also affect each other. For example, drinking alcohol to ease anxiety can actually make your anxiety worse in the long term. When you have an anxiety disorder, you may feel like you need to drink more alcohol to get the same effect. Drinking to cope with anxiety can lead to an alcohol use disorder. If you have an anxiety disorder, you may have an increased risk of developing an alcohol use disorder. However, having an alcohol use disorder doesn’t necessarily mean you have an anxiety disorder. The two conditions can feed off each other, causing you to use more alcohol, which can worsen your anxiety. If you have an anxiety disorder and you also drink too much alcohol, you should seek treatment for both conditions.

Signs and Symptoms of a Substance Use Disorder

A substance use disorder is the continued and excessive use of a substance despite the negative consequences it causes. This can include the inability to control your use, continuing to use the substance in spite of the desire to stop, and increasing the amount of substance you use. Substances that are commonly associated with substance use disorders include alcohol, marijuana, stimulants like cocaine, opioids like heroin, and other prescription drugs, including benzodiazepines. These signs and symptoms can be related to either anxiety or substance use and could indicate that you have a substance use disorder:

  • Worrying more and focusing less on daily activities
  • Experiencing mood swings and experiencing highs and lows
  • Experiencing feelings of restlessness and irritability
  • Experiencing feelings of anxiety, such as panic attacks, that cause distress
  • Experiencing feelings of depression, such as sadness and a lack of interest in things
  • Experiencing physical symptoms, such as headaches, sweating, and muscle aches
  • Experiencing changes in appetite, either eating more or less than usual
  • Experiencing changes in your sleeping patterns, either sleeping less or more than usual

What are the Psychological and Physical Symptoms of Anxiety Disorder?

Anxiety is a feeling of worry and nervousness that can range from mild to intense. There are many factors that can cause anxiety, and the severity of your anxiety and the symptoms you experience will depend on your particular situation. Symptoms of anxiety include a racing heartbeat, sweating, difficulty breathing, trembling or shakiness, feeling like you’re in a state of panic, difficulty concentrating and feeling as though you’re losing control. Anxiety can be caused by many things, such as stressful situations, trauma, genetics, or unhealthy habits such as substance use. These physical symptoms can be related to either anxiety or substance use and could indicate that you have an anxiety disorder:

  • Feeling anxiety, such as stress and the constant feeling of being on edge
  • Experiencing physical symptoms, such as shaking, sweating, or feeling hot and cold
  • Experiencing changes in your sleeping patterns, either sleeping less or more than usual
  • Experiencing changes in your eating habits, either eating more or less than usual
  • Experiencing restlessness and feelings of irritability
  • Experiencing feelings of sadness and a lack of interest in things

What is a Dual Diagnosis of Anxiety and Substance Use Disorder?

A dual diagnosis of anxiety and substance use disorder exists when a person has both an anxiety disorder and a substance use disorder at the same time. It’s important to note that not everyone with anxiety will have a dual diagnosis of anxiety and substance use disorder. And not everyone who has a substance use disorder will have anxiety. But having both conditions at the same time is a very common occurrence. Anxiety can make substance use disorder treatment more difficult by contributing to treatment dropout, complicating relapse prevention, and increasing the risk of harm to yourself and others. A dual diagnosis of anxiety and substance use disorder is a serious issue, as having both conditions simultaneously can greatly complicate treatment and create additional challenges. You may require additional support in order to overcome these conditions, and you should seek out help as soon as possible. 

The Risks of Having an Anxiety and Substance Use Disorder at the Same Time

Having both an anxiety disorder and a substance use disorder at the same time can create serious risks and complicate treatment. Some of the potential risks that come from having both conditions include:

  • Complicating treatment. Anxiety can make it more difficult to follow treatment plans, as it often requires more frequent appointments as well as the utilization of different strategies. Anxiety can also make it more challenging to understand treatment information and schedules.
  • Treatment dropout. Anxiety may cause you to miss treatment appointments, and you might not follow through with the recommended treatment as diligently as you would like. This can hinder treatment progress and result in incomplete treatment.
  • Inability to regulate substance use. Anxiety can make it more difficult to avoid using substances, and it can increase the risk of relapse.
  • Risk of relapse. Substance use disorders can be extremely difficult to overcome without the help of medication-assisted treatment. Anxiety can increase the risk of relapse, and it can make completing treatment difficult.

What Are the Symptoms of a Dual Diagnosis of Anxiety and Substance Use Disorder?

A dual diagnosis of anxiety and substance use disorder is not a type of mental disorder itself, but rather a combination of two common mental health disorders. The symptoms of anxiety and substance use disorders vary greatly depending on the individual. However, anxiety and substance use disorders can sometimes appear as one symptom, making it difficult to determine which condition you are dealing with. Some of the symptoms that suggest you may have a dual diagnosis of anxiety and substance use disorder include:

  • Anxiety occurring during or after substance use, such as after drinking alcohol or taking a benzodiazepine. – Using substances to cope with anxiety.
  • Experiencing insomnia and difficulty sleeping after substance use.
  • Experiencing withdrawal symptoms, such as sweating and shaking, after going without a substance for a prolonged period of time.
  • Using one or more substances in larger amounts or for a longer period of time than originally planned.
  • Finding that you need to increase the amount of substances you use in order to get the same effect.

How to Get Help for a Dual Diagnosis of Anxiety and Substance Use Disorder?

If you have a dual diagnosis of anxiety and substance use disorder, you will need specialized treatment that helps you overcome these conditions. The best way to get help if you have a dual diagnosis of anxiety and substance use disorder is to seek out a treatment facility that is specialized in treating co-occurring disorders. Treatment programs that specialize in treating co-occurring disorders understand the specific challenges that come with having two conditions at the same time and can provide you with the resources you need to overcome these conditions successfully. Find a treatment facility that offers a variety of different treatment options in order to find the best treatment option for you. You may find that you need medication-assisted treatment, cognitive behavioral therapy, or a combination of other treatment methods in order to overcome your conditions successfully. Remember to be patient with yourself as you progress through treatment. You will make mistakes and you will stumble along the way. It is normal to experience relapses along the way, and it doesn’t mean you have failed. Getting help for a dual diagnosis of anxiety and substance use disorder is the first step toward recovery and getting your life back on track.

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Edited by: David Beasley

David Beasley - Design for Recovery

David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen

Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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