Anxiety disorders are the most commonly diagnosed mental health issues in the world. These include conditions such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized anxiety, and social phobia. It is estimated that about 19.1 percent of all adults and 31.9 percent of all adolescents struggle with a form of anxiety in the United States alone, and that anxiety rates have been growing rapidly in the past few years. Additionally, disorders like anxiety can often lead to substance misuse.
Our understanding of anxiety is characterized by a disproportionate fear response – it is only human to worry, be scared, and to think about things negatively, but an anxiety disorder takes these traits to an extreme, preoccupying us with our worries at all times or amplifying our fears to a debilitating degree.
Sadly, treating an anxiety disorder can be difficult. Some anxiety disorders are more common and thus more heavily researched than others.
As mentioned earlier, anxiety disorders often co-occur with other mental health conditions, particularly depression and substance use disorder. It is estimated that at least one in every five people with anxiety is also struggling with a form of addiction. Furthermore, almost half of all people who struggle with a substance use disorder are also diagnosed with either anxiety, or anxiety and depression. That is a much higher prevalence than among the general population.
The link between anxiety and substance misuse is not just tangential; the two are much more intimately connected to the point that distinguishing between symptoms caused by anxiety and symptoms caused by substance misuse can be difficult sometimes. Understanding that link can help provide greater context for how they are treated, and why an addiction with a history of anxiety or an anxiety disorder with substance use might require different treatment than either one condition tackled alone.
Anxiety and Substance Misuse
A substance use disorder describes a set of symptoms that may develop after using an addictive drug (or multiple addictive drugs) for a long period.
For a person’s drug habit to develop into a substance use disorder, they must struggle with drug-related consequences that cannot be explained by physical or other mental health conditions, such as frequent memory gaps and blackouts, changes in personality, and an inability to stop using despite financial and social consequences (addiction). In many cases, substance use disorders are synonymous with withdrawal symptoms, severe cravings, and several relapses.
Anxiety disorders are different. They are a class of mental health disorders characterized by symptoms of excessive fear or worry. Anxiety disorders include conditions like:
- Generalized Anxiety – generalized anxiety is characterized by an overarching feeling of dread that persists even when there is no danger or trigger. A person experiencing generalized anxiety will be jumpy, will have trouble focusing or concentrating on things, and may experience physical and mental fatigue because of being in a constant state of worry.
- Social anxiety – social anxiety is a form of excessive fear and paranoia directed toward other people, especially in the context of being around strangers. People with social anxiety will constantly worry that they are being criticized or made fun of behind their backs or are scared about how they might embarrass themselves in front of others. They often misinterpret social cues as negative and have an overwhelmingly poor self-image.
- Post-Traumatic Stress Disorder (PTSD) – post-traumatic stress disorder is a form of anxiety caused by a neurological change after a traumatic experience. The brain changes in response to trauma, creating a state of hypervigilance which can lead to personality and behavior changes, as well as potential symptoms of dissociation, amnesia, or unwanted thoughts and flashbacks. PTSD symptoms differ between children, teens, and adults.
- Obsessive-Compulsive Disorder (OCD) – obsessive-compulsive disorder is an anxiety disorder that links obsessive thoughts (unwanted intrusive thoughts) with compulsive ideas (often ritualistic compulsions, repetitive behavior, or very specific superstitious actions) in an infinite cycle. People with OCD experience a discomforting obsession and need to soothe it with a compulsion – but that in turn primes them for the next obsessive thought, in a constant loop.
- Phobias – phobias are extreme and irrational fears that are debilitating and affect a person’s capacity to function in everyday life, socially and professionally. While most people are afraid of spiders or venomous snakes, for example, arachnophobia can be all-consuming, causing an extreme reaction to anything remotely spider-like, as well as fear and dread at the thought of spiders when none are present.
- And more.
There are currently three major reasons conditions like anxiety and substance use disorder co-occur frequently.
- First, substance use disorder and conditions like anxiety frequently have similar risk factors. This means that even in cases where the two are separate, the common denominator between them is a similar set of life experiences and genetic markers. Stress, trauma, and family history are major contributing causes to both anxiety disorders and addiction.
- Second, mental health conditions like anxiety can actively contribute to the onset of drug use. We know that people with untreated mental health issues, in particular, are much more likely to start using drugs frequently, often as a form of self-medication. Drugs like alcohol can even help temporarily soothe anxious symptoms, although they return in full force and get worse over time as a result of substance abuse.
- Lastly, substance use itself can deepen or lead to the onset and development of mental health issues. The changes introduced in the brain through long-term drug misuse can make a person more likely to struggle with depressive thoughts, anxious emotions, personality changes, and a diagnosis of mental illness.
This means that addiction and anxiety have psychological, as well as physical and social links, and that both conditions can feed each other, cause one another, and may be attributed to the same general causes. However, it is not correct to consider them as part of one disorder – nor is it correct to consider them in need of separate treatments. Instead, anxiety and addiction are two disorders that must be treated concurrently.
Why Co-Occurring Disorders Like Anxiety Matter
A co-occurring mental health disorder, or a dual diagnosis, is a term usually reserved for cases of substance misuse or addiction coupled with conditions like post-traumatic stress disorder, generalized anxiety, phobias, depression, bipolar disorder, or personality disorders.
The link between substance use and these different mental health conditions matters because concurrent treatment is the only way to address them effectively.
Treating anxiety without addressing addiction can simply lead to a relapse in both. Treating addiction without addressing a patient’s anxiety symptoms, on the other hand, also leaves them at risk of continuing to experience both conditions.
An individualized and holistic treatment plan is needed for patients with a dual diagnosis. In many cases, this requires an intensive outpatient or inpatient residential program with frequent psychological counseling, family therapy, and in some cases, psychiatric medication in addition to a detox and rehab program.
If you or a loved one are struggling with a substance misuse disorder alongside an anxiety disorder, professional treatment is necessary–and available at Amend Treatment.
Don’t go at it alone. Get help together. Get in touch with us today.