ANXIETY AND ADDICTION

Introduction

Anxiety and addiction have a close relationship. About 20% of Americans with anxiety or other mood disorder have a substance use disorder, and 20% of those with a substance use disorder also have anxiety or another mood disorder. Here is a detailed view of the interrelationship between anxiety and addiction and the best-recommended treatment.

The Connection Between Anxiety and Addiction

What is Anxiety?

Anxiety is a normal part of life. People often feel anxious about moving to a new city or starting a new job. This type of anxiety might be unpleasant, but it can motivate hard work and other actions. In short, anxiety is the body’s natural response to stress.
However, some anxiety feelings can be more extreme, lasting for more than six months and preventing normal functioning in everyday life. This long-term feeling is called an anxiety disorder.
People with an anxiety disorder have intense and persistent feelings of worry and fear about everyday situations. Instead of providing motivation, the extreme anxiety is debilitating and may cause them to stop doing the things they enjoy.
There are several types of anxiety, including:
  • Generalized anxiety disorder
  • Panic disorder
  • Social anxiety disorder
  • Obsessive-compulsive disorder
  • Phobia
  • Separation anxiety disorder
  • Post-traumatic stress disorder
According to the Anxiety and Depression Association of America, anxiety disorders affect 40 million adults age 18 and older, or 18.1% of the population every year.1

What is Addiction?

Addiction is a physical or psychological urge to do, take or use a substance, even though it could be harmful to you. The most common type of addiction is drug addiction, also known as substance use disorder.
Addiction does not only mean being physically and physiologically dependent on a substance, such as cocaine or heroin. It’s also possible to be addicted to various activities, such as gambling, eating, or working.
In addition to being unable to stop the addictive behavior, other signs of a substance use disorder include:
  • Lack of self-control
  • Having an intense desire for the substance or activity
  • Not accept the fact that substance use is causing problems
  • Struggling with other daily activities

How SUD Can Cause Anxiety

The use of substances can increase the risk of developing anxiety or can make pre-existing symptoms worse.
Stimulant drugs are most commonly related to causing and worsening symptoms of anxiety.2 Taking stimulants can lead to increased activity in the brain. Stimulants can also change the way nerve cells send messages. As a result, while on stimulants, you may feel restless and anxious, especially in high doses.3
Moreover, withdrawal from stimulant medications can lead to a sudden drop in the levels of neurotransmitters in the brain, which can cause anxiety that can last for up to two weeks.4
Withdrawal from CNS depressant drugs can also trigger anxiety.5

How Anxiety Can Cause SUD

Substance abuse, particularly alcohol abuse, is common among people with a social anxiety disorder. In a misguided attempt to feel more comfortable and relaxed in social situations, individuals with social anxiety turn to alcohol or drugs.
However, this can be extremely dangerous as the anxiety may make it difficult to tell when you’ve reached your limit. In some cases, an anxiety disorder may not even be diagnosed yet. Although drugs and alcohol can bring temporary relief, they can also intensify anxiety a few hours later or the next day.6

PTSD

People who have post-traumatic stress disorder (PTSD) are also at risk of developing an addiction. They often use alcohol or drugs to reduce their feelings of anxiety, but substance abuse can worsen PTSD symptoms. Roughly 50% of people seeking treatment for substance use also meet the criteria for PTSD.7

Anxiety Signs and Symptoms

The signs and symptoms of anxiety can vary from person to person. Feelings can range from restlessness to an increased heart rate.
Some of the most common anxiety signs and symptoms include:
  • Nervousness
  • Restlessness
  • Feeling tense
  • Increased heart rate
  • Sweating
  • Trembling
  • Trouble concentrating
  • Trouble sleeping
  • Weakness or lethargy
  • Feelings of danger, panic, or dread
  • Gastrointestinal (GI) problems
  • A strong desire to avoid the things that cause anxiety
  • Unable to control feelings of worry
Some signs and symptoms that can indicate an addiction include:
  • Strong urges to use the drug
  • Losing interest in activities that do not involve the harmful substance
  • Needing higher amounts of the drug to experience the same high
  • Taking larger quantities of the drug for a longer period than intended
  • Inability to stop taking the drug even though it is causing severe health and personal problems
  • Maintaining a supply of the drug
  • Spending large amounts of money on purchasing the drug
  • Doing illegal things to obtain the drug, such as stealing
  • Extreme changes in appearance, such as a lack of hygiene

Anxiety Medication with Addiction Risks

Some medications used to treat anxiety are habit-forming. People who have a history of use disorders are more at risk of developing an addiction.
The most common anti-anxiety medications are called benzodiazepines. They help reduce anxiety and make it easier to go to sleep.
When used as prescribed, benzodiazepines are safe and effective drugs.
However, they do carry a potential for abuse and can lead to addiction. For this reason, benzodiazepines are recommended to be taken only for a short time.
Some of the most commonly used benzodiazepines in the treatment of anxiety disorders include:
  • Clonazepam
  • Alprazolam
  • Lorazepam
  • Promazepam
  • Oxazepam
  • Chlordiazepoxide
  • Clorazepate
  • Diazepam

Dual Diagnosis Treatment for Anxiety and Addiction

CBT for Anxiety

Cognitive Behavioral Therapy (CBT) is one the most commonly used therapies for treating anxiety disorders. CBT can be quite useful in treating phobias, panic attacks, social anxiety disorder, and generalized anxiety disorder.
There are two main components, including:
  • Cognitive therapy that examines how a person's negative thoughts, or cognitions, lead to anxiety
  • Behavioral therapy that examines how a person behaves and reacts in situations that trigger anxiety
The core argument of CBT is that thoughts, not external events, affect how a person feels. This type of therapy aims to help you identify and correct negative thinking patterns.
CBT can occur in both individual therapies and group therapy settings.

Detoxification

Healing a mental health disorder means addressing addiction.
The first step in the dual diagnosis treatment for anxiety and addiction is detox. Detoxification is the process of eliminating the drug from the body. During detoxification, 24/7 medical care from addiction specialists, nurses, and doctors is provided. The team helps with detox from substances in the most comfortable way possible.
Detoxification deals with the physical aspects of addiction. However, it does not address any mental health disorders.

Inpatient Treatment

Following detoxification, the next steps of treatment include inpatient or outpatient treatment, depending on your needs.

Inpatient treatment is more suitable for addressing severe cases of addiction and includes 24/7 medical care. It involves living on-site at a drug rehab center while participating in different activities, including one-on-one therapy sessions and group meetings.

Outpatient Treatment

Outpatient treatment is a better option for addressing milder cases of addiction. This treatment works well for some people who cannot afford to live full-time at a treatment center. During this type of treatment, you live off-site but attend activities at the facility several times per week.

Anxiety Medication Used in Addiction Treatment

Medications such as selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for anxiety. They are considered safe and effective in treating anxiety disorders and carrying a low potential for abuse.
SSRIs such as citalopram, paroxetine, sertraline, and escitalopram increase serotonin amounts in the brain. This increased serotonin reduces negative thoughts and worries that stem from anxiety.
In addition to SSRIs, hydroxyzine is another medication that is approved for the treatment of anxiety. Hydroxyzine is the only antihistamine used for anxiety due to its unique effect on serotonin.
Some other medications that are prescribed off-label for anxiety include gabapentin and propranolol.
This information should not replace a visit to a doctor or treatment center. If you are concerned that you or a loved one is living with addiction while also experiencing anxiety symptoms, ask for professional help today.

Resources

Article Contents