More Americans suffer from anxiety disorders than from any other type of mental illness, with over 18 percent of adults in the US experiencing some form of anxiety, according to the National Institute on Mental Health.
Unlike the normal, healthy reactions that everyone experiences in response to stressful or dangerous situations, clinical anxiety is characterized by persistent, often unfounded fears that can interfere with work, close relationships, and social activities. The symptoms of anxiety can be both physical and psychological, and addressing these symptoms requires a multidisciplinary approach to treatment.
In an effort to cope with their symptoms, it is not uncommon for people with anxiety disorders to misuse alcohol or drugs. In fact, the National Institute on Drug Abuse estimates that individuals with anxiety are twice as likely to suffer from substance abuse as the general population. Unfortunately, attempts at self-medication often backfire by intensifying the effects of this psychiatric condition. Alcohol and drug use can worsen the psychological and physical symptoms of anxiety, reinforcing the need to use more of these substances in order to function normally. The result is a cycle of substance abuse that can lead to chemical dependence and addiction.
Although anxiety takes many forms, all of the anxiety disorders have certain signs and symptoms in common. Some of the key warning signs of an anxiety disorder include:
Anxiety can also have a direct influence on the body. People with anxiety may have strong physical responses to situations or objects that do not seem intrinsically dangerous or threatening. These responses may even seem life-threatening under certain circumstances:
In order to meet the diagnostic criteria for an anxiety disorder, the individual must experience the symptoms on most days of the week for six months or more.
However, people whose lives are affected by disabling fear should not wait to seek professional help. With the right combination of therapies, anxiety can be treated.
Although there are many theories about the root sources of anxiety, researchers are still exploring the causes of these complex disorders. In many cases, an anxiety disorder may develop as a result of multiple factors, such as:
Substance abuse is more common in people with anxiety disorders than in the general population. For example, anxiety disorders have been linked with higher lifetime rates of alcohol abuse and higher relapse rates after alcohol rehab, notes Psychiatric Times, and individuals with anxiety may also experience more severe withdrawal symptoms when they stop using alcohol or drugs.
The existence of a substance use disorder with an anxiety disorder or other form of mental illness is known as a dual diagnosis, or co-occurring disorders. There are several reasons why anxiety may trigger the need to misuse substances, or vice versa:
Talking to a family member or friend about anxiety can be challenging, especially if substance abuse is involved. Both topics are very personal and sensitive, and it might seem easier to overlook these issues, hoping that they’ll resolve on their own or that the individual will seek help independently. However, taking the initiative to express your concern to a loved one could be the factor that motivates the person to the next stage of recovery. Here are a few tips to keep in mind when talking to someone about drug or alcohol abuse and anxiety disorders:
Addiction is a progressive disease process that will continue to get worse without intervention, eventually leading to worsening health complications, disability, injury, or death. It is better to risk offending or angering a loved one than to let the process continue. Professional crisis intervention services are available to help friends and family members who need support in getting a loved on into treatment.
According to the Anxiety and Depression Association of America, anxiety is highly treatable with a combination of therapy, behavioral modification strategies, and anti-anxiety medications. Cognitive Behavioral Therapy is one of the most effective therapeutic modalities for both the treatment of anxiety and chemical dependence. In Cognitive Behavioral Therapy, or CBT, clients learn how to identify and modify self-defeating thought patterns that make them anxious and fearful. Clients with a dual diagnosis of an anxiety disorder and substance abuse can use CBT to acquire new coping strategies that will help them maintain their recovery goals, even in the face of high-stress situations. CBT can be applied in individual therapy and in group therapy settings.
Anxiety disorders are often linked with unresolved experiences of trauma. Statistics from Harvard Medical School/McLean Hospital indicate that up to 34 percent of males and 59 percent of females in substance abuse treatment meet the criteria for PTSD. There are several therapeutic modalities that target the effects of trauma and help clients cope more effectively with the repercussions of emotional pain or loss. Seeking Safety is an integrated, present-focused approach to treating PTSD and addiction through a focus on discontinuing substance abuse, managing symptoms of both disorders, reducing self-destructive behaviors, and fostering more positive, life-affirming views of the future.
When combined with psychological and psychosocial therapies, medication can be a valuable tool in overcoming anxiety. Medications in the SSRI category (selective serotonin reuptake inhibitors) are frequently prescribed to treat the symptoms of anxiety and help these individuals lead more satisfying lives. Drugs in this category are generally considered safe and effective, and they have a low potential for abuse or addiction. SSRIs — which include medications like citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft) — work by increasing the amount of serotonin available to the brain, thus reducing the negative thoughts and persistent worries associated with anxiety.
Eye Movement Desensitization and Reprocessing, or EMDR, has had positive outcomes in the treatment of clients diagnosed with anxiety and substance use disorders. A study published in the Journal of Psychoactive Drugs showed that eight sessions of EMDR, combined with traditional treatment for patients with dual diagnoses, resulted in an improvement in PTSD and depressive symptoms. In EMDR, therapists work with clients to resolve past traumas by guiding them through a series of rapid eye movements that make new informational connections that help to resolve unprocessed memories. This therapy, which has been applied effectively to PTSD and other psychological disorders, aims to help patients overcome the emotional suffering caused by past events while restoring their hope for the future through positive ideals.
Individuals with a dual diagnosis require specialized treatment that addresses both issues. A comprehensive recovery program for co-occurring substance abuse and anxiety includes several levels of care, beginning with detox and continuing through residential or inpatient rehab, outpatient treatment, and aftercare. Family therapy, 12-Step involvement, and modalities such as equine-assisted therapy also assist in the recovery process by strengthening the individual’s support system and reinforcing a sense of self-worth.
Constant worry and fear are not just personality quirks; they are debilitating symptoms of a psychological condition that can be treated with a combination of research-based therapies. When anxiety is complicated by substance abuse, the need for effective recovery services becomes even more acute.
Together, anxiety disorders constitute the most common type of mental illness in the US.
The solution to anxiety and substance abuse lies in comprehensive recovery programs that integrate services for mental health and addiction. While therapeutic interventions for anxiety were once kept separate from substance abuse treatment, research now shows that the most effective way to help clients with dual diagnoses is to provide integrated services that address both conditions at the same time.