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Anxiety is a normal human response to stressful situations, or to the anticipation of stress. But when anxiety becomes disconnected from triggers and begins to manifest randomly, or at intensity levels out of proportion to any conceivable threat, it could mean that an anxiety disorder has developed.
The unpredictability and severity of anxiety disorders make them a frightening form of mental illness. People who experience their overwhelming and disabling symptoms would do anything to find relief and healing, and unfortunately many turn to drugs and alcohol in the mistaken belief they can help them cope.
But drugs and alcohol will not help anyone get over an anxiety disorder. As coping mechanisms they leave a lot to be desired, since their mood-altering effects are only temporary. Most ominously, drugs and alcohol are habit forming, and people who use them to restore their emotional balance can quickly become addicted—and when that happens they’ll become more emotionally unbalanced than before.
Everyone experiences stress and anxiety as unpleasant. But people with anxiety disorders are often overwhelmed by their symptoms, and they become desperate to protect themselves against future anxiety attacks. They develop avoidance strategies to prevent possible exposure to anxiety-causing circumstances or events, and are restricted in their life choices and activities by the excessive nature of their condition.
According to one definitive study, 28.8 percent of Americans will develop an anxiety disorder at some point in their lives, and co-occurring anxiety disorders are frequently experienced[1].
The six types of anxiety disorder in all[2]. They include:
Each of these conditions increases the risk for substance abuse, and the risk for alcohol use disorder is relatively equal for all anxiety disorders. Generalized anxiety disorder (GAD) and panic disorder (with or without agoraphobia) have the strongest associations with drug use disorders and substance use disorders in general[3].
Substance-induced anxiety disorders reverse the cause-and-effect relationship. When these conditions develop, drinking or drug use will actually provoke the onset of anxiety symptoms. Substance-induced conditions can mimic any of the other anxiety disorders, but they are directly related to the consumption of an intoxicating substance, which cause chemical changes in the brain that produce the physical symptoms associated with anxiety.
The list of substances known to cause anxiety in at least some heavy users include alcohol, cannabis, caffeine, amphetamines, cocaine, hallucinogens, antipsychotics and antidepressant medications (the latter two categories of medication create risk if they are abused)[4].
Anxiety experienced in legitimately threatening situations increases the odds of survival. The “flight or fight” response mobilizes the body’s resources to react quickly and decisively, which is necessary when danger looms.
But people with anxiety disorders are constantly triggered by circumstances that are not truly threatening, and their repeated exposures to anxiety put them at risk for long-term health complications. In response to these imaginary hazards, a flood of chemicals like the hormone adrenaline are repeatedly released into the bloodstream, causing a cascade of symptoms (rapid heartbeat, heavy sweating, tightening in the chest and stomach, dry mouth, nausea, tingling in the hands and feet, etc.) that are useful in emergencies but wear the body out when they are experienced over and over again.
Untreated anxiety disorders can cause a deterioration in physical health, making those who have them more vulnerable to a broad range of medical conditions[5]. The problems experienced by people with anxiety disorders include:
The psychological aspects of anxiety also take a toll. People with anxiety disorders are plagued by fear and dread, anticipating unpleasant reactions in situations they cannot avoid. Their self-esteem and self-confidence are damaged by their inability to control their anxiety, and they become overly self-conscious and concerned about being judged because of their reactions.
For people with anxiety disorders, the constant stress and worry can become unbearable, to the point where they can no longer hold up under the strain. That leaves them highly vulnerable to depression, which is by far the most common co-occurring condition in people diagnosed with anxiety disorders. Nearly 50 percent of men and women with anxiety disorders will also experience episodes of depression, and if they seek treatment they are often prescribed antidepressants, since these medications are known to work for both conditions[6].
In addition to the impact of anxiety on their physical and emotional health, people with anxiety disorders also tend to be socially isolated. Their anxiety (and fear of it) prevents them from living fully and freely, and their desire to avoid environments that trigger attacks inevitably impacts their interactions with family and friends, while interfering with their ability to meet people and form new relationships. Naturally, this isolation has its own emotional impact and is likely implicated in the onset of the depression that so many men and women with anxiety disorders experience.
Given the physical, emotional, psychological and behavioral effects of anxiety disorders, it is not in the least surprising that many people with these conditions end up misusing drugs and alcohol. Substance use disorders grow from seeds of frustration, disappointment, trauma and emotional instability, and when treatment is provided it is essential that underlying mental health problems are addressed simultaneously with the drug and alcohol abuse—and that is especially vital when clinically diagnosable anxiety disorders are present.
Dual diagnosis treatment programs for anxiety disorders and substance use disorders are always customized to meet the specific needs of each patient. Nevertheless, they will usually include some combination of detox services, individual, group and family therapy, holistic healing practices for effective stress management, life skills and coping skills classes and transitional sober-living style options that are designed to help people in recovery strengthen their commitment to sobriety following the cessation of formal treatment. They may also include the administration of medication, for anxiety and/or to assist with the management of cravings and withdrawal symptoms associated with addiction, and possibly for depression if it has been diagnosed.
Substance use disorders and anxiety disorders are each amenable to treatment, and those who participate in dual diagnosis programs offered by licensed addiction or mental health treatment centers have excellent chances for recovery. Healing may not happen overnight, but it is a realistic goal as long as a person’s commitment to their treatment program stays strong.
