Addiction and Anxiety Disorders
Dual Diagnoses — the coexisting problems of addiction and mental illness — are often hard to treat because of the unstable nature of the individuals involved. Couple that with the fact that drugs and alcohol only make a mental condition worse, and you’ve got a high-risk patient who could easily spiral out of control.
This is especially true for those Dual Diagnosis patients who suffer from panic disorder, a condition that causes episodes of severe mental distress combined with the physical symptoms of anxiety.
Managing Anxiety in Recovery
Addiction and anxiety treatment often go hand in hand. Anxiety may be the reason an addict begins using drugs or alcohol. Or, it may develop as the addiction progresses. Either way, it is important that the person receive treatment for anxiety as soon as possible.
Dual Diagnosis of Addiction and Anxiety
When a person has an addiction plus a psychiatric illness such as anxiety, doctors say they have a “dual diagnosis”. The term is a reminder for physicians, nurses, and other medical professionals that this patient has extra challenges on the road to recovery. Depression and other psychiatric illnesses increase the risk of addiction. Of all people who are diagnosed as having a psychiatric illness, roughly 29% are alcohol or drug abusers. As many as 37% of people who abuse alcohol and 53% of people who abuse drugs have at least one serious mental illness. Depression, already common in the general population, is even more common among alcoholics and drug abusers.
Some people use alcohol and illegal drugs to deal with the symptoms of anxiety. Doctors call this “self-medicating”. The effects of alcohol or drugs can provide temporary relief from feelings of sadness, guilt or worthlessness. When the effects wear off, the bad feelings return. This cycle can lead to continuing use and eventual addiction.
Another link involves the consequences of anxiety. Depressed people often withdraw from social contacts and may even have trouble holding jobs. They may find themselves spending more time alone, without a supportive social network and turning to drugs or alcohol for comfort. It may even be easier to spend time with others who abuse alcohol and drugs instead of pursuing healthier relationships because social expectations may be lower.
Even for people who aren’t using alcohol or drugs to self-medicate and haven’t lost their social connections, anxiety appears to increase the risk of addiction. Many doctors think that whatever makes people vulnerable to anxiety also makes them more likely to abuse alcohol or drugs. Someone without anxiety may be able to try an illicit drug or drink alcohol regularly without any long-term problems; for a depressed person, these same activities may be more likely to lead to addiction.
How Addiction Contributes to Anxiety
Symptoms of addiction and anxiety can be very similar. When anxiety is directly connected to the drug or alcohol abuse and isn’t present independently, it’s not considered a “dual diagnosis” but just a consequence of the addiction. For example, several psychiatric problems are directly related to cocaine.
Cocaine abuse can lead to hallucinations, anxiety, sleep problems, sexual dysfunction and a mood disorder that includes anxiety. However, once the person stops using cocaine, the psychiatric problems generally get better. Amphetamines, heroin and inhalants can all have similar effects.
Addiction and Anxiety Treatment
When a person has both addiction and anxiety, one of the first steps in treatment is to figure out which came first. That may be possible from the patient’s history. The person may be able to describe depressed feelings that preceded the addiction. Or, they may describe self-medicating with alcohol or drugs. Sometimes, it’s necessary to help the person quit drinking or doing drugs first, and then evaluate for anxiety.
If it’s clear that the anxiety is a consequence of the addiction, treating the addiction is usually all that’s needed. If the anxiety is a separate issue, it must be addressed as well. Treatment may include special counseling and antidepressant medicines.
The combination of addiction and anxiety can make it more difficult to recover. When a person feels sad, hopeless or exhausted, battling an addiction is a special challenge that may be difficult to face. However, knowing about the link between addiction and anxiety, being aware that dual diagnosis is possible and seeking treatment to address both issues can help make recovery possible.
