Anxiety and addiction, while separate concerns, are often deeply intertwined. Many individuals struggling with anxiety don’t reach out for help. Instead, they turn to substances to cope. There are also individuals whose brains have been deeply altered by addiction, making their anxiety worse or putting them at greater risk for developing an anxiety disorder. 

Anxiety and addiction can exacerbate one another and worsen the symptoms of both disorders. They also complicate a person’s recovery. Treatment and support for an individual with both an anxiety and substance use disorder must address both.

What Is Anxiety?

Anxiety is a feeling of worry, fear, nervousness or dread. It may show up physically as increased heart rate or breathing, chest pain, sweating or headaches and stomach aches. It’s not uncommon to experience anxiety when faced with a stressful situation. However, when an individual has an anxiety disorder, the anxiety they experience is excessive and intense. They’re dealing with persistent fear or worry that frequently impacts their daily life.

Types of Anxiety

There are five main types of anxiety disorders with established criteria:

• Generalized anxiety disorder (GAD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Social phobia/social anxiety disorder

GAD is characterized by ongoing anxiety, excessive worry and stress that seems to exist for little to no reason. The individual likely knows the anxiety they feel is excessive, but they cannot control it. To receive a diagnosis, the individual will need to have experienced symptoms more days than not for a period of at least six months.

OCD is identified by obsessions and compulsions that impact an individual’s daily functioning and well-being. Obsessions are ongoing intrusive thoughts or images. These typically lead to compulsions, which are repetitive behaviors. The individual often uses the compulsions to try to stop the obsessions or lessen the related distress. For example, excessive and repetitive hand-washing may be linked to intrusive thoughts about hygiene or germs. Another person may have obsessive thoughts worrying about missing something important, so they save all documents and emails they receive regardless of their importance. 

Panic disorder is characterized by ongoing and unexpected panic attacks during which the individual experiences intense fear, physical symptoms of stress and a sense of loss of control. The physical symptoms may include:

• Dizziness
• Shortness of breath
• Increased heart rate
• Chest pain
• Sweating 
• Shaking or trembling
• Upset stomach

Since an individual with panic disorder has frequent panic attacks, they will typically feel nervous or stressed about having another episode. 

PTSD develops when a person experiences or witnesses a terrifying, shocking, dangerous or distressing event(s) and then has difficulty recovering. Symptoms include nightmares or flashbacks, avoiding situations that remind them of the trauma, hypervigilance/big startle responses and changes in thoughts and mood. To be diagnosed with PTSD, the person will need to have experienced these symptoms for at least a month.

Social phobia, or social anxiety disorder, is characterized by intense fear and self-consciousness associated with social situations. The individual is extremely anxious about being judged or criticized by others, so much so that it impacts their daily functioning. They may be afraid of talking with others, meeting new people, going to gatherings or eating in front of people. 

Anxiety Symptoms

Common symptoms of anxiety include:

• Feeling nervous, agitated, fearful, restless or on edge
• Having a looming sense of doom or dread
• Increased heart rate
• Shortness of breath
• Sweating
• Shaking or trembling
• Feeling weak or tired
• Difficulty focusing
• Issues sleeping
• Stomach aches 
• Feeling out of control
• Desiring to avoid anxiety triggers 

The Relationship Between Addiction and Anxiety

For some individuals, drugs and alcohol seem like good coping strategies for anxiety because they can dampen their feelings of worry. When people start to feel nervous or are heading into a stressful situation, they may use a substance to try to numb those feelings.

However, this isn’t a long-term strategy because the continued use of substances tends to cause brain damage that can make feelings of anxiety much worse. Substances can hurt the part of the brain that we use to deal with anxiety. When the drugs wear off, a rebound form of anxiety takes hold. Coupled with the brain damage, it can be very difficult to soothe those feelings without drugs. The two disorders tend to support and strengthen one another, making it very hard to overcome the two issues without help.

Co-occurring disorders are very common. The National Alliance on Mental Illness reported that nearly one-third of all people living with mental health disorders and 50% of those with severe mental health disorders also have a substance use disorder. In addition, they reported that 50% of all individuals struggling with drug abuse and one-third of individuals with alcohol abuse live with a mental health disorder. 

Diagnosing a Co-Occurring Disorder

Having co-occurring disorders, also known as a dual diagnosis, is when an individual has both a mental health and a substance use disorder. The combination of specific mental health or substance use disorders can vary, as can their symptoms. An individual with a co-occurring disorder will meet the diagnostic criteria for a specific mental health condition and a substance use disorder. 

To accurately diagnose, a clinician will seek to understand if the individual’s anxiety symptoms, for example, are substance-induced, meaning the person only experiences anxiety while using or withdrawing from the substance. Those with a history of trauma or a family history of mental health issues or substance use are often at a higher risk of developing a co-occurring disorder. 

Treatment for Co-Occurring Anxiety & Substance Use Disorder

When an individual has a co-occurring disorder, it’s crucial for their recovery that both disorders are addressed during treatment. If a substance use disorder is treated without addressing any underlying anxiety, the chances of the patient reverting to drug and alcohol use are much higher. This is especially true if there is a causal relationship between the person’s anxiety and addiction.

Treating a substance use disorder and anxiety can be difficult, as both disorders can be deeply intertwined in the brain. The longer these issues are left untreated, the more likely the brain has been changed, which will need to be addressed and reversed.

Dual diagnosis treatment combines several types of treatment to address both disorders and may include: 

• Detox
• Inpatient rehabilitation
• Outpatient rehabilitation
• Individual and group psychotherapy
• Family therapy
• Peer support groups
• Medication
• Psychoeducation regarding healthy coping skills (e.g., meditation, breathing exercises, physical exercise, journaling, healthy nutrition, etc.)

Can Sobriety Cause Anxiety?

Addiction alters the way your brain works. If you’ve been using a substance to cope with stress, and then that coping mechanism is gone, it’s going to take time to retrain your brain to use other coping strategies. Entering into sobriety is a major change, and it is common to feel anxiety with any life change. Many people temporarily feel anxious and agitated during the first several weeks of sobriety. However, if those feelings persist, then it’s a good idea to speak with a mental health professional because you may have underlying anxiety that needs to be treated. Untreated anxiety can put you at greater risk of relapse, so reach out for help. 

Find an Anxiety & Addiction Treatment Program in Orlando, FL

If you are struggling with anxiety and addiction, you deserve comprehensive and compassionate treatment that addresses all of your needs. Addressing both anxiety and substance use simultaneously during treatment gives you the best chance of success.

Orlando Recovery Center is a dual diagnosis treatment facility equipped to treat both anxiety and addiction. We also offer various amenities depending on your level of care to encourage your holistic well-being, such as a swimming pool, exercise gym, basketball courts, sand volleyball court, yoga, art and life-skills therapy options and lakefront views. 

We understand that finances are often a barrier to services. Our center works with many in-network insurance providers: 

• BCBS/Florida Blue
• Cigna
• Orlando Health Network
• Healthcare Solutions Group
• Humana
• Mines and Associates
• First Health
• First Choice
• Medical Mutual
• ClaimBridge Administrators
• Multiplan
• Preferred Medical
• America’s Choice Provider Network

If you need an anxiety and addiction treatment program, reach out to our staff today.