Addiction and Anxiety Disorders

Anxiety disorders are characterized by experiencing excessive fear and worry that can cause behavioral changes or interfere with daily life and normal functioning.^{1, 2}

Those diagnosed with an anxiety disorder may be at increased risk for developing a co-occurring substance use disorder, which is characterized by the use of alcohol and/or drugs despite significant impairment in health or daily functioning and a failure to meet major responsibilities at work, school, or home.³ Likewise, those with a substance use disorder are at an increased risk of developing an anxiety disorder.

When these conditions occur together in the same person, they are called co-occurring disorders. When another mental health disorder occurs alongside a substance use disorder, the standard of care is that both disorders be treated concurrently in an integrated, dual diagnosis treatment program.³ Understanding anxiety disorders, how they interact with substance use disorder, and how to find nearby dual diagnosis treatment centers can help you live a healthier life. Other examples of co-occurring disorders include depression, bipolar, and ADHD.

What Is Anxiety?

Anxiety is a normal reaction to stress typically in anticipation of a future concern or conflict. Anxiety is characterized by feelings of nervousness or anxiousness and is associated with muscle tension and avoidance behaviors.⁸ Everybody experiences anxiety at one point or another in their lives, but sometimes people experience it excessively in a way that interferes with normal daily functioning.

Anxiety disorders characterized by excessive worry or fear, often out-of-proportion to the level of danger that is being experienced.^1,2 Anxiety disorders can range from mild to severe, and can greatly impact the way in which somebody engages in daily life.¹ There are several different types of anxiety disorders, each with their own set of symptoms and diagnostic criteria, and there are three anxiety disorders that are most likely to cooccur alongside substance use disorder: generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder (SAD).

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is characterized by ongoing and excessive worry in response to routine issues or events.¹ With GAD, the level of anxiety is typically not proportionate to what is actually occurring.¹ The feelings of worry are difficult to control and can affect everyday well-being.¹ Symptoms can include difficulty concentrating, irritability, restlessness, inability to control the anxiety, unexplained pain in the body, and sleep difficulties^.1

GAD is a fairly prevalent mental health disorder, and those diagnosed with it may experience other co-occurring disorders ranging from other anxiety disorders to depressive disorders to substance use disorders.²

Panic Disorder

Panic disorder causes unexpected states of intense worry along with physical symptoms including shortness of breath, gastrointestinal problems, increased heart rate, and feelings of dizziness.¹ These episodes, called panic attacks, can happen without a known specific trigger for the symptoms.¹

People with panic disorder often worry severely about the onset of another panic attack and may go to great lengths to avoid circumstances or places that they fear will cause another episode.¹

Social Anxiety Disorder (SAD)

Social anxiety disorder is characterized by distressing and excessive worry in social settings.² Although it is common for many people to feel some worry in certain social situations, people with social anxiety disorder are affected significantly, often due to fear of being judged by others.¹ The anxiety causes marked distress and interferes with daily functioning and can lead to difficulties in relationships, at work, and the ability to enjoy activities in public.¹

People with social anxiety disorder usually know that their anxiety is excessive and irrational, though having this understanding does not prevent the anxiety from continuing on a regular basis.²

The Connection Between Anxiety and Addiction

Anxiety disorders and substance use disorders commonly co-occur, and although there are some cases where one disorder causes the other, it’s often difficult for even clinicians to distinguish which came first.⁵ While it can be helpful to know, research suggests that it’s rare for one disorder to cause the other. In fact, research has revealed a complex bidirectional relationship between both disorders, meaning that when a person has both an anxiety disorder and substance use disorder, the development, maintenance, and treatment of one disorder influences the other.⁵

Researchers theorize that this bidirectional relationship exists for a number of reasons.

In response to symptoms of anxiety disorders, some people may use substances to ease their anxiety symptoms.³ This is commonly referred to as “self-medicating,” however, while substances may ease symptoms initially, they are not medication and continued use can result in misusing substances uncontrollably.

Furthermore, misuse of substances can lead to changes in the brain that can affect the experience and intensity of anxiety.² Anxiety disorders and substance use disorders also share several risk factors. Common genetic and environmental influences, for example, can impact the development of both disorders. Furthermore, both disorders affect the same region. Unfortunately, research also suggests that the presence of both disorders leads to less desirable outcomes for both disorders vs. someone who has only has one of the disorders.

Treating Anxiety and Addiction

Treatment for anxiety disorders and substance use disorders is oftentimes provided by qualified professionals who focus on comprehensive integrated care. Treatment can include individual therapy, group therapy, a day treatment program, or inpatient rehabilitation that can also provide medical detoxification and medications for anxiety when needed.⁵ Twelve-step groups may also be utilized in conjunction with other types of treatment for addiction and anxiety disorders.⁵

Some common types of therapy one may encounter when receiving integrated treatment for co-occurring anxiety and substance use disorders may include:

• Cognitive behavioral therapy (CBT). One of the hallmarks of mental health disorder treatment, CBT is a form the therapy designed to help patients change the underlying thought patterns behind maladaptive behaviors that negatively affect them.^{6, 7}
• Dialectical Behavior Therapy (DBT). DBT is a therapy type that emphasizes the acceptance of oneself and their emotions, and how to exert better control over emotions that can lead to self-destructive behavior.⁷
• Medications can prove effective in treating both anxiety disorders and addiction to certain substances. Medications for addiction treatment are available for treating alcohol use disorder and opioid use disorder, and are often paired with a comprehensive counseling and other behavioral therapies.⁵

Finding Anxiety and Addiction Treatment Near You

If you’re struggling with substance use and a co-occurring anxiety disorder, it’s important to remember that there is help out there. A first step in finding help would be to locate a nearby dual diagnosis treatment facility. One of the first ways to go about finding these rehab centers would be to contact your doctor. They may be able to help determine your medical needs and may be able to refer you to a treatment program. You may also want to visit the SAMHSA treatment locator, which can help you find rehabs near you.

Addiction helplines can be another valuable resources in the search for anxiety and addiction treatment. American Addiction Centers (AAC) owns and operates a 24/7 helpline that can answer questions you may have about anxiety and addiction treatment. They may also be able to help you check your insurance. Don’t delay, call our team at to get started on finding anxiety and addiction treatment near you.

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