The Complex Connection Between Anxiety Disorders and Substance Use

Anxiety Disorders and Substance Use

The Complex Connection Between Anxiety Disorders and Substance Use

Most everyone experiences a natural amount of anxiety in response to stressful or dangerous situations. But when anxiety becomes persistent, based on unfounded fears, and interferes with daily life, it may be categorized as an anxiety disorder. In an effort to cope with these symptoms, an individual may attempt to self-medicate with the misuse of drugs or alcohol. Unfortunately, this can worsen anxiety symptoms, which reinforces the need to use substances and can result in a dangerous substance abuse cycle and addiction. Because of this, anxiety disorders and substance use disorders (SUDs) commonly co-occur. It is essential for professionals treating SUDs to understand the complex relationship between anxiety disorders and SUDs and that diagnosis and treatment for these co-occurring disorders are multifaceted and variable. 

Anxiety Disorders and Symptoms

  • Generalized Anxiety Disorder (GAD): The individual suffers from an almost continuous and ongoing sense of anxiety and worry. They have a persistent worry over several areas that are out of proportion to the impact of the events. They may also experience an inability to relax, feeling restless, and difficulty concentrating.
  • Social Anxiety Disorder (SAD): People with social anxiety disorder have persistent anxiety, fear, and self-consciousness towards interacting with others. Fears of appearing in crowded places, speaking before an audience, participating in social activities, and other public interactions are typical of this common condition. 
  • Post-Traumatic Stress Disorder (PTSD): This anxiety disorder can develop after an individual experiences a traumatic event, such as military combat, a violent crime, or natural disaster. It is characterized by flashbacks to the event, nightmares, insomnia, irritability or anger, hypervigilance, and paranoia.
  • Panic Disorder: Episodes of overwhelming, uncontrollable terror characterize this. A person suffering from one of these episodes may feel an overpowering sense of doom. Physical symptoms may include hyperventilation, a rapid heartbeat, dizziness, sweating, nausea and vomiting, and chest pain. 
  • Specific Phobias: The irrational, debilitating fear of a particular object, situation, or animal is considered a specific phobia. People with this disorder will go out of their way to avoid the object of fear, even if this interferes with their everyday lives.

Diagnosing Anxiety and Addiction as a Co-Occurring Disorder

Dual diagnosis, or a co-occurring disorder, describes the existence of an addictive disorder such as alcoholism or drug addiction, with a simultaneously occurring anxiety disorder or another type of mental health issue. The complex relationship between anxiety and addiction is that their symptoms, effects, and treatment methods are considerably interwoven. For example, anxiety symptoms can arise during the course of repeated intoxication, anxiety disorders can be a risk factor for the development of SUDs, anxiety disorders can alter the presentation and recovery outcome of SUDs, and SUDs can alter the presentation and treatment outcome for anxiety disorders.

Because of this complicated overlap, diagnosing and treating this can be difficult. Some common factors in determining when an anxiety disorder triggers substance abuse and substance abuse triggers anxiety include:

  • Self-Medicating: Individuals with anxiety disorders often turn to substances to control their anxiety’s physical or psychological symptoms. 
  • Substance Abuse or Withdrawal Effects: Alcohol and drug abuse can often cause symptoms that resemble anxiety, such as nervousness, fear, agitation. Additionally, some withdrawal symptoms may include restlessness, anxiety, and sleep disruptions. 

Due to the symptoms of substance abuse and withdrawal potentially mimicking anxiety disorders, observing symptoms during abstinence over time can potentially differentiate substance-induced symptoms of anxiety from anxiety disorders that warrant treatment. If symptoms continue long into recovery, the onset of anxiety started before the onset of SUD, or there is a family history of anxiety disorder, these suggest an independent anxiety disorder that should be treated. 


Integrating the treatments and services of both mental health and substance abuse fields is integral to the effective treatment of co-occurring disorders. According to a recent study, addressing both disorders simultaneously improves outcomes for certain anxiety disorders, namely, post-traumatic stress disorder. Interrupting the destructive cycle of using alcohol and drugs to fight against intolerable symptoms of anxiety is a critical undertaking in early recovery. In order to break this cycle, individuals in treatment need to learn to self-regulate anxiety symptoms and develop alternative, healthy coping strategies. 

Cognitive Behavioral Therapy (CBT) can be an effective therapeutic modality for the treatment of anxiety and SUD to develop these skills. In CBT, clients learn how to identify and modify self-defeating thought patterns. This can also help them acquire new strategies to help them cope with their anxiety and SUD and maintain their recovery goals. 

Because of the high occurrence of co-occurring anxiety disorders and SUDs, substance abuse professionals must address anxiety symptoms in individuals seeking addiction treatment. This process requires careful diagnosis, collaboration with other health professionals, and treatment that is tailored to each individual case. In addition to CBT, it is vital to understand the options for pharmacotherapeutic treatments for anxiety disorders and SUDs. When combined with therapy, medication can be a helpful tool in overcoming anxiety. However, some medications used to treat anxiety, such as benzodiazepines, can potentially undermine treatment of substance abuse because of the possibility of abuse or addiction. This complex connection between anxiety disorders and SUDs is why it is so critical to have an accurate diagnosis and treat these cases with the utmost care. At Alta Centers, we offer a variety of treatment programs, including Dual Diagnosis, CBT, and more. For more information, call us today at (888) 202-2583.

About Alta Centers

Alta Centers Detox is Los Angeles Addiction Treatment and Recovery center .