Is There A Correlation Between Anxiety And Addiction?

Published on September 12, 2023

Anxiety disorders and substance use disorders often co-occur. For some people, anxiety symptoms appear first, while others experience substance use first. Whatever the case, treatment that addresses both conditions at the same time is the most successful.

Home > Anxiety And Addiction

Connection Between Anxiety And Addiction

Anxiety disorders are among the most highly comorbid (co-occurring) mental health disorders with substance abuse, according to the National Institute on Drug Abuse (NIDA).

Anxiety and substance use are correlated, but the relationship between them is not always clear.

In some cases, the effects of substance abuse cause anxiety. In others, anxiety was self-medicated with drugs or alcohol and an addiction developed. Or perhaps both arose at the same time.

When it comes to treatment, research shows that people with dual diagnoses get the best results when both conditions are treated at the same time.

A Note On Anxiety Vs. Anxiety Disorders

Anxiety is normal, helping us stay aware of danger and other situations that may need our attention.

However, when anxiety starts to interfere with daily life, it can be indicative of an anxiety disorder, which requires professional treatment.

There are many types of anxiety disorders, including:

panic disorder
phobias
separation anxiety
generalized anxiety disorder
social anxiety disorder

These disorders can wreak havoc on our life in myriad ways. For example, a panic attack, which is a sign of a panic disorder, can feel like a heart attack or another medical emergency.

Different Theories On Co-Occurring Anxiety Disorders And Addiction

There are two main theories about why anxiety-related mental health conditions often co-occur with substance use disorder (SUD).

Self-Medication Of Anxiety

In some cases, an addiction may develop when a person is self-medicating their anxiety. To calm the symptoms of anxiety, a person may drink alcohol or rely on illicit substances to calm down.

Substances that are central nervous system (CNS) depressants, like alcohol, initially limit neural activity that causes feelings of stress or anxiety.

But over time, continued use of these substances causes the brain to adapt to them, which means that the person may now require increasing amounts of these substances in order to relax.

Substances might also be used to stop persistent negative thoughts or emotions, gain courage to face social situations, or otherwise handle experiences involving anxiety.

Over time, substance use may develop into an addiction or physical dependence, especially if a person has other risk factors like a family history of substance abuse.

Anxiety Due To An Addiction

In some cases, an SUD can cause significant anxiety or even an anxiety disorder. This is thought to be due to the way in which drug and alcohol abuse causes changes in the brain.

For example, studies have shown that cocaine use can cause panic attacks. Cocaine use can increase stress hormones, leading to anxiety disorders in some people.

Withdrawal symptoms when stopping the use of many substances often include anxiety, which may perpetuate substance abuse.

Substance-induced anxiety disorder, which occurs when a person stops or starts taking a drug, is rare but also an indicator of anxiety caused by drugs or alcohol.

Other Contributing Factors

Other factors that can contribute to a dual diagnosis of addiction and an anxiety disorder include a family history of mental illness comorbidity.

This may involve dysregulation of chemicals in the brain, such as low levels of the neurotransmitter serotonin.

Other influencing factors may include experiencing traumatic events or having post-traumatic stress disorder (PTSD).

Dual Diagnosis Treatment Of Anxiety Disorders And SUDs

Dual diagnosis treatment and interventions can help people dealing with addiction and a co-occurring anxiety disorder recover from both conditions at the same time.

Behavioral Therapy

Behavioral therapy approaches are the core feature of mental health treatment. Helping people get at the roots of their addiction and anxiety provides a solid foundation for recovery.

Therapies that may help with addiction and anxiety disorders include:

cognitive behavioral therapy (CBT)
eye movement desensitization and reprocessing (EMDR)
mindfulness-based therapy
relaxation and grounding techniques
exposure therapy
dialectical behavior therapy (DBT)
acceptance and commitment therapy (ACT)
Seeking Safety programs

Other Common Addiction Treatment Approaches

Other common addiction treatment options may be helpful in treating co-occurring disorders as well.

Customized treatment plans may feature:

12-step groups or other peer support groups
detox services
inpatient treatment
outpatient treatment
family therapy
holistic therapy options such as art therapy
sober living environments
medication management
aftercare

Treatment for people with anxiety disorders and SUD can help build greater well-being and provide healthy ways to cope when triggers and stressors arise.

Prescription Medications

Benzodiazepines such as Xanax (alprazolam) are used to treat anxiety, but due to their addictive nature, they are not recommended for people at risk of developing an addiction or for dual diagnosis treatment.

The safest medications recommended for treatment of anxiety tend to be selective serotonin reuptake inhibitors (SSRIs).

Because low levels of serotonin are linked to depression and anxiety, medications that help raise serotonin levels can be effective treatment options.

Common SSRIs for anxiety include citalopram, sertraline, fluoxetine, and paroxetine.

Medication management is provided at many addiction treatment centers so that clients receive the best, most appropriate medications for dual diagnosis care.