Dual Diagnosis Treatment for Anxiety and Addiction
Anxiety disorder and substance use disorder are two of the most prevalent mental health conditions in the United States. Researchers estimate that 29% of people in the United States will develop anxiety disorder at some point in their lives, and 15% will meet the criteria for substance use disorder. Not only are anxiety disorder and substance use disorders common individually, they also commonly occur together. Substance abuse is a major contributing factor behind many people’s anxiety disorders.
Similarly, the experience of anxiety can drive people to abuse drugs and alcohol. When an individual suffers from anxiety disorder and a substance use disorder, it is easy for them to fall victim to a vicious and self-perpetuating cycle from which it is difficult to escape without outside help.
Individuals who suffer from a substance use disorder in addition to another mental health condition are referred to as “dual diagnosis.” Their conditions are commonly spoken of as comorbid. Dual diagnosis individuals with comorbid anxiety disorder often find that the symptoms of their anxiety disorder and substance abuse disorder overlap and exacerbate each other.
As a result of suffering from both conditions, they are likely to experience health issues, legal problems, financial difficulties, and obstacles in their interpersonal relationships. Unfortunately, many dual diagnosis people find it difficult to escape from these symptoms, since treating dual diagnosis conditions requires a multifaceted treatment approach.
What is Anxiety Disorder?
Anxiety disorder is a mental health condition that is not the same as simply feeling anxious. While it is normal for people to feel anxious at high-pressure moments of their lives, individuals suffering from anxiety disorder generally find that their experiences of anxiety are so frequent and intense that functioning normally becomes difficult if not impossible. They may suffer from anxiety in situations or settings where there is no clear reason to feel anxious. In some cases, their anxiety can cause feelings of emotional distress so acute that they avoid certain situations entirely.
It is important to understand that anxiety is a common symptom of many mental health disorders, including substance use disorder, but anxiety disorder is a condition unto itself. Sufferers regularly experience unease, worry, fear, and insecurity. It is also often associated with social phobias and panic attacks.
This condition, which afflicts almost one third of all Americans at some point in their lives, can happen to anyone, regardless of their age, economic background, or gender. Anxiety disorder is a spectrum disorder that occurs at a range of severities, though the severity of one individual’s anxiety disorder is liable to change considerably over time, especially if it is left untreated.
Common symptoms of anxiety disorder include:
- Sense of imminent danger or doom without any justifiable cause or reason
- Feeling threatened or panicked for no discernable reason
- Nervousness or tension
- Trembling, shaking, or chills
- Rapid heart rate and respiration, also known as hyperventilation
- Altered eating and sleeping habits
- Difficulty concentrating, often because worries are monopolizing one’s thoughts
- Weakness or tiredness
- A strong urge to avoid people, places, or things that trigger anxiety
- Unusual mood changes, such as increased irritability or moodiness
- Stomach problems
What is Substance Use Disorder?
Substance use disorder is the clinical term for an addiction to drugs or alcohol. This umbrella term refers to a wide variety of addictions. Individuals who are addicted to opioid drugs like heroin or fentanyl are said to suffer from opioid use disorder. Those who cannot stop drinking may be diagnosed with alcohol use disorder. Substance use disorders are, by and large, share similar traits regardless of the substance being used.
In essence, a substance use disorder is a brain disease that causes people to continue engaging in compulsive substance abuse no matter how harmful the consequences are. Some people experience greater harmful consequences than others, but the fact of being unable to stop is what characterizes addiction. While media depictions of addicts generally focus on downtrodden people living on the street, the reality is that addiction affects people of all classes and backgrounds.
When talking about addiction, it is important to be clear: substance use disorders are legitimate mental health conditions. Many people mistakenly believe that those who engage in addictive behavior are simply failing to use sufficient will power. This misconception is profoundly harmful, because it causes many people with addictions to believe that they simply need to try harder to stop using drugs and alcohol.
The truth is, individuals who have developed substance use disorders are unable to quit drugs and alcohol on their own without outside help. This is not because they are weak or because they are choosing to continue. The most notable fact about substance use disorders, in fact, is that they take away a person’s ability to choose.
It is also crucial to distinguish substance use disorders from physical dependence. Physical dependence generally occurs alongside substance use disorders, but it is very possible for a person to suffer from an addiction long after they have stopped being physically dependent.
This partially explains why some people are able to successfully withdraw from drugs or alcohol for periods of time and then subsequently relapse. Even when people recognize that continued drug and alcohol use is a terrible decision, suffering from a substance use disorder makes it impossible for a person to make the “right” choice, no matter how strong their desire is.
Common symptoms of a substance use disorder include:
- Having intense urges to use a drug that make it impossible to think about anything else
- Needing higher and higher quantities of a drug over time in order to achieve the same effects
- Feeling that drug use needs to be engaged in regularly, daily or even many times a day
- Needing the guarantee that a steady supply will always be available
- Taking higher quantities of a drug than intended
- Failing to meet obligations at work or school because of substance abuse
- Failing to meet obligations to friends and family
- Reduced involvement in social or recreational activities
- Engaging in out of character behavior in order to obtain drugs, such as stealing
- Using drugs long after one has understood the negative consequences
- Suffering from withdrawal symptoms after one stops taking the drug
- Repeatedly failing in attempts to stop abusing the drug
Left untreated, most people’s substance use disorders tend to get worse over time. Certain drugs directly harm people’s health and cause them to engage in dangerous behaviors. However, the nature of addiction itself also inherently leads to a number of harmful long term consequences.
Most people prioritize obtaining substances, using substances, and recovering from substance abuse to such an extent that they find it difficult to meet obligations at work or school. Antisocial behavior can damage relationships with friends and family members, leading to conflict or simply social isolation.
Physical health issues, money issues, and legal issues can become increasingly problematic. As a result of consistent substance abuse, many people develop comorbid mental health conditions, such as anxiety disorder. Unfortunately, as these problems become more severe, so too does the attraction of drugs and alcohol, since substances offer temporary relief from the misery that they themselves brought about.
Understanding the Comorbidity of Anxiety Disorder and Substance Use Disorder
Effects of Drugs on Anxiety
Regular substance abuse has an enormous impact on a person’s mental state and it can dramatically worsen anxiety. Over an extended period of time, consistent drug and alcohol abuse can cause a person to develop a tolerance for their substance of choice. Once the body has adapted to substance abuse, it takes greater and greater quantities of a substance in order for an individual to achieve their sought-after “high.” At this point, an addiction can set in that takes a toll on a person’s mental health.
Physical dependence also means that when people stop taking a drug, they experience a wide range of adverse physical and psychological symptoms. One of the most common symptoms of drug and alcohol withdrawal is anxiety. As such, addiction is one of the most important causal factors for anxiety disorder.
Many individual substances also have a notable impact on anxiety disorder. People who abuse or develop addictions to these substances are often especially susceptible to anxiety difficulties.
Alcohol and Anxiety
One of the most commonly cited reasons for drinking alcohol is to calm the nerves. Many people drink in social situations because it makes them feel looser and more at ease. However, when people drink alcohol in enormous quantities the result can be an increase in anxiety. Alcohol induced anxiety most frequently occurs when a person has developed a tolerance for alcohol. Because alcohol is a depressant, the body handles the drug by stimulating its own central nervous system.
As a result, people who are physically dependent on alcohol will generally find themselves more overstimulated, nervous, and prone to anxiety when they are not drinking. When a person is hungover or withdrawing from alcohol, these feelings of anxiety can be so strong that they result in panic attacks. Unfortunately, the cycle is difficult to escape from, because alcohol can provide temporary relief from these uncomfortable feelings.
Many people also experience anxiety as a result of their drinking episodes. People who black out or experience memory lapses while drinking are likely to feel anxiety the next day as they try to recall what they said or did. The erratic or dangerous behavior people engage in while drinking can lead to chaos in their lives. It is only natural that people living disordered and wild lives that they can only half remember will often suffer from anxiety.
Stimulants and Anxiety
Stimulants are a class of drug that increases the activity of the central nervous system (CNS). Drugs of this class include cocaine, amphetamine, and crystal meth. Many popular prescription drugs are stimulants as well. Prescription stimulants include Adderall and Ritalin. These drugs are commonly prescribed to treat the symptoms of attention deficit hyperactivity disorder (ADHD).
However, they are also used for a wide range of recreational purposes. It is increasingly common for college students to abuse prescription stimulants in order to increase their energy, focus, and cognitive function while studying for exams. While these drugs may offer temporary boosts in focus and energy levels, abusing them also directly leads to symptoms of anxiety. Once a person has developed an addiction to these substances, it is likely that their stress levels will further increase, which may cause them to rely on the drugs more.
Cannabis and Anxiety
Marijuana, like alcohol, is frequently used by people as a means of relaxing or being more in the moment. However, marijuana abuse often occurs when a person wants to avoid their worries or anxieties. It may be tempting to rely on this drug to attain a sense of inner peace, but when the body adapts to it and becomes physically dependent, the result is actually an increase in baseline anxiety.
Once the euphoric high has worn off, one of the most notable symptoms of marijuana withdrawal is a feeling of anxiety, stress, and impatience. However, it is important to note that the marijuana high itself often includes symptoms of anxiety. It is common for marijuana users to talk about having had a “bad high,” during which they experience marijuana induced anxiety or even panic attacks. When a person is addicted to marijuana, these experiences can become even more severe.
Can Substance Use Contribute to Anxiety?
People engaging in regular substance abuse are at a higher risk of developing anxiety disorders. The irony is that one of the most common reasons people have for engaging in substance abuse is that it relieves the symptoms of anxiety. In reality, however, these anxiety-relieving effects tend to be short lived. When people rely on drugs and alcohol to escape from their feelings, they are unlikely to address the underlying causes of their anxiety.
Escaping from reality may feel good for a while, but such escape gives reality an opportunity to get worse! In fact, the behaviors associated with substance abuse, which damage relationships, finances, health, and career prospects, can furnish people with additional sources of anxiety. When people develop dependence on drugs and alcohol, they also tend to experience greater levels of anxiety when they are sober or cannot access their substance of choice. As a result, even people with no history of anxiety disorder may develop the condition.
Anxiety as a Factor in Substance Abuse
The relationship between anxiety disorder and substance abuse goes both ways. Not only does drug and alcohol abuse directly lead to anxiety issues, anxiety itself causes many people to develop substance use disorders. Many people initially turn to drugs and alcohol to relieve symptoms of emotional distress. In many cases, they suffer from undiagnosed or untreated anxiety disorders or other mental health conditions. In the absence of proper treatment, it is understandable that people tend to take matters into their own hands.
However, the risks of self-medicating with drugs or alcohol far outweigh the temporary benefits. People who find relief from their symptoms of anxiety in recreational drugs are generally quick to develop physical dependence. They may come to feel that they cannot function normally at work or in social situations without access to their substance of choice. Over time, however, their addictions tend to decrease their ability to function, which can trigger anxiety further. The result is a cycle of anxiety and addiction that is difficult to escape from.
According to the National Institute on Drug Abuse, approximately 7.7 million Americans suffer from addiction alongside a comorbid mental health condition. 38% of people with addiction meet the criteria for one or more additional mental illnesses. Among people with diagnosed mental health disorder, 18% develop debilitating substance use disorders. The longer people suffer from one condition, the more likely it is for them to develop another. As such, young people who begin using drugs and alcohol at an earlier age are more likely to develop mental health difficulties. In fact, research shows that substance abuse can cause long term neurological damage, especially among young people whose brains are not fully developed.
Unfortunately, the vast majority of people fail to receive treatment for either their mental illness or their addiction. 53% of dual diagnosis individuals receive no treatment whatsoever. Among people who do receive treatment, 35% only ever receive treatment for their mental health disorder — but not their addiction. Only 9% of people seeking treatment get help with both of their comorbid conditions. As a result, dual diagnosis individuals continue to experience a high likelihood of relapse even after undergoing treatment.
Is There Treatment for Anxiety and Addiction?
Individuals who suffer from substance abuse disorders alongside anxiety disorders require care for both conditions. Even people who get high quality addiction treatment, if their anxiety disorders are not dealt with, continue to be at risk of relapse if their anxiety flares up. Likewise, those who receive mental health treatment but not addiction treatment can very easily return to anxiety as a result of their continued substance abuse. Both conditions are triggers for each other. As such, it is essential for people to enter treatment programs that offer comprehensive integrated treatment plans for comorbid conditions.
Outpatient Treatment for Dual-Diagnosis
Outpatient treatment programs are often the best option for people suffering from addiction and anxiety. Outpatient programs provide treatment for a period of time each day while allowing individuals to return home each night to their own beds. These flexible treatment programs are therefore helpful for individuals who are working to rebuild their lives in the outside world. Outpatient programs help people learn new coping tools for dealing with their anxiety and addictions, and they provide people with opportunities to practice these newfound skills in real-world situations.
NuView Treatment Center, a treatment center located in Los Angeles’ Westside, provides outpatient treatment at all levels of care. The programs we offer include:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Outpatient programs (OPs)
- Aftercare planning
We recognize that recovering from addiction involves more than just being physically abstinent from drugs and alcohol. Most people with substance use disorders suffer from a number of other issues underlying their addictions, including mental health disorders like anxiety. NuView Treatment Program’s individualized treatment plans emphasize holistic evidence-based methods.
We work to ensure that everyone who walks through our doors develops new skills and coping tools so that they can meet the challenges ahead. Recovering from addiction and anxiety is a lifelong process, but it can be immensely rewarding. At NuView Treatment Center, people come to a better understanding of themselves, work toward new goals in sobriety, and develop strong sober social support systems.
No matter how hopeless your situation may seem, remember that everyone is capable of turning their life around. It’s just a matter of reaching out for help. Contact NuView Treatment Center today.