Generalized Anxiety Disorder And Addiction

The Link Between Generalized Anxiety Disorder And Addiction

Generalized anxiety disorder (GAD) and addiction often are co-occurring disorders because of the close relationship they have in psychological, biological, and behavioral factors.

Generalized anxiety disorder often involves a constant or near-constant state of worry that can impact every part of one’s life. Anxiety disorders are very common. About 14.5%-33.7% of people will have an anxiety disorder in their lifetime. Substance use disorders (SUD) are also common, with as many as 14.6% of people having one in their lifetime.

Nearly 18% of people with addiction are also diagnosed with anxiety disorders. Multiple factors contribute to this overlap. In some cases, people with GAD may use alcohol and drugs to cope with their anxiety symptoms. Unfortunately, people who have GAD are also more likely to become addicted to drugs and alcohol than people without anxiety disorders.

Addiction and substance use disorders may also occur more frequently in people with other mental health conditions, such as depression and schizophrenia.

Which Substances Are Commonly Used By People With Anxiety?

Substance use disorders can have a significant impact on anxiety symptoms and also has a significant overlap with the symptoms of anxiety.

Some of the more common substances that are associated with generalized anxiety disorder include:

• Benzodiazepines (Xanax, Ativan, and Klonopin)
• Cocaine
• Methamphetamine
• Stimulants
• Marijuana
• Alcohol

The overlap between the two conditions can lead to an increased risk of dependency and addiction. People who take substances to treat anxiety symptoms may develop dependence, which means that they may need increasing doses of medications to achieve the same results.

Many people with anxiety turn to substances to try to decrease their anxiety symptoms. Benzodiazepines are often prescribed for anxiety, but this is not recommended in people with a substance use disorder due to the risk of addiction. People with a SUD may believe that drugs like alcohol or marijuana will decrease their anxiety, though this relief is typically short-lived.

Other substances, such as cocaine and methamphetamine, are more stimulating and may give a short burst of confidence.

Types Of Anxiety Disorders

Generalized anxiety disorder is the most common form of anxiety disorder associated with substance use disorders. However, there are other types of anxiety disorders.

• Panic disorder is associated with sudden episodes of intense fear (panic attacks). These attacks often cause chest pain, shortness of breath, and dizziness.
• Social anxiety disorder generally causes intense fear in social situations and a fear of being judged by others. Many people with this disorder will avoid social interactions.

There are also more specific phobias where someone experiences anxiety related to a particular object or situation.

Generalized Anxiety Disorder Symptoms

Generalized anxiety disorder is associated with excessive anxiety and worry and difficulty controlling it for at least six months. Common symptoms include:

Many of the symptoms of GAD overlap with substance abuse. People with both conditions commonly experience rapid or pounding heartbeat, muscle tension, sleep disturbances, feelings of dread, and difficulty concentrating. Friends and family may notice increased irritability or mood swings in those affected.

Can Substance Abuse Cause Anxiety?

Substance abuse can contribute to both the development of anxiety disorders and worsening symptoms in someone who already has underlying anxiety.

Many substances can directly affect brain chemistry and the nervous system. Substance use can cause chemical imbalances in the neurotransmitters of the brain, which can increase the symptoms of anxiety and other mood disorders. When someone withdraws from substances, it can also cause intense symptoms of anxiety.

People who have substance abuse issues may experience legal, financial, employment, or relationship struggles. These struggles can also increase anxiety levels. This may lead to a cycle of reinforcement where substances are used to control anxiety symptoms, and that use leads to more anxiety.

This is why treatment for someone who has both a substance use disorder and anxiety needs to simultaneously address both conditions.

Diagnosing Generalized Anxiety Disorder

Generalized anxiety disorder is generally diagnosed by a healthcare professional. Your primary care physician or a mental health professional will discuss both your physical and psychological symptoms. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has specific criteria for diagnosing generalized anxiety disorder.

Symptoms of anxiety must be present more days than not for at least six months. At least three of the following symptoms must be present for that amount of time:

• Restlessness or feeling on edge
• Fatigue
• Trouble concentrating
• Muscle tension
• Trouble sleeping
• Being more irritable

Your healthcare provider may recommend doing lab work or other testing to evaluate for other conditions, such as thyroid disease, that can mimic the symptoms of generalized anxiety disorder. Anxiety symptoms must interfere with work or social interactions and cause distress to be considered GAD.

In people who have co-existing substance use disorder, it can be more difficult to diagnose GAD and other mental health conditions. The conditions have significant overlap, and in some cases, someone may need to be off substances for a long duration to get an accurate assessment of which symptoms are related to which diagnosis.

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Treating Generalized Anxiety Disorder And Addiction

When someone has both GAD and substance abuse issues, both conditions must be addressed during treatment.

Anxiety disorder and addiction treatment require an approach that treats both conditions simultaneously. Comprehensive treatment may include psychotherapy, lifestyle modification, and medications.

One common type of therapy, cognitive-behavioral therapy, involves recognizing negative thinking patterns and modifying them. This can help someone develop healthier mechanisms for coping with anxiety and addiction.

There are medications, such as selective serotonin reuptake inhibitors, that can be used to treat anxiety symptoms and may benefit people with substance use disorder. Other medications may be used for SUD, which may help manage cravings or withdrawal symptoms.

Having both GAD and addiction can make treating both conditions harder, so it is important to make sure that the treatment team includes an addiction specialist with experience treating dual diagnosis.

Long-term treatment may include ongoing monitoring, support groups, counseling, and a personalized treatment plan designed to help prevent relapse.

Find A Dual Diagnosis Treatment Center

People with generalized anxiety disorder and co-occurring addiction should seek professional treatment to help manage their conditions. If left untreated, these conditions can worsen and significantly impact a person’s life for years.

If you or someone you love is struggling with generalized anxiety disorder and addiction, there are many dual diagnosis treatment options available. To learn more about these options, visit our rehab directory or contact a treatment provider today.