Substance Use Disorders and Anxiety

Reviewed Jan 17, 2024

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Summary

Facing both substance use and anxiety issues can be confusing and overwhelming. Both conditions are treatable, and many people recover from these co-occurring conditions.
 

It’s easy to see how anxiety can lead to an issue with substances. It is also easy to see how overusing substances can lead to anxiety. It is quite common that people can have both of these problems. The Anxiety and Depression Association of America estimates that 20 percent of people with mood disorders, such as anxiety, also develop substance use disorders. Likewise, about 20 percent of people with substance use disorders also have a mood disorder like anxiety or depression.  

Co-occurring disorders are complicated
 
Very often, people with anxiety feel nervous and worried. They may also sleep poorly. It is common to feel unable to relax or focus when feeling anxious. Having a beer or glass of wine might seem like something that would help. But, after the relaxing feeling of alcohol wears off, symptoms of anxiety can worsen. The body senses that alcohol has caused sedation. The body then works against the drugged feeling, with processes in the body that act against it. This adds to feelings of anxiety. If someone is drinking to ease anxiety, it is easy to see how a cycle begins. Sometimes people refer to this as self-medicating anxiety. The problem is that it does not work for more than a few hours, and can make it worse.

A similar process happens with people who over use substances. An example is someone who drinks alcohol or uses cocaine. When the first “high” of the drug wears off, the feeling after that can be bad. Many people feel depressed and anxious after a period of drug abuse. The body produces withdrawal symptoms. These produce the desire for more of the substance. In the presence of anxiety or agitation often more drugs are used. The high will wear off, and again, anxiety and depression may follow the high. The cycle of mood problems and drug abuse may carry on for a period of time. Eventually, the body develops tolerance to a substance, so it calls for more and more of it to feel high. Part of the cycle is a worsening mood and an overall sense that life is getting out of control.

You can see that anxiety and a substance use disorder is a bit of a tangled mess. Sometimes people do not realize how out of control their lives are, until those close to them help them see the results of their behavior. Relationships may be hurt. Trust may be ruined. Jobs may be lost. Health and financial problems may be starting. These are all signs that treatment is needed.

Other signs that treatment is a good idea:

  • Not able to focus on parts of life, such as work, parenting, maintaining a home, or enjoying free time without using a drug or feeling anxious.
  • Coping with anxiety feels out of reach unless using a drug (including alcohol).
  • Sleeping too little or not at all unless a drug or alcohol is used before sleep.
  • Using drinking and drugs to try to soothe yourself, even though you realize you will feel more anxious after the effects wear off.

Treatment

The first part of treatment is to stop the over use of substances. If this is too hard to do alone, there are in-hospital and outpatient detoxification programs. It most often takes a few days, but depends on the person. After detox is finished, it is helpful to take part in a rehabilitation program. Most last two weeks and involve individual and group therapy. During that time, anxiety issues and coping skills can be addressed.

Most people leave rehab with a plan to avoid relapse with substances, and a way to take care of mood issues if they are a problem. Many people return to their lives and use new coping skills to find a path toward wellness. Often it helps to continue treatment by either going to individual therapy or a mixture of therapy and Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings. It helps to know you are not alone with your problems. It also helps to hear how others have recovered from anxiety and substance use disorders. Talking to others who know your stresses can be a huge source of support. Start by talking to your doctor about your anxiety and substance use issues, and accept the help offered.

By Rebecca Steil-Lambert, MSW, LICSW, MPH

Summary

Facing both substance use and anxiety issues can be confusing and overwhelming. Both conditions are treatable, and many people recover from these co-occurring conditions.
 

It’s easy to see how anxiety can lead to an issue with substances. It is also easy to see how overusing substances can lead to anxiety. It is quite common that people can have both of these problems. The Anxiety and Depression Association of America estimates that 20 percent of people with mood disorders, such as anxiety, also develop substance use disorders. Likewise, about 20 percent of people with substance use disorders also have a mood disorder like anxiety or depression.  

Co-occurring disorders are complicated
 
Very often, people with anxiety feel nervous and worried. They may also sleep poorly. It is common to feel unable to relax or focus when feeling anxious. Having a beer or glass of wine might seem like something that would help. But, after the relaxing feeling of alcohol wears off, symptoms of anxiety can worsen. The body senses that alcohol has caused sedation. The body then works against the drugged feeling, with processes in the body that act against it. This adds to feelings of anxiety. If someone is drinking to ease anxiety, it is easy to see how a cycle begins. Sometimes people refer to this as self-medicating anxiety. The problem is that it does not work for more than a few hours, and can make it worse.

A similar process happens with people who over use substances. An example is someone who drinks alcohol or uses cocaine. When the first “high” of the drug wears off, the feeling after that can be bad. Many people feel depressed and anxious after a period of drug abuse. The body produces withdrawal symptoms. These produce the desire for more of the substance. In the presence of anxiety or agitation often more drugs are used. The high will wear off, and again, anxiety and depression may follow the high. The cycle of mood problems and drug abuse may carry on for a period of time. Eventually, the body develops tolerance to a substance, so it calls for more and more of it to feel high. Part of the cycle is a worsening mood and an overall sense that life is getting out of control.

You can see that anxiety and a substance use disorder is a bit of a tangled mess. Sometimes people do not realize how out of control their lives are, until those close to them help them see the results of their behavior. Relationships may be hurt. Trust may be ruined. Jobs may be lost. Health and financial problems may be starting. These are all signs that treatment is needed.

Other signs that treatment is a good idea:

  • Not able to focus on parts of life, such as work, parenting, maintaining a home, or enjoying free time without using a drug or feeling anxious.
  • Coping with anxiety feels out of reach unless using a drug (including alcohol).
  • Sleeping too little or not at all unless a drug or alcohol is used before sleep.
  • Using drinking and drugs to try to soothe yourself, even though you realize you will feel more anxious after the effects wear off.

Treatment

The first part of treatment is to stop the over use of substances. If this is too hard to do alone, there are in-hospital and outpatient detoxification programs. It most often takes a few days, but depends on the person. After detox is finished, it is helpful to take part in a rehabilitation program. Most last two weeks and involve individual and group therapy. During that time, anxiety issues and coping skills can be addressed.

Most people leave rehab with a plan to avoid relapse with substances, and a way to take care of mood issues if they are a problem. Many people return to their lives and use new coping skills to find a path toward wellness. Often it helps to continue treatment by either going to individual therapy or a mixture of therapy and Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings. It helps to know you are not alone with your problems. It also helps to hear how others have recovered from anxiety and substance use disorders. Talking to others who know your stresses can be a huge source of support. Start by talking to your doctor about your anxiety and substance use issues, and accept the help offered.

By Rebecca Steil-Lambert, MSW, LICSW, MPH

Summary

Facing both substance use and anxiety issues can be confusing and overwhelming. Both conditions are treatable, and many people recover from these co-occurring conditions.
 

It’s easy to see how anxiety can lead to an issue with substances. It is also easy to see how overusing substances can lead to anxiety. It is quite common that people can have both of these problems. The Anxiety and Depression Association of America estimates that 20 percent of people with mood disorders, such as anxiety, also develop substance use disorders. Likewise, about 20 percent of people with substance use disorders also have a mood disorder like anxiety or depression.  

Co-occurring disorders are complicated
 
Very often, people with anxiety feel nervous and worried. They may also sleep poorly. It is common to feel unable to relax or focus when feeling anxious. Having a beer or glass of wine might seem like something that would help. But, after the relaxing feeling of alcohol wears off, symptoms of anxiety can worsen. The body senses that alcohol has caused sedation. The body then works against the drugged feeling, with processes in the body that act against it. This adds to feelings of anxiety. If someone is drinking to ease anxiety, it is easy to see how a cycle begins. Sometimes people refer to this as self-medicating anxiety. The problem is that it does not work for more than a few hours, and can make it worse.

A similar process happens with people who over use substances. An example is someone who drinks alcohol or uses cocaine. When the first “high” of the drug wears off, the feeling after that can be bad. Many people feel depressed and anxious after a period of drug abuse. The body produces withdrawal symptoms. These produce the desire for more of the substance. In the presence of anxiety or agitation often more drugs are used. The high will wear off, and again, anxiety and depression may follow the high. The cycle of mood problems and drug abuse may carry on for a period of time. Eventually, the body develops tolerance to a substance, so it calls for more and more of it to feel high. Part of the cycle is a worsening mood and an overall sense that life is getting out of control.

You can see that anxiety and a substance use disorder is a bit of a tangled mess. Sometimes people do not realize how out of control their lives are, until those close to them help them see the results of their behavior. Relationships may be hurt. Trust may be ruined. Jobs may be lost. Health and financial problems may be starting. These are all signs that treatment is needed.

Other signs that treatment is a good idea:

  • Not able to focus on parts of life, such as work, parenting, maintaining a home, or enjoying free time without using a drug or feeling anxious.
  • Coping with anxiety feels out of reach unless using a drug (including alcohol).
  • Sleeping too little or not at all unless a drug or alcohol is used before sleep.
  • Using drinking and drugs to try to soothe yourself, even though you realize you will feel more anxious after the effects wear off.

Treatment

The first part of treatment is to stop the over use of substances. If this is too hard to do alone, there are in-hospital and outpatient detoxification programs. It most often takes a few days, but depends on the person. After detox is finished, it is helpful to take part in a rehabilitation program. Most last two weeks and involve individual and group therapy. During that time, anxiety issues and coping skills can be addressed.

Most people leave rehab with a plan to avoid relapse with substances, and a way to take care of mood issues if they are a problem. Many people return to their lives and use new coping skills to find a path toward wellness. Often it helps to continue treatment by either going to individual therapy or a mixture of therapy and Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings. It helps to know you are not alone with your problems. It also helps to hear how others have recovered from anxiety and substance use disorders. Talking to others who know your stresses can be a huge source of support. Start by talking to your doctor about your anxiety and substance use issues, and accept the help offered.

By Rebecca Steil-Lambert, MSW, LICSW, MPH

The information provided on the Achieve Solutions site, including, but not limited to, articles, assessments, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological, or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©Carelon Behavioral Health

 

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