Anxiety has become one of the most common mental health issues that people are experiencing today. Most of us may feel anxious when we are faced with a stressful situation, but there are some people who experience excessive anxiety or more persistent anxiety. These people may be suffering from an anxiety disorder. There are different kinds of anxiety disorders such as: –
Generalized anxiety disorder (GAD): Free floating anxiety about all or many different areas of life, not limited to a specific situation.
Social anxiety disorder (SAD): Anxiety regarding social situations, interactions with people.
Specific phobias: Excessive fear of a specific object or situation that interferes with one’s functioning, such as fear of heights, water, closed spaces, etc.
Obsessive Compulsive disorders (OCD): Repetitive, intrusive, obsessive thoughts, images or ideas characterize obsessions, eg. Thoughts about contamination, thoughts about threat to one’s family, etc.
Repetitive compulsive actions that provide some form of relief from one’s anxiety or obsessive thinking characterize compulsions, eg. Excessive handwashing or bathing, checking behavior or counting behavior.
Panic disorders: Anxiety manifests as sudden bouts of panic, a feeling of impending doom or death, inability to control the fear, coupled with physical symptoms such as hyperventilating, feeling of choking, etc.
The symptoms of each disorder differ from each other but there are some common symptoms. The symptoms of anxiety are physical as well as psychological. Some of the common physical symptoms are sweating, palpitations, trembling, fatigue, loss of sleep or appetite, restlessness, etc. Some of the common psychological symptoms are: a feeling of dread, uncontrollable and irrational feelings of worry or fear, hypervigilance, irritation, sensations of uneasiness or panic for no apparent reason, trouble concentrating, repeated failed attempts to decrease fear or tension, a decline in one’s work or social life, etc.
Anxiety and Addiction
There are many psychiatric disorders or mental health issues with which anxiety co-occurrs frequently. One group of individuals who suffer anxiety at a higher rate than others are current and recovering addicts. Anxiety disorders have been found to be significantly related to alcohol as well as drug addiction. Studies also show that anxiety disorders are more strongly associated with substance dependence rather than just substance abuse. That means that more severe level of consuming substance (dependence on the substance) is related to disorders of anxiety. Out of all the types of anxiety disorder, Generalized anxiety disorders (GAD) and Panic disorder have the highest association with Substance use disorders.
Link between Anxiety and Addiction
When Anxiety and Substance use disorders occur at the same time, these become functionally intertwined in each others development and maintenance. This means that each disorder fuels the other and maintains it or keeps it alive. A common misconception is that the anxiety is caused by addiction but that is not the only way that these two disorders can coexist. There are three kinds of links or pathways in which anxiety and addiction manifest. These are:
- Anxiety predates Addiction
This is a self medication approach used by an anxious person. An anxiety disorder usually causes a lot of turmoil before it is diagnosed and even while one is getting treated for it. To cope with this turmoil one may use substances to get respite from the persistent undercurrent of tension. Alcohol is a depressant and makes one feel relaxed. Even other drugs such as marijuana make one feel relaxed. Any substance alters ones state of mind, and pulls one out of their ruminative thinking. This helps a person with anxiety to step out of their continuous, negative anxious thoughts and emotions. But in turn, addiction adds to more anxiety, once the high of the substance fades and makes anxiety worse. Thisincreased anxiety makes one turn more and more towards the substance, thus creating a vicious cycle between anxiety and addiction.
- Addiction predates anxiety
Anxiety may sometimes be substance-induced. Substances are mood altering and though they usually relax a person, they may have the opposite effect and increase one’s anxiety. Substance induced anxiety manifests as restlessness, nervousness or panic. Alcohol, cocaine, non prescription medicines, caffeine, stimulant drugs can also lead to increased anxiety. This induced anxiety may not just be limited to the time that one is intoxicated, it can remain at a higher level even when one is sober. Some drugs can lead to anxiety which will last several weeks after one stops taking them. Withdrawal from the substance can also add to one’s anxiety. If a person had anxiety issues before taking substances, this anxiety can even become exacerbated or more intense after taking the substance.
- A third variable pathway
There may be another factor which contributes to both anxiety and addiction. In cases of dual diagnoses, there is a high chance of there being a wide range of mental health issues which become a factor in each disorder. For instance, an individual may have a Hugh genetic predisposition to neurotic (anxious, fearful, ruminating) tendencies. An individual may have an underlying chronic depressive episode which is co-occurring with the addiction and anxiety and fueling both. They may have a personality disorder or the anxiety and addiction could have arisen out of a traumatic event in their lives. The permutations and combinations of how mental issues manifest and contribute to each other are numerous and at least the major ones have to be identified and processed efficiently to overcome one’s addiction or anxiety issues.
Evidence from studies suggests that substance-induced anxiety disorders are relatively rare, occurring in only 0.2% of Comorbid cases. A third variable link may be more common that substance-induced anxiety but more research is required in the area. However, the first link, of anxiety disorders predating substance use disorders is very common, seen in at least 75% of cases. This supports the self medication hypothesis and shows that this may be the most commonly seen link.
Regardless of how the two disorders manifest and link together, both of them lead to a mutual maintenance of each other. Each disorder perpetuates and sustains the other. As addiction becomes more severe, the addict’s tolerance to the substance increases and they need more quantity or harder drugs to get high and alleviate the signs of anxiety. This causes financial strain, lower performance at work, distress in relationships, self judgement, and many other issues which in turn ramp up the anxiety.
As anxiety sky rockets, the pattern of avoidance increases, the person seeks more and more substance to feel relief. Even if a third variable is involved, addiction and anxiety may fuel the third variable as well, creating a codependent system of mental issues.
What can you do?
Whatever the person is suffering from, the most effective way to deal with it is to get professional help which can be received in a clinic, a mental health center, hospital or rehabilitation center. Addiction as well as anxiety, both are issues which can make a person isolate themselves and shy away from seeking help. But this isolation only makes the problems worse. Seeking support by consulting a psychiatrist and a psychologist helps one to address their issues, using medication and psychotherapy. Rehabilitation centers, especially rehabs in Mumbai, Delhi or Pune receive many admissions for Substance use disorders or severe anxiety disorders.
The environment, change in lifestyle and consistent support and therapeutic approach of a rehabilitation center is beneficial for a person who is suffering from any or both issues. This is exactly what our rehabilitation center, ZorbaWellness aims to do. We understand that nothing anxiety and addiction are disorders in which one faces many triggers or risky situations in one’s daily life which can set off craving or an anxious response, such as difficult social situations, stress, etc. A rehabilitation center takes one away from their usual triggers and helps one to learn how to cope with them effectively so that one can adapt to these issues when they go back. A holistic approach that focuses on physical health and mental health in a variety of ways is imperative in the treatment of addiction or anxiety disorders.