Anxiety & Drug or Alcohol Addiction: Co-Occurring Disorders

Individuals can experience a mental health disorder and a substance use disorder (SUD) at the same time. This is known as a co-occurring disorder, or a dual diagnosis.1 According to the National Institute on Drug Abuse (NIDA), research shows a high prevalence of co-occurring SUD and anxiety disorders, a general term that includes a number of different types of anxiety disorders.2

This article will help you understand symptoms of anxiety disorders, factors for co-occurring disorders, dealing with anxiety and alcoholism, and how you, or your loved one, can seek help at an addiction treatment center to start the road to recovery.

What is Anxiety Disorder?

It’s common to experience anxiety from time to time. Anxiety is a normal and often temporary response to a fearful situation or stressor.3 For many people, feelings of anxiety subside once the stressor or situation resolves. If feelings persist and interfere with your overall wellbeing and ability to function, you may be experiencing an anxiety disorder.3

Symptoms of Anxiety Disorder

There are different types of anxiety disorders, but they all share similar symptoms of excessive and uncontrollable worry and fear in situations that are not life-threatening along with behavioral disturbances.4 Common anxiety disorders that co-occur with substance use disorders include generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder.5

Each disorder has its own unique set of symptoms. In general, anxiety symptoms usually involve a combination of emotional and physical symptoms, such as:4

  • Feelings of dread or fear.
  • Tension.
  • Nervousness.
  • Restlessness.
  • Irritability.
  • Expecting the worst to happen.
  • Being hypervigilant.
  • Pounding or racing heart.
  • Shortness of breath.
  • Sweating.
  • Twitching.
  • Headaches.
  • Inability to fall asleep or stay asleep.
  • Frequent urination.

People with anxiety disorders sometimes experience panic attacks, which can cause distressing symptoms that can be mistaken for a heart attack.5 These include:5

  • Chest pain.
  • Heart palpitations.
  • Dizziness
  • Upset stomach.

Co-Occurring Anxiety Disorder and Drug or Alcohol Addiction

woman concerned about substance misuse

As previously mentioned, a co-occurring anxiety disorder (or another mental health condition) and a substance use disorder is also referred to as a dual diagnosis.1 Co-occurring disorders are common. According to the National Institute on Drug Abuse, around half of people who experience a mental health condition also experience SUD, and vice versa.2

Symptoms of Co-Occurring Anxiety and Addiction

Symptoms of co-occurring anxiety and addiction can be debilitating and significantly interfere with your life. It’s not always clear what comes first, anxiety or addiction, but a complex relationship exists between the two and each disorder can influence or worsen the other, especially if left untreated.6

Symptoms of co-occurring anxiety and alcoholism or the misuse of drugs involve the previously mentioned symptoms of anxiety in combination with symptoms of SUD. SUD symptoms include symptoms such as:7

  • Using substances more often or in greater quantities than originally intended.
  • Wanting to reduce your substance use but being unable to cut down or control your substance use.
  • Spending a lot of time getting, using, or recovering from use of a substance.
  • Cravings, or strong urges to use the substance.
  • Failing to attend to responsibilities at work, home, or school because of substance use.
  • Continuing to use substances, even though it negatively impacts your relationships with others.
  • Giving up or cutting back on activities you once enjoyed due to substance use.
  • Using substances in dangerous situations, such as driving a car or playing sports.
  • Continuing to use the substance despite knowing that you have a mental, social, or physical health problem that is likely due to substance use.
  • Tolerance, or needing to use more of the substance to experience previous effects.
  • Dependence, which means you experience withdrawal symptoms if you stop using the substance.

Can Anxiety Cause Drug or Alcohol Addiction?

People who want to know does anxiety cause addiction should understand that the relationship between anxiety and substance use is complex and multifaceted. It’s difficult to determine just how much one influences the other. When anxiety and substance use disorders co-occur, each disorder influences the development and maintenance of the other.5

Researchers have identified three primary pathways that may lead to developing co-occurring substance use and mental health disorders. These include:8

  • Shared risk factors. Common genetic and environmental influences can impact the development of both disorders.
  • Mental health conditions can impact SUD. People with mental health conditions like anxiety may address their symptoms through self-medication to find relief, but this tends to make things worse.
  • Substance use and SUDs may trigger the development of mental health disorders. Substance use can cause brain changes that can increase a person’s susceptibility to mental health problems.

Risk Factors for Co-Occurring Anxiety and Addiction

Certain risk factors may increase your susceptibility for developing anxiety, depression, and addiction,  or another mental health condition.

Both disorders share some common risk factors, and each disorder is the result of a complex interplay of different influences and is not caused by just one factor alone.8

Risk factors for anxiety disorders can include:3

  • Being shy or nervous.
  • Exposure to stress or trauma.
  • A family history of mental health disorders.
  • Physical health conditions, like thyroid disorders.
  • Caffeine, certain medications, or other substance use.

Risk factors for substance use disorders can include:9

  • Having one or more parents who misuse substances.
  • Having one or more parents who have a mental illness.
  • Experiencing poverty.
  • Being exposed to violence.

Both conditions possess risk factors unique to them, however there are some prominent shared factors for developing this specific co-occurring disorder, including family history of mental illness and exposure to trauma.

How to Help Someone With Anxiety and Substance Use Disorder

Group therapy for drug and alcohol addiction

If you’re wondering how to help someone with anxiety and addiction, or another co-occurring disorder such as bipolar and addiction or PTSD and addiction, you should know that there are many steps you can take. One of the most important actions would be to encourage the person to seek an evaluation with a physician.3 They can help determine what factors might be playing a role, assess both conditions, and provide referrals for treatment.

You can also take certain steps to help a family member or another loved one, such as:

  • Educating yourself about anxiety and substance use.
  • Encouraging them to attend a mutual support group for people with co-occurring conditions.
  • Helping them seek treatment.

Treating Anxiety and Addiction

It is currently the standard of care to treat both anxiety and addiction at the same time, rather than separately, with an approach known as integrated treatment.1,8 Integrated treatment can include a variety of therapies, medication, or a combination of both.7 Integrated treatment is individualized to your specific needs and situation.8

River Oaks offers integrated treatment along with other evidence-based treatments throughout different levels of care. Depending on your needs, treatment might begin with at our Riverview, FL medical detox facility, which can help you safely and comfortably withdraw from substances under medical supervision, so you can become medically stable and begin formal treatment.1

You might then enter another form of treatment at our drug rehab in Tampa, FL, such as:

  • Inpatient rehab. If you’re wondering what to expect in inpatient rehab, you should know that you’ll live onsite for the duration of treatment. It provides a highly structured environment without the distractions of daily life. Inpatient treatment can benefit people with severe co-occurring disorders or those who require 24-hour observation.1
  • Outpatient drug and alcohol rehab near Tampa. We offer different levels of outpatient care, including highly supportive partial hospitalization and intensive outpatient programs, which can be beneficial for people who are stepping down from inpatient rehab or those who need a high level of care but cannot commit to an inpatient stay.

River Oaks offers evidence-based treatment for people struggling with drug addiction and co-occurring mental health disorders in our luxurious, relaxing treatment setting near Tampa, FL. You will participate in individual therapy with your own therapist as well as group therapy, which provides support from others who are in the same situation. Some of the therapies you may participate in can include:

  • Cognitive behavioral therapy (CBT) – This helps people make positive changes to unhealthy thoughts or behaviors that contribute to anxiety and addiction.8
  • Motivational interviewing – This helps increase your motivation and addresses underlying resistance or ambivalence about making changes.5
  • Family therapy – This can help repair and restore relationships that were affected by the addiction and/or mental health condition.

If you or a loved one are struggling, you can get help—it’s never too late to start your recovery journey. You can start the admissions process today, find out more about your rehab payment options, learn about rehab insurance coverage, and quickly with us online.

Call us right now at to learn about the many treatment options we offer.

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