Anxiety and Addiction

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Anxiety Disorders & Substance Abuse 

It’s common for individuals with substance use disorders to develop anxiety use disorders and vice versa. Anxiety and addiction are the two most common psychiatric disorders in the United States. 


When someone has co-occurring anxiety and substance abuse disorders, they have a dual diagnosis. 


Anxiety and addiction are highly correlated to genetics, stress levels, and traumatic experiences. Dual diagnosis typically requires comprehensive treatment that takes both disorders into account.

Prevalence of Anxiety Disorders & Addiction

The National Alliance on Mental Illness reports that 9.5 million Americans have an anxiety disorder and substance use disorder (SUD) in 2019. 


Both anxiety and substance abuse are linked to significant changes in similar brain regions. This is one possible reason for the high prevalence of co-occurrence between addiction and anxiety disorders. 


According to the American Psychological Association (APA), around half of all people seeking treatment for addiction or anxiety have co-occurring disorders. The APA also notes that five out of 10 people with anxiety or depression also have a substance use disorder.

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Anxiety Disorder Symptoms & Substance Abuse Disorders

When someone feels fear, stress, or unease, it can be a normal response to a potential threat. But those with anxiety disorders experience overwhelm and fear that often interfere with their daily lives. 

Anxiety disorders diagnosis include: 

  • generalized anxiety disorder 
  • social anxiety disorder (social phobia) 
  • obsessive-compulsive disorder (OCD) 
  • panic disorders 
  • post-traumatic stress disorders (PTSD) 
  • complex post-traumatic stress disorder (CPTSD) 

Symptoms of Anxiety Disorders

Each person will have symptoms unique to their specific anxiety disorder. An official diagnosis will need to be made by a healthcare professional. 


The most common traits experienced by those with an anxiety disorder include: 


  • excessive worry or anxious thought patterns that are difficult to control 
  • debilitating anxiety that interferes with everyday life
  • rapid heart rate
  • muscle tension 
  • shortness of breath
  • avoiding people, places, or things that are associated with feelings of fear

Symptoms of Addiction

Drug and alcohol abuse often increases “feel good” chemicals such as dopamine in the brain. This can lead to extremely high levels of dopamine which hijack the reward system. If continued, this change may become permanent. 


Although no two addictions are exactly alike, common symptoms of addiction include: 


  • changes in mood and behavior 
  • withdrawing from friends and family 
  • compulsive drinking or drug use (despite adverse consequences) 
  • trouble slowing or stopping drinking or drug use 
  • drug or alcohol tolerance or withdrawal symptoms 
  • intense cravings 


Substance abuse can also worsen anxiety symptoms, causing increased substance abuse to self-medicate. Luckily, substance-induced anxiety symptoms usually disappear with treatment. 


People with a dual diagnosis will likely experience a combination of symptoms from both disorders. 

Potential Risk Factors

When two or more disorders are present, one doesn’t necessarily cause the other. Instead, having one can increase the risk of developing another disorder. 


Risk factors include genetics, health, and your environment. All of which can influence the development of co-occurring disorders. Addiction and mental health disorders are associated with changes in brain chemistry. 


A change in brain chemistry can mean someone with a generalized anxiety disorder is more vulnerable to the effects of alcohol and drugs. It’s relatively common for people with undiagnosed anxiety disorders to abuse drugs and alcohol as a form of coping. 


Certain drugs, like cocaine, may increase the risk of developing a mental illness. The risk increases when substance abuse occurs in adolescence because the brain is still in development. 


Dual Diagnosis Treatment for Anxiety & Addiction

When someone experiences an anxiety disorder in addition to addiction, it can feel very overwhelming, but help is available. Treatment requires both diseases to be addressed with a multidisciplinary treatment approach. 


Comprehensive treatment involves teams of doctors and specialists working to treat co-occurring disorders. Therapists and addiction specialists are just a couple of the healthcare professionals that may be involved in treatment.  

Depending on your unique needs, treatment may include:


Inpatient medical detox programs prepare people for addiction treatment through the complex withdrawal process. Detox is a vital step in dual diagnosis treatment because substance withdrawal symptoms can trigger or worsen anxiety symptoms. 


Residential or Inpatient Treatment

Inpatient treatment programs are live-in, long-term treatment that provides mental health treatment and addiction treatment from professionals. Residential programs offer structure through daily schedules that may include healthy activities, support groups, family therapies, and behavioral health therapies.


Outpatient Treatment

Outpatient programs range in intensity and can be helpful for those at the end of their recovery process or with less severe addictions. These program types are generally not recommended for people with dual diagnoses as they don’t provide enough support to heal from multiple disorders at once.


Behavioral Health Therapy

Behavioral health therapy is a crucial part of treatment that targets behavior patterns associated with substance abuse and mental illness. Each behavioral therapy aims to improve negative thoughts, beliefs, and behaviors. 


Types of behavioral health therapy include: 


  • cognitive behavioral therapy (CBT) 
  • dialectical behavioral therapy (DBT) 
  • Acceptance and commitment therapy (ACT) 
  • contingency management (CM) 
  • motivational interviewing (MI)

Medication-Assisted Treatment

Medications are sometimes paired with behavioral health therapy to help treat anxiety disorders. Many drugs used to treat anxiety and panic attacks include benzodiazepines like Xanax, which have a high risk of abuse. 



Mental health professionals may prescribe other non-addictive medications like antidepressants to decrease the risk of substance abuse. Specific serotonin inhibitors (SSRIs) include Paxil or Prozac, which can effectively treat anxiety and addiction.


Anxiety & Addiction Frequently Asked Questions (FAQ)

Q: Which substance use disorders frequently co-occur with an anxiety disorder?

A: Anxiety disorders are commonly linked to stimulant abuse. Because the withdrawal symptoms of a drug are often the inverse of its effects, stimulants like meth or cocaine cause high energy when withdrawing. They cause high anxiety. This can significantly increase the risk of developing an anxiety disorder. 


Q: Does an anxiety disorder increase the risk of alcohol abuse?

A: On average, people with an anxiety disorder are two to three times more likely to develop an alcohol use disorder (AUD) than the rest of the population. 


AUD co-occurs with several types of anxiety disorders, including generalized anxiety disorder (GAD), panic disorders, PTSD, CPTSD, OCD, and social anxiety. 


You Don’t Have To Go It Alone

If you or a loved one would like more information on dual diagnosis treatment, TruHealing Centers can help. Contact us today to discuss your treatment options with an addiction treatment specialist. 

Lets Recover Together.



American Psychological Association – Mental Illness and Drug Addiction may Co-Occur Due to Disturbance in the Brain’s Seat of Anxiety and Fear

National Alliance of Mental Illness – Substance Use Disorders


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