Medical Reviewer

Anxiety and Addiction: Signs, Symptoms, and Treatment Options

Last Medical Review On: July 17, 2024
Updated On: June 15, 2024
7 min read
Written by:

Amanda Stevens, B.S.

Medical Review by:

Dr. Po-Chang Hsu, M.D., M.S.

Anxiety and addiction frequently coexist, presenting a complex challenge for individuals grappling with these issues.[1] Anxiety can drive individuals toward substance abuse as a means of coping with overwhelming emotions. Conversely, substance abuse can intensify feelings of anxiety, perpetuating a distressing cycle of mental health struggles and substance dependency.

Understanding the link between anxiety and addiction is crucial for obtaining the necessary support and treatment interventions for healing. Fortunately, there are several treatment approaches available to begin your recovery journey, addressing both the underlying anxiety and the patterns of substance use.

Anxiety and Addiction

Key Points

  • Anxiety and addiction frequently coexist, with anxiety sometimes driving individuals towards substance abuse as a coping mechanism.
  • Conversely, substance abuse can intensify feelings of anxiety, creating a cycle of mental health struggles and dependency.
  • Understanding the relationship between anxiety and addiction is crucial for obtaining appropriate support and treatment.
  • Treatment approaches are available to address both underlying anxiety and substance use issues simultaneously.
  • Lifestyle changes like exercise, healthy eating, stress reduction, and social connections can complement treatment efforts.
Jump to Section

    What Is Anxiety?

    Anxiety disorders encompass a range of conditions marked by intense and excessive fear, worry, and physical symptoms that significantly impact daily life.[2] These disorders can manifest as persistent and uncontrollable feelings of apprehension, avoidance of triggering situations, and physical manifestations such as palpitations, sweating, and trouble sleeping. Anxiety disorders are prevalent across the world, affecting an estimated four percent of the global population.[3]

    The onset of anxiety symptoms often occurs during childhood or adolescence. It may persist into adulthood, impacting individuals’ quality of life and increasing the risk of depression and substance use disorders. Despite the availability of highly effective treatments for anxiety disorders, only about one in four people in need receive any treatment, highlighting the need for increased awareness and accessibility to mental health and dual diagnosis services.[4]

    Take the First Step Toward Recovery

    Our representatives are standing by 24-7 to help you start healing today.

    How Are Anxiety and Addiction Related?

    Anxiety and addiction share a complex relationship, often occurring together (referred to as co-occurring or dual diagnosis).[5] Those experiencing anxiety may turn to substances as a form of self-medication, seeking temporary relief from overwhelming feelings of fear and worry. This can lead to the development of substance use disorders, further complicating the management of anxiety. Conversely, substance abuse can intensify feelings of anxiety, perpetuating a cycle where the individual continues to use substances to cope with heightened anxiety.

    This mutual influence can make it difficult to break free from either condition, and both anxiety and addiction can involve similar neurobiological pathways, contributing to their co-occurrence. Understanding this intricate link is crucial for developing comprehensive treatment approaches that address the unique needs of individuals facing both challenges. Integrated treatment strategies that simultaneously target anxiety and addiction can offer a more effective path to recovery and long-term well-being.

    What are the Risk Factors for Anxiety?

    While the specific causes of anxiety disorders are complex and multifaceted, several established factors are known to contribute to their development:[6]

    • Genetics: Family history can significantly impact an individual’s susceptibility to anxiety disorders. Genetic predispositions can influence the development of anxiety and related conditions within families.
    • Neurobiological factors: Imbalances in neurotransmitters, such as serotonin, gamma-aminobutyric acid (GABA), and norepinephrine, are associated with anxiety disorders. Disruptions in these neurotransmitter systems can affect mood regulation and contribute to heightened anxiety.
    • Trauma: Exposure to traumatic events, such as physical or emotional abuse, natural disasters, or accidents, can increase the risk of developing anxiety disorders. Additionally, significant life changes, like divorce, relocation, or financial difficulties, can trigger or exacerbate anxiety symptoms.
    • Chronic medical conditions: Individuals dealing with chronic illnesses or managing serious health concerns may be more vulnerable to developing anxiety disorders. The stress and uncertainty associated with chronic medical conditions can contribute to the onset or exacerbation of anxiety symptoms.
    • Substance abuse: Substance abuse, including alcohol and drugs, can exacerbate anxiety disorders. Conversely, individuals with anxiety disorders may turn to substance abuse as a means of self-medication, leading to a harmful cycle of dependency and heightened anxiety.
    • Environmental factors: Adverse environmental conditions, such as socioeconomic hardships, exposure to violence, or unstable living situations, can contribute to the exacerbation of anxiety disorders, particularly in vulnerable populations.
    • Personality traits: Certain personality traits, such as excessive worry, perfectionism, or a tendency towards negative thinking, can increase an individual’s susceptibility to anxiety disorders.
    • Childhood experiences: Early-life experiences, including neglect, abuse, or significant disruptions in attachment, can impact the development of anxiety disorders later in life. Adverse experiences during childhood can contribute to the formation of anxiety-related conditions.
    • Chronic stress: Prolonged exposure to stress from work, relationships, or other life demands can overwhelm an individual’s coping mechanisms, leading to the development or exacerbation of anxiety disorders.
    • A lack of social interaction: Social isolation, a lack of supportive relationships, or feelings of loneliness can contribute to the development of anxiety disorders, as supportive social connections are vital for maintaining your mental well-being.

    What are the Risk Factors for Addiction?

    Likewise, several factors contribute to the development of addiction:[7]

    • Genetics: Genetic predispositions significantly influence addiction susceptibility. Individuals with a family history of addiction are at a higher risk of developing addiction due to inherited genetic factors.
    • Environmental factors: Exposure to substance abuse within the family or peer group, socioeconomic status, substance availability, and cultural attitudes toward substance use can all increase the likelihood of addiction.
    • Childhood trauma: Adverse childhood experiences, including abuse, neglect, or other traumas, can elevate the risk of addiction later in life. Trauma may lead individuals to use substances as a coping mechanism to self-medicate or escape distressing emotions.
    • Dual diagnosis issues: Co-occurring mental health disorders, such as depression, anxiety, trauma-related disorders, or personality disorders, are common among individuals with addiction, heightening vulnerability to substance abuse as individuals use substances to alleviate symptoms or self-medicate.
    • Peer influence: Peer pressure and societal norms surrounding substance use can influence an individual’s likelihood of experimenting with or developing addiction. Associating with peers who engage in substance use can elevate the risk of substance abuse.
    • Substance use at an early age: Initiation of substance use during adolescence, when the brain is still developing, can increase addiction risk. Early substance exposure may alter brain chemistry and heighten susceptibility to developing addictive behaviors.
    • Stress: Chronic stress, life transitions, and traumatic events can trigger or worsen substance abuse as individuals turn to substances to cope with challenging emotions or situations.
    • Neurobiological factors: Differences in brain structure and function, including alterations in neurotransmitter systems like dopamine and serotonin, reward circuitry, and impulse control, can contribute to addiction vulnerability.

    Co-Occurring Disorder Treatment for Anxiety and Substance Abuse

    Effective treatment for co-occurring anxiety and substance abuse requires an integrated approach that addresses both conditions simultaneously.[8] Such an approach involves collaboration between mental health professionals, substance abuse counselors, and medical professionals to develop a comprehensive treatment plan tailored to your individual needs.

    The treatment process begins with a comprehensive assessment to evaluate the extent of both the anxiety disorder and substance use, as well as any other co-occurring mental health issues. Medication management may also be employed to alleviate symptoms of anxiety and stabilize mood. However, medications are typically used in conjunction with psychotherapy and other forms of treatment rather than as a standalone intervention.

    In addition to formal treatment modalities, lifestyle changes such as regular exercise, adequate sleep, and stress-reduction techniques can complement treatment efforts and improve overall well-being. Developing strategies for relapse prevention is also crucial. These involve identifying triggers, creating a relapse prevention plan, and building a strong support network to promote long-term recovery and prevent the recurrence of either disorder.

    Anxiety and Substance Abuse Treatment Levels of Care

    Dual diagnosis facilities typically provide a variety of care environments to accommodate your needs:

    • Medical Detoxification (Detox): Detoxification, commonly referred to as detox, entails the deliberate elimination of harmful substances such as drugs or alcohol from the body. Typically conducted under close medical supervision, either in medical facilities or specialized detox centers, this process aims to manage the physical symptoms of withdrawal safely. By doing so, detox prepares individuals for subsequent phases of treatment and rehabilitation.
    • Medically Managed Care: Medically managed care integrates medical expertise with therapy to provide comprehensive support to patients throughout their recovery journey. This level of care involves continuous monitoring by medical professionals who customize treatments and collaborate closely with other healthcare team members. This integrated approach fosters comprehensive healing and supports long-term well-being by addressing patients’ physical and psychological aspects of their conditions.
    • Inpatient Residential Treatment: Inpatient treatment, also known as residential treatment, entails individuals residing in a specialized facility to receive comprehensive care for their addiction or mental health issues. This level of care is particularly suitable for severe cases requiring intensive, round-the-clock support. Within these facilities, patients participate in various therapeutic activities, including individual and group therapy, alongside medical and psychiatric assistance. The structured environment of inpatient treatment fosters focused recovery, with program lengths varying from weeks to months, depending on individual needs and progress.

    Therapies Used in Anxiety and Addiction Treatment

    Alpas is proud to offer several evidence-based approaches to treat co-occurring mental health and substance use issues:

    • Cognitive Behavioral Therapy (CBT): CBT is commonly employed to tackle negative thought patterns and behaviors associated with various mental health conditions, including depression and addiction. Through collaborative sessions with a therapist, individuals are equipped with tools to challenge distorted thinking, acquire coping strategies, and effectively manage cravings. This empowering method facilitates insight into thought processes and behavior patterns, empowering individuals to initiate positive changes and attain enduring recovery.
    • Dialectical Behavior Therapy (DBT): DBT seamlessly blends mindfulness, acceptance, and behavior change strategies within a cognitive-behavioral framework. Initially developed to treat borderline personality disorder (BPD), DBT has expanded its scope to address various mental health concerns, including addiction. It focuses on skill development across emotion regulation, interpersonal effectiveness, and distress tolerance. Therapists employ a multifaceted approach, incorporating individual sessions, group training, coaching, and assignments to equip individuals with coping mechanisms and foster emotional stability throughout treatment.
    • Motivational Interviewing (MI) is a counseling approach focused on enhancing motivation for behavior change. Therapists engage in collaborative conversations, demonstrate empathy, and utilize reflective listening techniques to help individuals align their behavior with their desired goals. MI aims to empower individuals by bolstering their readiness and commitment to making significant life changes. Through this supportive and non-confrontational approach, individuals are encouraged to explore their ambivalence about change and discover their intrinsic motivations for growth and improvement.
    • Contingency Management: Contingency management is a therapeutic strategy that employs rewards to reinforce desired behaviors, such as maintaining sobriety. Individuals are incentivized to meet treatment goals, such as attending sessions or passing drug tests. These rewards, whether vouchers or prizes, boost motivation and foster adherence to treatment objectives. By providing tangible incentives for positive actions, contingency management helps individuals stay engaged in their recovery journey and increases the likelihood of successful outcomes.
    • Motivational Enhancement Therapy (MET): MET is a counseling approach to bolster motivation and commitment to behavior change. Using structured discussions and feedback, MET targets ambivalence surrounding behavior change by assisting individuals in clarifying their values and goals. By instilling confidence in their capacity for change, MET prioritizes internal motivation for positive transformation rather than delving deeply into the root causes of addiction. Through this process, individuals are empowered to take ownership of their journey toward change and are supported in cultivating the mindset necessary for sustained progress.
    • Experiential Therapy: Experiential therapy utilizes interactive activities to engage individuals in emotional processing and facilitate personal growth. Diverging from conventional talk therapy, it incorporates hands-on approaches such as role-playing and art therapy. These activities allow individuals to express emotions and develop coping skills within a supportive environment that addresses the holistic aspects of the body, mind, and spirit. By actively participating in these experiences, individuals can embark on a journey of profound personal transformation, gaining insights and skills that extend beyond traditional verbal communication methods.
    • Relapse Prevention: Relapse prevention aids individuals in recognizing triggers, crafting coping strategies, and establishing plans to avoid relapse. Within this therapeutic framework, participants delve into understanding warning signs like stress and emotional triggers while acquiring skills to manage them effectively. By nurturing self-awareness and furnishing practical tools, relapse prevention therapy delves into the root causes of addictive behaviors, thereby fostering the foundation for long-term sobriety. Through insight and actionable techniques, individuals are empowered to navigate challenges and sustain their journey toward lasting recovery.
    • Twelve-Step Facilitation: Twelve-step facilitation plays a pivotal role in addiction recovery, offering guidance through programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These structured programs cultivate community and accountability through group meetings, step work, and peer support. Through active engagement in these programs, individuals not only establish but also maintain sobriety while acquiring invaluable tools for long-term recovery. By adhering to the principles of these programs and drawing strength from the collective support of peers, individuals navigate their journey toward sustained sobriety with greater resilience and determination.

    When searching for addiction treatment centers, Maryland‘s Alpas Wellness provides a detailed approach to your recovery journey, addressing every aspect with equal care.

    Share this post on your social networks:

    Ready to get help for you or a loved one? Contact us

    Editorial Guidelines At Alpas Wellness

    To ensure accuracy and quality, every contributor to the Alpas Wellness resource library undergoes a thorough evaluation of their experience, credentials, and achievements prior to publication.

    Frequently Asked Questions about Anxiety and Substance Abuse


    What are the long-term effects of addiction and anxiety?


    The long-term effects of addiction and anxiety can be severe and pervasive. For addiction, these effects may include deteriorating physical health, strained relationships, financial problems, legal issues, and difficulty maintaining employment or academic performance. Anxiety, when left untreated, can lead to chronic stress, depression, social isolation, impaired cognitive function, and an increased risk of developing other mental health disorders.


    What role does medication play in treating addiction and anxiety?


    Medication can play a crucial role in treating addiction and anxiety. In addiction treatment, medications may be used to manage withdrawal symptoms, reduce cravings, and prevent relapse. For anxiety disorders, medications such as selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and beta-blockers are commonly prescribed to alleviate symptoms. However, medication should be used with therapy and other supportive interventions for optimal outcomes.


    Are there specific therapies tailored for addressing both addiction and anxiety simultaneously?


    Yes, there are specific therapies tailored for addressing both addiction and anxiety simultaneously. Integrated treatment approaches, such as CBT, aim to address the complex interplay between addiction and anxiety. These therapies incorporate techniques to manage both conditions concurrently, helping individuals develop coping skills, challenge negative thought patterns, and build resilience against relapse triggers.


    How can family and friends support someone struggling with addiction and anxiety?


    Family and friends can support someone struggling with addiction and anxiety by providing unconditional love, understanding, and encouragement. It’s essential to educate oneself about addiction and anxiety to offer informed support. Encouraging the individual to seek professional help and participating in family therapy sessions can foster communication and strengthen relationships. Creating a supportive environment, setting healthy boundaries, and avoiding enabling behaviors can promote recovery and overall well-being.


    Are there lifestyle changes that can help manage addiction and anxiety?


    Yes, lifestyle changes can help manage addiction and anxiety. Regular exercise, healthy eating habits, and adequate sleep can positively impact physical and mental health. Stress-reduction techniques such as mindfulness, meditation, and deep breathing exercises can help alleviate symptoms of anxiety and promote relaxation. Engaging in enjoyable activities, hobbies, and social connections can also provide a sense of fulfillment and support recovery efforts.


    [1] McHugh, R. K. (2015). Treatment of Co-occurring Anxiety Disorders and Substance Use Disorders. Harvard Review of Psychiatry, 23(2), 99–111. on April 10, 2024

    [2] National Institute of Mental Health. (2023, April). Anxiety Disorders. National Institute of Mental Health; National Institute of Mental Health. on April 10, 2024

    [3] World Health Organization. (2023, September 27). Anxiety Disorders. World Health Organization. on April 10, 2024

    [4] World Health Organization. (2023, September 27). Anxiety Disorders. World Health Organization. on April 10, 2024

    [5] Smith, J. P., & Book, S. W. (2008). Anxiety and Substance Use Disorders: A Review. The Psychiatric Times, 25(10), 19–23. on April 10, 2024

    [6] National Institute of Mental Health. (2023, April). Anxiety Disorders. National Institute of Mental Health; National Institute of Mental Health. on April 10, 2024

    [7] Mayo Clinic . (2022, October 4). Drug addiction (substance use disorder) – symptoms and causes. Mayo Clinic; Mayo Clinic. on April 10, 2024

    [8] National Institute on Drug Abuse. (2020, April). What are the treatments for comorbid substance use disorder and mental health conditions? National Institute on Drug Abuse. on April 10, 2024

    Begin Your Recovery Journey Today