Anxiety and addiction. These two conditions, though distinct, often intersect in ways that many might not immediately recognise.

This guide explores the relationship between anxiety and addiction, providing a comprehensive look at how these challenges can overlap, the science behind them, and how both conditions can be treated simultaneously.


What Is Anxiety?

Anxiety can be defined as the natural response to a perceived threat or danger. It’s a basic survival mechanism that triggers the “fight or flight” response, preparing an individual to either confront or flee from the threat. While everyone experiences feelings of anxiety from time to time, these feelings usually subside once the triggering event has passed.

When these feelings become overwhelming, irrational, persistent, and interfere with day-to-day life, it may indicate an anxiety disorder. Chronic anxiety can have a range of symptoms that can feel debilitating, including restlessness, rapid heartbeat, irritability, muscle tension, sleep disturbances, and excessive worry.

Unfortunately, individuals with chronic anxiety may sometimes turn to drugs or alcohol as a way to alleviate their symptoms. However, substance use can actually increase feelings of anxiety and even trigger anxiety disorders.


Types of Anxiety Disorders

There are many anxiety disorders that individuals may experience, as well as addiction. See below for a general overview of the most common types of anxiety disorders.

  • Generalised Anxiety Disorder (GAD) – Characterised by excessive and persistent worry about various aspects of life, such as health, work, or personal relationships. This worry is hard to control and often seems out of proportion to the actual likelihood of the feared event.
  • Panic Disorder – An anxiety disorder that is known to cause recurrent, unexpected panic attacks. A panic attack is a sudden surge of intense fear and includes symptoms such as sweating, trembling, and feelings of impending doom.
  • Social Anxiety Disorder – This condition involves a strong fear of social situations and judgement. It can make everyday activities extremely daunting, causing individuals to withdraw from new experiences or see friends and/or family.
  • Anxiety Inducing Phobias – intense fears of specific objects or situations that pose little or no actual danger, such as a fear of clowns or spiders.
  • Obsessive-Compulsive Disorder (OCD) – Individuals with OCD have recurrent, unwanted thoughts and/or behaviours that they feel forced to engage in. For example, someone might have obsessive thoughts about germs and contamination, making them feel compelled to wash their hands repeatedly.
  • Post-Traumatic Stress Disorder (PTSD) – This condition can develop after experiencing a traumatic event. Symptoms include flashbacks of the traumatic event, avoiding situations that remind one of the event, and negative changes in mood or personality.


Common Signs and Symptoms Of Anxiety

Common signs of anxiety can differ based on the specific anxiety disorder. However, there are general symptoms that indicate someone is experiencing anxiety.

These physical responses, thoughts and feelings include (but are not limited to):

  • Fear.
  • Terror.
  • Trembling.
  • Fatigue.
  • Sweating.
  • Increased heart rate.
  • Fainting.
  • Paranoia.
  • Obsessive thoughts.
  • Phobia.
  • Discomfort.
  • Panic.

It’s also important to note that symptoms of anxiety may vary greatly between different people, so it’s essential you are assessed by a medical professional before a valid diagnosis can be made. For instance, if you suffer from anxiety attacks, the treatment you will receive will differ compared to someone who suffers from obsessive-compulsive disorder.


The Relationship Between Anxiety and Addiction

When it comes to anxiety addiction, at the heart of the matter is a cycle where each condition can amplify the other, leading to a deteriorating spiral of mental health.

One of the most prominent theories to explain the connection is the self-medication hypothesis. It suggests that individuals who experience anxiety, whether diagnosed or just below the clinical threshold, may turn to substances as a way to alleviate their discomfort.

Alcohol, drugs, and even legal substances (e.g. nicotine) can provide somewhat of a temporary release from the feelings of dread, panic, or unease that characterise anxiety. Over time, what might start as an occasional drink or pill can escalate as the person becomes reliant on the substance to cope.

However, this temporary solution often introduces a host of new problems. The very substances that offer relief can also worsen anxiety symptoms. For example, the aftermath of consuming substances can lead to heightened feelings of paranoia, restlessness, and dread, which are symptoms that are often found with anxiety disorders.

This creates a vicious cycle. Increased anxiety can lead to increased substance use, which can also lead to heightened anxiety.

It’s also worth noting that not everyone with anxiety will develop an addiction, and not everyone with an addiction has an underlying anxiety disorder. However, the co-occurrence rate is notably high. This suggests that there are potentially shared vulnerabilities, whether genetic, environmental, or a mix of both, that predispose individuals to both conditions.

Escapism and Addiction

Those who live with anxiety often seek forms of escapism. So, whether genetically predisposed or induced by external factors, this behaviour can play a role in driving individuals to engage in addictive behaviours.

Drugs, alcohol, and even behavioural addictions (such as gambling) offer temporary relief from reality. For many, these behaviours can provide a momentary escape from the pressing weight of negative emotions. Gaming, compulsive shopping, or other similar activities also create an alternate reality where someone may feel a momentary escape. But while these behaviours might seem harmless initially, they can evolve into destructive patterns that mask the real issue – underlying anxiety.

For those with clinical anxiety, substance misuse can often become the primary coping mechanism. Over time, as drugs or alcohol are continually used to numb anxiety, an addiction can be formed. What’s more, withdrawal symptoms, both psychological and physical, become another hurdle. This cycle is further complicated by the fact that substance misuse often exacerbates anxiety, creating what’s known as ‘rebound anxiety’. Individuals find themselves feeling trapped, trying to relieve their anxiety, whilst inadvertently making it worse.


Dual Diagnosis Treatment

Dual diagnosis refers to the simultaneous presence of a mental health disorder, such as anxiety, and a substance use disorder, such as addiction.

New data suggests that half of the individuals with a substance use disorder in their lifetime will also face a mental health disorder. When an individual is living with both of these challenges, it’s essential to treat them concurrently to maximise the chances of successful recovery.

Within a dual-diagnosis treatment plan, individuals will start by undergoing a thorough detox process, which is when all toxins associated with substances are removed from the body. Once this stage is complete, psychological treatment begins. One of the primary therapeutic approaches used for dual diagnosis is Cognitive Behavioural Therapy (CBT).

Cognitive Behaviour Therapy

Cognitive behaviour therapy (CBT) is a form of talking therapy and is widely seen as an effective route for treating a range of addiction and anxiety disorders.

CBT seeks to alter the underlying thoughts and feelings that power both the addiction and anxiety disorder. Specifically, CBT helps us to address distortions in how we view ourselves and the wider world. CBT also helps you develop healthier coping mechanisms to manage thoughts and feelings that are attached to anxiety.

There are two central approaches to this type of psychological therapy. The first approach is behavioural therapy. Behavioural therapy helps you understand how you react to situations that may have caused both conditions. Cognitive therapy helps you understand and work through negative thoughts and feelings. This process helps to identify, deconstruct and reframe distorted beliefs and thoughts so you may continue to live your life without resorting to substance misuse.

What’s more, cognitive restructuring is also an important element for those who are receiving dual diagnosis treatment. This is also known as thought-challenging. Here, you are encouraged to identify and then challenge negative thoughts. You are then encouraged to replace these thoughts with positive alternatives that are closer to reality. For instance, anxiety disorder causes the sufferer to perceive situations as more dangerous than they actually are.


Alternative Treatment Therapies For Anxiety and Addiction

Although cognitive behavioural therapy is often a core element of a dual diagnosis treatment plan, a combined approach is often required. Some examples of this may include (but are not limited to):

  • Exposure therapy – This involves exposing yourself to a situation that’s mildly anxiety-producing and then working your way up to the most anxiety-producing situation slowly and over time. This allows you to challenge your anxiety in a gradual fashion.
  • Dialectical behavioural therapy (DBT) – This is a form of CBT, however, it is typically included in a dual diagnosis plan for individuals who feel emotions very intensely and require a longer and more intensive approach.
  • Support groups – Often beneficial for those who have feelings of shame or loneliness as a result of addiction. Support groups are a safe space that allows individuals to share their thoughts and experiences with others who are on a similar journey.
  • Medication – In some cases, individuals may require medication alongside psychological treatment. This may be prescribed as either a short or long-term solution, depending on the individual.


Find Help For Anxiety and Addiction Today

If you are struggling with addiction and anxiety, we can help you. At Ocean Recovery, we are a leading rehabilitation clinic that offers comprehensive dual diagnosis treatment, which includes a personalised treatment plan to ensure that individuals receive the highest quality and standard of care.

For more information on how we can support you, contact us today.

John Gillen - Author - Last updated: October 11, 2023

John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.