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Anxiety and Substance Abuse: A Dangerous Dual Diagnosis

Anxiety is difficult to treat, plain and simple. The nature of the disorder itself makes it difficult to even pursue help, and medication and therapy are the only forms of treatment generally accepted. Like any mental illness, it can’t simply be turned off or cured with some cough medicine. Instead, managing this disorder requires a multi-faceted approach and a lifelong commitment to treatment. The same can be said for many addictions, and when addiction and anxiety are a part of a dual diagnosis together, both the risks and the need for treatment are escalated.

Panic disorders like generalized anxiety disorder and social anxiety disorder begin in the amygdala, which is a part of the brain that plays a role in emotion processing and memory. When functioning improperly, the amygdala associates fear with things that would normally never produce the emotion, like speaking with friends or driving. Usually, panic disorders display similar side effects like constant anxiousness, nausea, fatigue, irritability, and insomnia. The non-stop fear and anxiety produced by panic disorders can feel impossible to deal with. This is why over 30% of those with panic disorders end up abusing alcohol or other substances.

Substances like alcohol and prescription pills like benzodiazepines often make those suffering from panic disorders feel better for a short period of time. This is because both drugs work by shutting down parts of the brain, producing a depressive effect. Instead of feeling anxious or irritable, users may feel tired and relaxed. However, this is extremely short lived, as the half life of substances like these are short, meaning the body will want more soon after. They can flood the brain with euphoria produced by neurotransmitters in the brain, but when the substance leaves the body, the brain is left vacant when before it wasn’t. This empty, depressed state can bring anxiety back in forms far worse than what it was before.

This is one of the greatest dangers of a dual diagnosis. Users will often feel worse than they did before they began abusing a substance, and will return to drugs or alcohol to help curb these negative feelings. In reality, all this is doing is worsening both the substance dependence and the mental illness. Unfortunately, over 40% of those with generalized anxiety disorder won’t ever seek treatment. When coupled with the amount of those with generalized anxiety disorder who also abuse substances, this means that many individuals with a comorbid anxiety and substance issue will never be diagnosed or helped. This needs to change, as a combination of substance use and anxiety can quickly lead to death. If you or someone you know may be suffering, there is no better time than right now.