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Generalized Anxiety Disorder (GAD) And Addiction

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

June 4, 2019

People with generalized anxiety disorder (GAD) have a higher risk than the general population of developing a substance abuse problem. Overcoming co-occurring anxiety and substance use disorders (SUDs) typically begins with seeking professional treatment.

Anxiety disorders are some of the most common psychiatric disorders experienced by people in the United States. According to research, as many as 28.8 percent of people may meet criteria for an anxiety disorder at some point in their lifetime.

This intense level of anxiety involves more than an occasional feeling of worry or stress. Anxiety disorders can become debilitating, affecting both a person’s personal and professional lives. This includes generalized anxiety disorder (GAD), which can cause constant fear and anxiety.

Having GAD can put a person at greater risk for other mental health struggles, including substance abuse and addiction.

Treating co-occurring GAD and addiction requires an integrated approach that treats both problems together at the same time. This is known as dual-diagnosis and is a common treatment offered within drug and alcohol rehab programs.

What Is Generalized Anxiety Disorder (GAD)?

Generalized anxiety disorder (GAD) is characterized by persistent anxiety about many things within a person’s life. This can involve excessive worry about money, health, relationships, work, and more.

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These consistent feelings of stress and anxiety can become a challenge to manage over time. Many people may struggle just to get through the day, regardless of whether or not their worries seem rational to others around them.

In order to cope with their intense anxiety, many people turn to substances like drugs and alcohol for relief. Although this can initially bring a sense of calm and help people avoid their worries, over time this can make GAD symptoms even worse.

Symptoms Of Generalized Anxiety Disorder (GAD)

Worrying about things within or out of one’s control can cause significant strain on a person’s emotional and even physical well-being.

Even stressors that seem small or insignificant to one person may be anxiety-provoking to someone else with an anxiety disorder.

Signs and symptoms of GAD can include:

  • feeling on edge
  • fast heartbeat
  • sweating
  • restlessness
  • nausea
  • difficulty concentrating
  • weakness or fatigue
  • insomnia
  • stomach or digestive problems (e.g. pain, diarrhea, constipation)
  • rapid breathing (hyperventilation)
  • excessive worry and always expecting the worst

Several of these signs and symptoms overlap with those of substance use disorders (SUDs) and withdrawal. Anxiety is in itself a common symptom of drug and alcohol abuse, as are other mood-related symptoms such as restlessness and depression.

Anxiety And Substance Abuse

People with anxiety disorders are two to three times more likely to develop substance abuse problems than the general population. Generalized anxiety disorder (GAD) in particular is one of the most common anxiety disorders to co-occur with drug and alcohol abuse.

Many people develop symptoms of GAD as a result of their substance abuse, or during withdrawal. However, substance abuse and GAD can also be experienced as separate disorders that together create a difficult cycle to break alone.

What Causes Addiction Among People With GAD?

In many cases, anxiety disorders precede substance abuse. In these instances, drinking alcohol or using drugs can become a way for people with high anxiety to self-medicate.

Many drugs can also cause symptoms of mental disorders. This can make it more difficult to tell whether or not anxiety symptoms are drug-induced or an independent disorder.

Anxiety disorders that precede any abuse of substances may be treated with anti-anxiety medications. Some of these medications, like Xanax and Klonopin, have a moderate abuse potential and can become addictive.

Common substances of abuse among people with GAD include:

Both types of disorders also share some of the same risk factors. Substance abuse and anxiety are common among people that have experienced abuse, neglect, or another form of trauma. Mental disorders can also be genetic.

What Are The Dangers Of Substance Abuse and Untreated Anxiety?

Relying on drugs or alcohol to cope with daily anxiety can harm both physical and mental health. People who are struggling with substance abuse may at some point become unable to attend to their daily responsibilities, whether within the home, in school, or at work. This can create even more stress.

Drug and alcohol dependence is also dangerous on its own. People that abuse drugs or alcohol to manage feelings of anxiety or depression can develop a tolerance to substances over time. This requires taking higher doses in order to feel the same effects.

When a person is regularly increasing their drug use, this puts them at higher risk for serious health consequences, including organ failure. It also increases the risk for overdose, which can be deadly.

Additional dangers from co-occurring substance and GAD can vary depending on the drug of abuse.

Other consequences can include:

  • fatigue
  • more severe alcohol withdrawal
  • mood swings
  • paranoia
  • depression
  • isolating from others

Nearly seven million adults in the U.S. are affected by GAD, yet only 43.2 percent receive treatment for it. Anxiety and drug addiction are still heavily stigmatized, and struggling with both can even further complicate a person’s willingness to seek treatment.

Even people that are aware of the dangers involved with their substance abuse can have a difficult time admitting they need help. Avoiding the problem, however, and refusing to seek help can only make the problem worse.

How To Treat Generalized Anxiety Disorder And Addiction

The most effective way to treat co-occurring anxiety and addiction is through an integrated approach. This is more effective than treating each disorder separately.

Several factors may be considered in the process of developing a treatment plan for generalized anxiety disorder (GAD) and addiction.

Considerations for treatment include:

  • severity of a person’s substance dependence
  • frequency and duration of substance abuse
  • whether the anxiety preceded the substance abuse
  • previous treatment history

Treatment for anxiety and addiction often includes a combination of behavioral therapy and medications. Detoxification (detox) services may also be needed in order to withdraw from a drug or substance. The safest recommendation for this is medically assisted detox, a service offered within many rehab programs.

Most people seeking treatment for co-occurring mental and substance use disorders are recommended inpatient care within a rehab center. This offers an intensive level of treatment capable of providing a great deal of support that can be helpful for early sobriety.

Cognitive Behavioral Therapy (CBT)

Behavioral therapies, such as cognitive behavioral therapy (CBT), are the most effective way to help people with anxiety and addiction problems achieve long-term recovery. Through counseling, patients can identify their emotional triggers and practice using healthy coping skills.

Aftercare support and relapse prevention services can also provide benefit for patients within rehab programs. This connects patients to resources outside of an inpatient program to continue their treatment on an outpatient basis for long-term recovery.

Medication-Assisted Therapy (MAT)

In addition to therapy, medications with low abuse potential can also be helpful to treat underlying anxiety and avoid relapse. These are prescribed on a case-by-case basis, depending on each patient’s mental health and substance abuse history.

Contact us to learn more about generalized anxiety disorder and addiction or to find dual diagnosis treatment options today.

Anxiety and Depression Association of America - Generalized Anxiety Disorder (GAD), Facts & Statistics, Symptoms

National Institute on Drug Abuse - Common Comorbidities with Substance Use Disorders

U.S. National Library of Medicine: PubMedCentral - Anxiety Disorders with Comorbid Substance Use Disorders: Diagnostic and Treatment Considerations

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