Addiction and Generalised Anxiety Disorder

According to research, about 20% of people who have an anxiety disorder also have a substance abuse disorder. Because generalised anxiety disorder (GAD) symptoms look like the side effects of drug abuse or alcoholism, it is often difficult to pinpoint where one disorder ends and the order begins.

Both legal and illegal drugs have the potential to cause anxiety. These can range from cocaine to methamphetamine, marijuana, amphetamines, alcohol and prescription drugs such as Ativan or Adderall. Paradoxically, the drugs that are supposed to treat your anxiety could actually end up making it worse.

If you suffer from anxiety, one of the first things a physician will want to know is the root cause of the problem. Sometimes, this can be traced to a traumatic experience or a genetic cause. Where substance abuse is responsible, the doctor will begin by treating you for addiction. This sort of problem (where anxiety is associated with an addictive substance) is called ‘dual-diagnosis’. Both conditions are often treated separately, to achieve complete recovery.

Do you suffer from anxiety? Is somebody close to you experiencing severe panic attacks caused by substance abuse? It is easy for such a diagnosis to go under the radar.

We will discuss the signs and symptoms of GAD, its relation to substance abuse and how you can help someone suffering from it – including yourself.

What is Generalised Anxiety Disorder (GAD)?

Before you can help yourself or someone suffering from GAD, you must understand how anxiety works, particularly when it stems from addiction.

The feeling of anxiety is somewhat normal, particularly during stressful situations, for example just before a medical operation or when you are late for an important job interview. However, when this anxiety persists for prolonged periods and begins to affect your everyday life, then it’s more than just ordinary stress. In such cases, you may be struggling with generalised anxiety disorder.

Typical characteristics of GAD include a consistent, unyielding feeling of worry and anxiety. People afflicted by GAD tend to focus on negative outcomes and worst-case scenarios, even when there is little evidence to back up these pessimistic thoughts.

The extent of this anxiety supersedes a bad attitude. Because of the constant worrying and negative thoughts, individuals who suffer from GAD find it difficult to focus on regular tasks such as family responsibilities, school work, their jobs and even maintaining friendships.

Where the anxiety is substance abuse-related, people with GAD believe they cannot function without the addictive substance. Their brain has been conditioned to use drugs as the only way to function normally. Therefore, without the substance, they cannot move on.

GAD is estimated to affect up to 5% of the UK’s population. It can be difficult for anybody dealing with GAD. You may shut yourself off and deprive yourself from living a truly fulfilling life. However, there is a solution. With the right treatment and support, you can reintegrate with society and live the abstinent, anxiety-free life you deserve.

Origins of Generalised Anxiety Disorder

In 1980, the American Psychiatric Association first introduced GAD as a diagnosed disorder. Then, anxiety neurosis was divided into two:

In the Diagnosis and Statistical Manual of Mental Disorders (DSM III), it was defined as the uncontrollable and diffuse worry or anxiety (that is excessive and unrealistic) that may continue for four weeks or longer.

The high rates of comorbidity of GAD and severe depression has led many experts to posit that GAD may be better off theorised as an aspect of major depression rather than an independent disorder.

Of course, individuals were already displaying GAD centuries ago, but the concept was not officially established until the late 1970s – 80s. Perhaps the most common forms were evident on battlefronts. Stories are told of World War veteransSigns and symptoms of Generalised Anxiety Disorder

Signs and symptoms of Generalised Anxiety Disorder

Other common symptoms include:

GAD is not limited to behavioural and mental problems. Over time, the severe mental stress takes its toll on you physically.

Physical symptoms of GAD

It is normal for people with GAD to suffer bodily fatigue after going through a serious emotional experience. For people diagnosed with GAD, fatigue is only one of the incapacitating physical symptoms. In fact, GAD patients are at risk of additional health problems because of the great strain they inflict on their body through obsessive worries and thoughts.

Other physical symptoms of GAD include:

It is important to note that during detox, a patient may experience symptoms of GAD. Because they mimic regular withdrawal symptoms, it’s easy to miss them and therefore for GAD to go untreated. Hence, you must never try to detox alone or without trained professionals.

More so, if a substance-abuse patient attempts to treat GAD with the usual anti-anxiety medication, they could end up feeding their addiction, because most anti-anxiety medications stimulate GABA receptors, which are responsible for addiction.

How do you know if your spouse, partner, best friend or relative is a substance abuser? If you observe sudden changes in behaviour like loss of interest in things they used to love or lack of personal grooming – even weight-loss – this could be a red flag. With adolescents, you can take them for a health examination immediately. With adults, it is not as easy.

Sometimes, you might not even know you’re suffering from GAD. Try to use frequent body checks to pick up physiological (body) signs. Pay more attention to your/the person’s emotional state and feelings. Do anxious thoughts cross your mind when you don’t take your prescription pills? What about erratic behaviour or violent outbursts?

Below are some physical, emotional and behavioural signs of addiction-related GAD.

While the first three methods are ideal for self-diagnosis, reflexive behaviours are an effective way to spot addiction-related GAD in a friend or loved one. When you do, approaching them with a solution is the next step, but it must be done with caution.

Underlying causes of anxiety and substance abuse

Nobody is sure of the exact cause of GAD. While there are several theories, researchers are currently studying the roots of this complex disorder.

The misuse of alcohol or drugs can produce neurological changes in the brain and spark (or increase) anxiety. Conversely, anxiety may be a motivating factor for substance abuse. This paradox has concerned many scientists over the years; that the same drugs responsible for treating hyperactivity eventually lead to anxiety and hyperactivity in addicts.

Besides substance abuse, other notable factors responsible for GAD include:

Age/ gender/social status

Your age and gender can also expose you to stress and anxiety. It is believed that women are more at risk of GAD than men. Additionally, people aged between 45 and 64 years have a higher risk of GAD when compared to younger age groups. Perhaps, it’s the reason for the ‘mid-life crisis’.

Young men are also at higher risk of GAD than older men. During this time, stress from work, family, taxes, and other societal demands are starting to creep up on them. The reverse is the case in women, as it is older women who are more prone to GAD than younger women.

Other mental problems

Many psychiatric ailments can lead to anxiety. For instance, a person suffering from depression is more prone to anxiety disorder than someone without mental health problems. In the case of dual-diagnosis, some mental disorders feed into (or intensify) other mental disorders. If you suffer from schizophrenia, the worrying things that don’t actually exist will only serve to increase your fear and thoughts of negativity.

Other high-risk cases include people with bi-polar disorder (mental health problems), widows, separated or divorced individuals, and those with pre-existing medical conditions.

If you fall into any of these categories and use addictive-substances, the chances of developing an addiction will be very high. It’s best to avoid using drugs altogether. If you must use a prescription medicine, make sure you discuss with your physician about possible preventive measures.

The relationship between Generalised Anxiety Disorder and addiction

The relationship between Post-Traumatic Stress Disorder (PTSD) and substance abuse disorder comorbidity has been known among scientists right from the early days of PTSD diagnosis. However, not enough is understood about the relationship between other anxiety disorders such as GAD and addiction.

According to the National Institutes of Mental Health, anxiety disorders such as PTSD, GAD, obsessive compulsive disorder (OCD), panic disorders and social phobia can reinforce or be reinforced by addiction.

For example, a report from the Psychiatric Services discovered that from a survey of 326 addicted patients, nearly half (48%) of them also suffered from anxiety or anxiety and depression. Among army veterans, those who experienced traumatic events recorded even higher rates of addiction and co-occurring anxiety disorders.

Further studies reveal that anxiety and addiction not only tend to be co-morbid with each other, but that anxiety can even lead to addiction. Subsequently, there may be a causation and correlation between both disorders. Evidence of this has been seen in studies that show anxiety predating addiction, which also revealed that using interventions to reduce anxiety also reduces subsequent incidence of addiction.

An example was demonstrated in a recent study that treated children for anxiety disorders and observed the rates of addiction among them nearly eight years later. Researchers compared results among those who remained anxious and those who didn’t; there was a significant difference. Children who were anxiety-free were far less susceptible to abusing addictive substances than the children (now young adults) who still suffered from anxiety.

In the researchers’ own words: “If left untreated, childhood anxiety can lead to…substance abuse.” Note that based on this study, the researchers’ understanding of the work, anxiety and addiction are much more coincidentally paired; stating that substance abuse is caused by anxiety.

Notwithstanding, many studies have also revealed that addiction can cause anxiety. The University of North Carolina School of Medicine concluded from a study that alcoholism can rewire the brain, thus making a person more prone to anxiety problems.

Although substance abuse increases a person’s risk of traumatic experience that may trigger post-traumatic stress disorder, the physical and chemical changes that occur in the brain are enough to cause them to develop generalised anxiety disorder. According to the university’s findings, there is a relationship between alcohol (an addictive substance) and anxiety on a molecular level.

When treating addiction, anxiety and substance abuse behaviour need to be addressed together. It’s for this reason that home detox is always a bad idea. Only a professional can help you successfully navigate the path through treatment and recovery, despite the mental health issues along the way.

Talking to a friend or family member who is experiencing addiction and GAD problems can be challenging. Most people prefer to overlook the signs, because it is easier. They just hope the individual will resolve it on their own or find help independently.

If you do this, you’ll be enabling them to continue in the wrong direction. Besides, most substance abusers can hardly recover alone. It might be too late by the time they realise this. Take the initiative to express your concern and motivate the affected person to the next step of recovery.

Here are some things to bear in mind when talking to somebody about substance abuse-related anxiety disorder.

Be prepared for denial or defensive attitude

One of the common symptoms of addiction is denial. Don’t be surprised if the person you want to talk to about substance abuse becomes defensive and hostile. Additionally, anxiety disorders such as PTSD can cause paranoia and delusional beliefs that hinder communication.

In such situations, it may be better to consider an intervention. Involve two or more close friends or family members to help you. Alternatively, an intervention specialist could prove extremely valuable, especially if you expect an aggressive reaction. Bear in mind that addiction and anxiety disorders are both diseases.

In the past, addiction to substances like drugs and alcohol were once referred to as problems of weak-willed or morally deficient people. Today, addiction is widely accepted as a chronic brain disease.

Similarly, GAD is not just a personality problem, but a form of mental illness. Both addiction and anxiety can be treated with therapeutic techniques and the support of trained experts.

Offer reasonable solutions

When talking to someone about addiction, it is better to suggest specific solutions for recovery. For instance, give the name and address of a therapist, a Narcotics Anonymous group, or a rehab centre that specialises in dual-diagnosis treatments involving addiction and generalised anxiety disorder.

Be practical with your help and provide emotional support

Besides reassuring your loved one or friend, be willing to offer some practical assistance. Accompanying them to rehab and helping them through the check in process is just one way. Another is by getting rid of all drug-use materials such as bongs, syringes or hidden bottles of alcohol.

A physician will normally recommend either inpatient or outpatient rehab, but you could help the friend understand that the inpatient programme is more suitable for them.

Addiction is a progressive disease that will exacerbate if there is no intervention, causing debilitating health problems, injury, disability or even death. You’re better off risking an altercation with your friend or loved one than allowing the disease to continue.

Professional crisis intervention specialists are always available if you need guided support.

The costs of Generalised Anxiety Disorder

Therefore, it is best to treat any anxiety disorders before they escalate.

Other costs of having GAD include:

Social limitations

Anxiety prevents you from building meaningful relationships and connecting with people who may reject your advances. Although the interest might be there, the anxiety causes you to withdraw and lose out on the opportunity to grow socially.

Things like intense fear of meeting new people, attending conferences and taking rewarding risks can prevent you from becoming a high-functioning individual in society.

Job losses

People with GAD set limitations for themselves and you may find it difficult to secure a job you really want. When you do, low self-esteem or morbid fear might affect productivity and hold you back from excelling.

Financial issues

Without a job or any substantial means of income, some people with anxiety disorders become unable to settle financial obligations. They may resort to borrowing; for addiction-related GAD, this may be to buy more drugs or alcohol. Eventually, they pose an economic burden to friends and family.

Strained relationships

It is difficult to maintain mutually-beneficial relationships when you’re constantly worrying about little things. People struggling with GAD often obsess about themselves, making it almost impossible to care about other people. They also withdraw into their shell and strain what existing relationships they have.

If you suffer from GAD, you can begin treatment that will lead you towards the path of self-confidence. There are scientifically-proven therapies with high success rates. You will no longer live in fear of your surroundings. The cost of not receiving treatment is too high not to try. Take a positive decision to overcome this today.

People with GAD don’t like to socialise

Most of the time, people with anxiety disorders do want to socialise but they can’t. They experience this impending sense of doom; a constant fear of making a mistake, disappointment or fear of failure. Simply thinking of socialising may make them anxious. So, contrary to what many might think, the willingness to socialise is there, but the capacity to do so isn’t.

Taking anxiety medications will make you an addict

While it’s true that some benzodiazepines (anxiety meds) are habit-forming, there are other drugs like Clonidine that work without affecting the GABA receptors. Even if you use a ‘benzo’ medicine with proper guidance from a physician, you can successfully treat your condition without developing dependence.

If a person believes that they are at risk of becoming dependent, they may try alternative medications such as beta blockers or depressants. By discussing with your therapist and enquiring about the side effects of a drug, you can avoid forming tolerance.

People with GAD can get better with proper treatment. Many myths interfere with the treatment process and can affect your mental resolution to get better. If there is something you are not sure about, always ask a doctor.

Dual diagnosis treatment for Generalised Anxiety Disorder and addiction

A dual diagnosis is a mental health problem that occurs along with a substance abuse disorder. It may be more complicated to treat dual diagnosis of GAD than anxiety alone.

The physician responsible for treatment must be able to address the patient’s mental health disorder and the substance abuse problem. Professionals who treat dual diagnosis are cross-trained in mental health issues such as GAD and drug or alcohol addiction.

If you suffer from GAD, you can receive treatment and recover by using a combination of detox, psychotherapy, group support and medical-assisted therapy. Medicines such as SSRIs (selective serotonin reuptake inhibitors) have successfully been used to treat GAD. Tranquilisers were also popular in the past, but therapists have since become cautious about using medication that may trigger dependence.

Prior to treatment, you will be given an assessment test to determine the severity of your dependence on the substance. Diagnosis is key to starting the right treatment procedure.

Common GAD and substance abuse diagnosis exams include:

• Physical exams
• Blood and urine tests; to gauge the quantity of the drug in the body and how severe withdrawal might be
• Psychological questionnaire (where you answer questions about your mental conditions and substance abuse habits)

According to research, only 43.2% of people diagnosed with generalised anxiety disorder receive treatment. Psychotherapy for GAD involves visiting a psychiatrist on a need-to basis to identify behavioural therapies to reduce anxiety.

Some common therapeutic solutions for GAD include:

Some rehab specialists adopt holistic treatments, aimed at helping the mind relax without medication. Since GAD is caused by overexcited nerve cells, these alternative therapies have proven to be effective. They include meditation and mindfulness, yoga practice, acupuncture, Reiki and massage therapy.

Symptoms of addiction that look like anxiety disorders are different from actual generalised anxiety disorder symptoms. It would therefore be counter effective to treat them using the same medication. More so, some GAD medications could be antagonistic to addiction recovery, so knowing how to differentiate both disorders is critical.

For example, someone addicted to Ativan or Xanax will usually experience anxiety rebounds during withdrawal. However, it is dangerous to give them any anti-anxiety medication that acts on GABA receptors as it will feed their addiction. Instead, Clonidine can help, because it balances out anxiety through even blood circulation.

Another thing to consider is whether the patient mixes other substances such as alcohol with their anti-anxiety medicines. This will help the therapists look out for additional mental health problems such as delirium tremens, bi-polar disorder and depression.

These challenges make it impossible to attempt detox alone. Your best option is a detox clinic with addiction specialists on hand.

Facts and statistics for Generalised Anxiety Disorder

• Anxiety disorders are the most common forms of mental illness, with over 40 million adults affected every year.
• Although anxiety disorders are highly treatable, only 36.9% of people diagnosed with the condition receive treatment.
• In the US, GAD affects nearly seven million adults (3.1%), but only 43.2% of afflicted individuals get treatment.
• Women are two times more likely to suffer GAD than men.

If you suffer from a substance abuse related mental health disorder, talk to a specialist today.

Frequently Asked Questions

Sources

• https://www.nhs.uk/conditions/generalised-anxiety-disorder/#who-is-affected