Anxiety and addiction

What are anxiety disorders?

While some anxiety can be good for us – for example, helping us stay away from dangerous situations – anxiety disorders affect our mental health to the point that they stop the sufferer from being able to function. Anxiety disorders cause us to overthink negative thoughts around situations, which can lead to a loss of control of our responses. This can have obvious knock-on effects and lead us to feel anxious in everyday life even before we experience the triggers. We can even start to avoid friends and family members.

What are the different types of anxiety disorders?

Anxiety disorders may result in a frequent feeling of overwhelming dread or fear in different situations. These may even manifest into physical or mental symptoms, such as sweating or chest pain. So many things can trigger anxiety, and it tends to be different from person to person. The trigger could be a stressful period at work, job interview, money worries, societal pressures, problems with a family member or even small things that may seem trivial to many people.

The numerous triggers mean that anxiety disorders can take many different forms and vary in their severity. The main different types of anxiety disorders are generalised anxiety disorder (GAD), social anxiety disorder, panic disorder, agoraphobia and separation anxiety disorder.

Generalised anxiety disorder (GAD)

Generalised anxiety disorder (GAD) is the most common type of anxiety disorder in the UK. If you suffer from GAD, it may have an impact on your daily life, and you may experience excessive worrying about various events and experiences. In fact, you will probably find that you feel anxious a lot of the time, and it could have an impact on your ability to hold down a job, travel or sleep.

You may also experience physical symptoms, such as increased sweating and muscle tension when you encounter stressful events.

These symptoms are similar to many other types of anxiety disorders, and as such, generalised anxiety disorder is quite difficult to diagnose. To help with diagnosis, it is important to track how long you have felt anxious for and what sort of impact your anxiety has had on your day-to-day life.

Social anxiety disorder

While many of us experience a certain level of anxiety when it comes to social or performance situations, social anxiety disorder (sometimes known as social phobia) is a much more intense dread or fear of these sort of events.

Stressful events that may make you feel anxiety include meeting new people, dating, public speaking or eating or drinking in public. While most people will feel some level of anxiety during these situations, people who suffer from social anxiety disorder may experience more physical symptoms, such as a faster heartbeat, sweating, blushing and a wavering voice.

Panic disorder

If you have regular panic attacks that don’t appear to have any particular trigger, you may suffer from panic disorder. This sort of panic attack is incredibly intense and can be very frightening to experience. If you know what sort of situations can trigger a panic attack – for example, feeling claustrophobic – then you probably don’t suffer from a panic disorder.

Agoraphobia

Agoraphobia is the fear of being in a situation where you feel that escape or getting help if things go wrong would be impossible. This is often assumed to only happen in large open spaces, but agoraphobia is a complex condition that occurs in many different situations, such as on public transport or in particularly crowded spaces.

Like other anxiety disorders, you may have implemented a series of lifestyle changes so that you can avoid such situations – but this may not be a sustainable way to live, and you may need to consider seeking professional help.

Separation anxiety disorder

Separation anxiety disorder is most commonly experienced by children, and it refers to the feelings of anxiety or stress when you are away from your family members, particularly parents. These feelings can manifest themselves into a number of different anxiety symptoms, such as extreme crying, headaches, vomiting, temper tantrums or a refusal to sleep alone.

Other anxiety disorders

There are many other anxiety disorders that may require treatment, such as trichotillomania (hair pulling), dermatillomania (skin picking) and post-traumatic stress disorder (PTSD).

Causes of anxiety

There are many different causes of anxiety, and academic research institutions have studied this in order to find out more. The general consensus is that the root causes of anxiety disorders are genetics, a traumatic event, drugs (including alcohol and caffeine) and individual circumstances.

Whatever the cause or trigger of an anxiety disorder, it is important that you seek help from professionals. If you find that that your anxiety symptoms are impacting your day-to-day life, such as your work or your relationship with friends or family, then it may be time to see your doctor to talk about the different treatment options.

How can you treat anxiety?

There are many different treatment options when it comes to tackling anxiety disorders. It is likely that you will be advised to try psychological treatment before any medication is prescribed. These include:

• Cognitive behavioural therapy (CBT)
  Cognitive behavioural therapy is widely regarded as the most effective treatment for most anxiety disorders, particularly GAD. The idea of CBT is to get you to question the anxious thoughts that you have, while encouraging you to put yourself in situations that usually trigger anxiety. You will usually be required to meet with a trained professional for a weekly one-hour session for three to four months.
• Guided self-help
  You may be advised to complete a course, either from a book or on a computer, which will help you work through your own anxiety disorder treatment. This may be CBT-based, or you may be encouraged to attend a group course with others who are experiencing similar problems with anxiety disorder.
• Applied relaxation
  A slightly different way to treat anxiety disorders is to focus on relaxing your muscles, and a trained therapist can teach you the various techniques to use when you first notice feelings of anxiety.
• Medication
  After trying one or more psychological treatments, you will have your anxiety medically reviewed again. If it is decided that these treatments haven’t helped sufficiently, you may be advised to try medication. A GP can prescribe a variety of medications depending on your anxiety disorder, general medical condition and mental health.
  If you do go down the medication route, it is very important to make regular appointments with your doctor so that they can monitor your progress and any side effects.

What is addiction?

Addiction, like anxiety disorders, is a mental illness. It is the term used when you find yourself having no control over using, taking or doing something to the point that you are causing yourself harm. This is most commonly related to drug use, alcohol dependence or substance use, but there are plenty of other things that you can be addicted to, such as gambling, work, solvents, shopping and the internet.

If those with addiction try to stop doing, taking or using these things, they will start to feel unpleasant withdrawal symptoms that make it difficult to avoid the addictive substance without professional support.

What causes addiction?

Similar to anxiety disorders and other mental health disorders, it is difficult to pinpoint an exact cause of addiction. It can be caused by any number of factors, which can vary depending on the type of the addiction.

Drug addiction often materialises from the addictive nature of the substance itself. Drug use is often seen as an escape for people who are suffering, or it can create an artificial feeling of euphoria. A powerful urge to replicate that feeling again and again can develop into a drug addiction. Gambling addiction is similar in that we are always looking to replicate the high of winning – once it has become a habit, it is incredibly difficult to stop.

Some peer reviewed studies have suggested that addiction can be genetic, and we can inherit characteristics that make us more susceptible to addiction. Of course, environmental factors are also a huge factor, and addiction could be traced back to a traumatic event in our past. Finally, there is certainly a crossover between addiction and other mental health disorders.

Addiction and other mental health disorders

Studies have shown that high rates of people who suffer from addiction also have other mental disorders and vice versa. While these disorders can include depression, bipolar disorder, ADHD and psychotic illness, there is a very strong link between addiction and anxiety disorders.

People will often turn to alcohol or other drug use to help them deal with their anxiety. For example, people who suffer from social phobia may find that they turn to alcohol in social situations to remove their social inhibitions and alleviate their anxiety. The thought of being in social situations without drinking alcohol can then cause feelings of anxiety, creating a vicious circle.
This one example illustrates how easy it is for one mental illness to feed into another, and how easily an anxiety disorder can both cause, and be caused by, a drug addiction. This is often called dual diagnosis, or co-occurring disorders.

Co-occurring disorders

Dealing with any mental health issues, such as an anxiety disorder or addiction, is incredibly challenging on your own. When you have co-occurring disorders, it is very important that you seek help from medically trained professionals.

It can be difficult to diagnose co-occurring disorders initially. The symptoms and causes of two separate mental health disorders can often overlap. Take the above example of an anxiety disorder and alcohol addiction. We might find that certain social situations can make a person feel anxious, and they start to drink alcohol to help them relax. They may soon find that they turn to alcohol to prevent those feelings of anxiety appearing. Then, if they try to avoid alcohol, they will start to feel anxious again. At some point a physical dependence on alcohol has formed, and their anxiety disorder and alcohol addiction are intertwined.

When it comes to diagnosis, these blurred lines may lead to a focus on the addiction, and the anxiety disorder may be ignored. This means that the agreed addiction treatment may not be the best option, and the anxiety disorder may get even worse if it is left untreated.

However, if you speak to a professional who has experience in dual diagnosis, they will be well placed to recommend the best treatment options for you.

Treatment options for co-occurring disorders

There are numerous options when it comes to treatment for co-occurring disorders. It can, however, be difficult to determine exactly which one to take, as you will need to establish which mental health condition is causing the other.

Think of it as a big ball of mixed up string – if you pull hard at the wrong threads, you are just making you task more difficult. You need to take your time and slowly unravel some bits, until it becomes more straightforward. To use the anxiety disorder/addiction example, some medication prescribed for drug use could actually cause more anxiety, and the whole vicious cycle is set on course again.

Despite the various options, your treatment will follow the same basic principles:

• Detox:
  Usually with medical supervision, a detox will provide the perfect platform for your treatment, whatever your addiction or anxiety disorder. With any form of substance misuse, the first step is to remove any trace of the harmful substance from your system.
• Counselling:
  Both addiction and anxiety disorders are treated with counselling. This is your opportunity to develop new ways of thinking to make positive changes to your life. This is where you really start to work on your mental health.
• Individual ownership:
  If you are suffering from co-occurring disorders, you should understand that you will need to address both your addiction and anxiety disorder in order to give yourself the best chance at a full recovery. If you just focus on your anxiety disorder, you will probably find that your addiction will return after you complete your treatment. It is so important to address both of your conditions and to understand that your life will only move forward when you do.

Rehab options for co-occurring disorders

Whatever your addiction or anxiety disorder, you will have the option of inpatient or outpatient rehab. Outpatient rehab is when you are required to attend individual sessions, before returning home. Inpatient rehab, also known as residential rehab, refers to when you stay in a rehabilitation centre for the duration of your treatment.

It may be that your everyday responsibilities – such as childcare – lead you to opt for outpatient rehab. For co-occurring disorders, however, it is strongly recommended that you attend inpatient rehab if possible.

When you are staying in a centre’s premises, it will give you the best chance to combat your anxiety disorder and addiction. You will be removed from the situations that may have led you to feeling anxious or panicked, or where there is a temptation to take drugs or drink alcohol. You will have medical professionals on hand to monitor your medical condition during your detox or medication use, and to monitor your mental health. Your meals will be provided, which will help you start on a healthy diet, and the centre provides a clean and safe environment where substance use is impossible.

First steps toward anxiety and addiction treatment

It is important to remember that while co-occurring disorders, specifically an anxiety disorder and an addiction, are very challenging to overcome, they are treatable conditions. With the right treatment, and determination from you, both your mental health and medical condition will improve and you can make a start on your new life.

Get in touch with UKAT today and we can discuss your various treatment options. We are not specialists in treating co-occurring disorders, and require your mental health to be stable enough to begin addiction treatment. However, all of our workshops and meetings will address and support any mental health disorder, including anxiety disorders.