Dual diagnosis is a term used to describe coexisting disorders of addiction and mental illness when they occur together.
Current research has established that mental health disorders and alcoholism are closely linked. Unfortunately, when they occur together, they are often misdiagnosed and poorly treated.
Anxiety and alcoholism are two of the most prevalent mental disorders in the United States, with symptoms that range in levels of severity from mild to debilitating.
People with anxiety and other mood disorders are almost three times more likely to develop alcoholism or other substance use disorders than the general population.
How Addiction Affects Anxiety Disorders
Co-occurring disorders are often difficult to treat due to the unstable nature of the patients who have them.
When a person with anxiety self-medicates with alcohol or drugs, it exacerbates symptoms of mental illness, often leading to severe and chronic mental distress.
Without proper mental health treatment, people with anxiety may self-medicate with alcohol for many years, in an attempt to gain relief from symptoms of anxiety. When left untreated, both anxiety disorder and alcoholism often lead to poor health outcomes.
Because of the close relationship between anxiety and alcoholism, mental health disorders and alcoholism are now commonly treated together. This helps achieve higher rates of recovery.
Types Of Anxiety
Anxiety often causes a person to feel hypervigilant and suffer from constant negative thoughts and emotions.
There are five major types of anxiety disorder, that vary in presentation and symptoms.
These disorders include:
- Generalized Anxiety Disorder (GAD) — an anxiety disorder characterized by chronic anxiety, exaggerated worry, and tension without cause or reason
- Obsessive-Compulsive Disorder (OCD) — an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions)
- Panic disorder — characterized by unexpected and repeated episodes of intense fear and physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress
- Post-Traumatic Stress Disorder (PTSD) — an anxiety disorder that can develop after exposure to trauma or physical harm, such as assault or combat
- Social Phobia, or Social Anxiety Disorder — an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations
Why Anxiety And Alcoholism Occur Together
People with alcoholism are much more likely to develop symptoms of mental illness. In turn, those with a mental illness are at higher risk of alcohol or drug use.
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However, researchers cannot determine why this happens, or why alcoholism and mental health disorders co-occur together so frequently.
They believe substance abuse and mental disorders may develop together due to one or more of the following reasons:
- common risk factors such as genetic predisposition (family history), stress, and trauma
- underlying mental health disorder as a driving factor of alcoholism
- alcoholism as a contributor to the development of mental illness
People with both anxiety disorder and alcohol abuse problems may have a harder time in recovery, compared to people who only struggle with one disorder.
Common Symptoms Of Anxiety And Alcoholism
The co-occurrence of substance abuse, particularly alcohol abuse, is common among people with an anxiety disorder.
People with this disorder may believe that alcohol helps lessen their anxiety, although it often leads to more severe symptoms.
Symptoms of anxiety include:
- low energy and lethargy
- restlessness, agitation, or tension
- difficulty concentrating
- muscle tension
- poor digestion
- insomnia or disrupted sleep patterns
- panic attacks
When anxiety is treated by a qualified physician, psychotherapy and prescription medications that include serotonin reuptake inhibitors (SSRIs) are often prescribed.
Alcoholism may develop after the onset of untreated mental illness or other mood disorders. When an individual finds it difficult to cope with daily life without drinking alcohol, it is likely they are exhibiting symptoms of alcohol use disorder.
Some symptoms of alcoholism include:
- being unable to stop alcohol consumption
- alcohol cravings
- continuing to drink alcohol in spite of negative consequences
- consuming alcohol in unsafe situations, such as driving
- increased tolerance of alcohol that leads to needing more alcohol to gain the same effects
- experiencing withdrawal symptoms when attempting to stop drinking
Over time, a person who self-medicates with alcohol may develop a tolerance to the substance and require more to gain the same effects. As this occurs, both physical and chemical dependency develop together.
Treatment For Anxiety And Alcoholism
A dual diagnosis condition may require the treatment of both co-occurring disorders, such as alcoholism and symptoms of anxiety, at the same time. Treating these disorders together is often more complex than treating substance abuse alone.
Drugs and alcohol change the way neurotransmitters within the brain process information, directly influencing the pleasure and reward centers of the brain. The chemical changes caused by alcoholism often lead to dramatic fluctuations in mood.
Further, individuals who struggle with prolonged alcoholism or substance abuse may no longer be able to experience normal and regulated emotions. This means they may not be able to have feelings of reward, pleasure, and happiness without the presence of alcohol.
When a person who has both anxiety and alcoholism suddenly quits drinking, they may find themselves unable to cope with negative emotions, increased anxiety levels, and withdrawal symptoms that occur as they begin to detox.
Safe and effective substance abuse treatment for this dual diagnosis condition requires addressing:
- all factors of addiction
- mental health issues
- the person’s overall physical condition
Getting Help For Addiction
Without medical assistance, people with both alcoholism and anxiety may struggle with heavy drinking and symptoms of mental illness for many years.
Several addiction treatment options and alcohol treatment programs are available to support the safe withdrawal from alcohol abuse for those with a co-occurring mental illness.
Dual diagnosis treatment addresses the unique needs of the patient and may be performed on both an inpatient and outpatient basis.
If you, a family member, or a loved one suffer from alcoholism and anxiety, please connect with our treatment center through our helpline today to learn about treatment options.
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- U.S. Department of Health & Human Services — What are the five major types of anxiety disorders?
- ProQuest — Anxiety and addiction: A clinical perspective on comorbidity
- National Alliance on Mental Illness (NAMI) — Substance Use Disorders
- National Institute on Alcohol Abuse and Alcoholism — Alcohol’s Effects on Health
- National Institutes of Health — The Challenge of Dual Diagnosis
- National Center for Biotechnology Information — Anxiety and Substance Use Disorders: A Review