The last decade has seen a sharp rise in diagnoses for anxiety-related mental health disorders as well as rates of opiate and methamphetamine use and abuse. The co-occurrence of anxiety and chemical dependency might be more than a coincidence; one study found untreated childhood anxiety to be a reliable predictor of later drug use, and some researcherseven go so far as to say anxiety disorders directly cause addiction. Others hypothesize that both anxiety and addiction have a shared underlying cause, namely a malfunction in the synapses that form neural networks and dictate certain behaviors.
According to a review on anxiety and addiction published in 2008, substance abuse disorders have always had high rates of comorbidity with a range of anxiety disorders including generalized anxiety disorder (GAD), panic disorder (PD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and social phobia (also known as social anxiety disorder). And it doesn’t stand alone; study after study has repeatedly linked OCD with smoking
The 2008 study draws a distinction between substance dependency and substance abuse, concluding that individuals with anxiety were more likely to struggle with the former than the latter, and that anxiety disorders predated substance use in “at least 75% of cases.” At the time, researchers wanted to explore genetic predispositions and “anxiety sensitivity” as pathways to addiction but concluded further research was needed.
On the other hand, neuroscientists hypothesizethat a person’s neurology, rather than genealogy, leads to both addiction and anxiety. Certain patterns of neuronal and synaptic plasticity (the brain’s ability to change over time) lead to the disease or disorder, they argued, and could be treated by altering the affected neural circuits. It turns out psychologists have been usingbehavioral therapy, mindful meditation, and the brain’s plasticity to treat addiction for some time, perhaps whether they knew it or not.
When a person uses drugs or alcohol to self-medicate, more receptors for that substance build in the brain. Detoxing from narcotics can therefore be a painful process, and physically and mentally exhausting, in part because it takes time for those receptors to start dying from lack of use. Dr. Joseph Troncale writesthat addiction and anxiety reinforce one another, particularly when it comes to seeking treatment. If not done properly, says Dr. Troncale, patients can “experience panic…and may even have a seizure because of the extreme over-activity of the brain in withdrawal.” This can create a cycle of anxiety and substance abuse where patients start then abruptly stop a panic-inducing detox to self-medicate.
It is important for those with a dual diagnosis of anxiety and chemical dependency to understand the underlying neural impulses and networks that fuel their addictive symptoms, including intense drug cravings, withdrawal symptoms like dysphoria and panic, and even the thought patterns and personal beliefs that trigger usage. Once the medical detox is complete, you can begin to work on rewiring your brain to crave more constructive activities and behaviors. With cognitive-behavioral therapy, twelve-step programs, contingency-management interventions, family and individual counseling, or a combination of treatments, patients can learn to replace dysfunctional thought structures and destructive habits with healthy coping strategies like meditation, working out, and community involvement.