anxiety word cloudAnxiety or feeling anxious at times is normal for people. There are potential problems everywhere and people with generalized anxiety disorders worry about things that ‘might’ happen more than others. Anxiety fuels addictions to alcohol, drugs, both illegal and by prescription to temporarily quiet the symptoms.  Acute anxiety is experienced during detoxification withdrawal symptoms from both anti-anxiety drugs and alcohol and can lead to a seizure if not treated properly.

If you are struggling with clinical anxiety, you are not alone. According to the nonprofit Anxiety and Depression Association of America, approximately 40 million US adults experience some type of anxiety disorder, nearly 1 in 5 people.

Lasting Recovery has a mental health treatment program that can help. After you receive education about your illness and evidence-based therapies, you will be in a better position to manage your symptoms and live the happier and more balanced life that you deserve.

“(The LR Staff) allow personal attention. My last recovery program did not give me one on one time with my therapist,  nor acknowledgment of my anxiety. With Lasting Recovery, I received both”.


What is Anxiety Disorder?

“Anxiety Disorder” is a blanket term for a group of mental illnesses that are characterized by overwhelming, often debilitating, feelings of fear and anxiety. While everyone experiences these “normal” emotions from time to time, clinical anxiety differs because the feelings persist and worsen.
Anxiety disorders rarely go away on their own, and left untreated, they can progress to the point that they interfere with your ability to function in your daily life.

What is the Difference Between Anxiety Disorder and Stress?

Because “anxiety” is the word we use to describe both a diagnosable mental disorder and the emotion we feel when we are worried or stressed, it is important to highlight the differences.

Stress can be defined as a reaction to a problem, event, or experience that threatens us physically or mentally.

Anxiety can be defined as a reaction to stress. It is the worry, fear, and other physical and emotional symptoms – avoidance, hyper-vigilance, “fight-or-flight”, etc.

Here’s the key difference – these reactions go away when the underlying issue is resolved or removed. If there is no longer a problem, then the stress and the anxiety soon disappear.

Clinical Anxiety, on the other hand, persists long after any presenting stressors are removed. The person still experiences worry and fear and everything else, but it does not go away, even when there is no present threat of harm.

In other words, instead of feeling justified and even concern or worry, they are overwhelmed by irrational fear.

Anxiety Disorders vs Social Anxiety

We all experience anxiety during stressful moments such as job interviews, public speaking, and social situations. But if our anxiety becomes chronic or debilitating, we may be diagnosed with an anxiety disorder. Anxiety disorders can come in many forms, including generalized anxiety disorder, social anxiety disorder, and post-traumatic stress disorder. It’s important to note that anxiety disorders must be diagnosed by a mental health professional and must meet distinct clinical criteria. They are different than the anxiety we feel during everyday life situations like meeting new people in a social situation or hosting an important meeting.

What Causes an Anxiety Disorder?

There are several factors that may contribute to the development of an Anxiety Disorder, either alone or in combination. It is important to note that these factors often overlap, further increasing the likelihood.

  • Genetics: Anxiety Disorders run in families. Up to a third of the risk is inherited. For example, the children of someone with Generalized Anxiety Disorder are six times more likely to also develop the condition.
  • Underlying Medical Conditions: Diabetes, Heart Disease, Endocrine Diseases, and Chronic Obstructive Pulmonary Disease (COPD) have all been linked to a higher incidence of Anxiety Disorders.
  • Stress: There is also a correlation between chronic stress and Anxiety. This can come from health problems, financial worries, social justice concerns, and increasingly, the isolation caused by the COVID-19 coronavirus.
  • Substance Use: Anxiety levels can be elevated significantly by the use of or dependence on mood-altering substances, especially alcohol, marijuana, and benzodiazepines. In fact, nearly half of people who are diagnosed with a Substance Use Disorder also meet the criteria for a diagnosis of Anxiety Disorder.

Types of Anxiety Disorders

man struggling with anxiety disorderThere are several different types of anxiety disorders, each manifesting in different ways and requiring distinct treatment strategies. It is possible to have multiple types of varying severity.

  • Generalized Anxiety Disorder (GAD): Non-specific, excessive, and persistent worry and fear, often characterized by over-concern with everyday matters. GAD is the most common anxiety disorder among older adults.
  • Specific Phobias: Cases, where extreme anxiety and fear are triggered by specific situations or stimuli, make up the largest category of anxiety disorders, affecting up to almost 9% of the US population. 1 in 5 cases of phobia is “severe”, to the point of interfering with other areas of life.

While the trigger can literally be anything, common phobias include:

  • Agoraphobia – fear of open spaces
  • Germophobia – fear of germs or contamination
  • Nosophobia – fear of contracting a disease
  • Necrophobia – fear of death
  • Monophobia – fear of being alone
  • Panphobia – fear of everything
  • Social Anxiety Disorder (SAD): Extreme distress and emotional distress in social situations. A person with severe SAD may miss out on social or career opportunities to accommodate their illness.
  • Panic Disorder: Recurring episodes of fear and anxiety to the point of terror. The physical symptoms of a panic attack can be so severe as to resemble a heart attack. At increased risk of PD are victims of past child abuse.

Anxiety Disorder Symptoms

Every anxiety disorder is characterized by several distressing emotional and physical symptoms. These will manifest differently in every individual, depending on the severity of their condition, ranging from merely uncomfortable to completely debilitating.

  • Exaggerated response to being startled
  • Difficulty in concentration
  • Mind going blank
  • Irritability
  • Irrational fear
  • Insomnia or sleep disturbance
  • Dizziness
  • Fainting
  • Depersonalization
  • Feelings of unreality
  • Thoughts that they are losing control or going crazy
  • Fear that they are dying
  • Feeling on edge
  • Panic
  • Restlessness
  • Inability to relax
  • Nausea
  • Stomach pain
  • Muscle tension and aches
  • An urge to flee or escape
  • Feelings of impending doom
  • Crying
  • Hot flashes
  • Cold chills
  • Excessive sweating
  • Trembling or shaking
  • Numbness
  • Tingling
  • Dry mouth
  • Inability to speak
  • Difficulty swallowing
  • Choking sensation
  • Difficulty breathing
  • Hyperventilation
  • Chest pain
  • Heart palpitations
  • Freezing up
  • Sexual dysfunction

Anxiety and Substance Abuse

Of special relevance to people with any kind of Substance Use Disorder, there are many drugs that can cause or worsen an anxiety disorder. This can happen with chronic use, intoxication, or even withdrawal from substances such as:

  • Opioids (OxyContin, Vicodin, Oxycodone, Fentanyl, Codeine, Heroin, etc.)
  • Benzodiazepines (Xanax, Valium, Klonopin, Ativan, etc.)
  • Stimulants (Adderall, Ritalin, Concerta, Methamphetamine, Cocaine, Caffeine)
  • Hallucinogens (Cannabis, Peyote, LSD, Ecstasy, magic mushrooms, etc.)
  • Inhalants (Model Glue, Acetone, Gasoline, Spray Paint, Butane, Nitrous Oxide, Amyl Nitrate “Poppers”, etc.)
  • Alcohol
  • Tobacco

The relation between addiction and Anxiety is complicated and dysfunctional, because each illness causes, is caused by, and worsens the other.

For example, did you know that having Anxiety is one of the leading predictors of Alcohol Use Disorder?

Many people suffering the mental anguish that accompanies an Anxiety Disorder will often turn to alcohol or drugs in an attempt to alleviate their symptoms. They hope that by getting high or drunk, they won’t be quite so afraid all the time.

But here’s the insidious truth – substance abuse ALWAYS creates more problems – DUIs, legal issues, health issues, relationship difficulties, etc.

The result? More reasons to be anxious.

After temporary artificial relief, they feel worse than they did before. To cope, the person drinks and uses, even more, resulting in more problems and triggering more anxiety.

It becomes a self-perpetuating downward spiral.

Even more relevant, if the roots of the anxiety – the unresolved personal trauma, for example – are not addressed, then the person will continue to suffer.

What Anxiety Does to You

woman in bed struggling with anxiety disorderAnxiety Disorder is more than just the catalog of symptoms and how they make you feel mentally, physically, and emotionally. The truest test for an existing mental illness is the effect that it has on the rest of your life.

Clinical anxiety can manifest so severely as to affect other areas of your life. It can disrupt relationships, negatively impact your social life, cause difficulties at work or school, isolate you, and otherwise make your life completely unmanageable.

For example, a person suffering from severe agoraphobia may be too afraid to leave their home, to the point that they are unable to work, go grocery shopping, or have any kind of social life.

How is a Medical Diagnosis of an Anxiety Disorder Made?

It can be difficult to diagnose an anxiety disorder because there are no objective blood or lab tests that can detect it. The diagnosis depends completely on the presence of symptoms. But because so many of these symptoms can also be attributed to other conditions, clinicians use in-depth questionnaires to establish an accurate diagnosis.

Some of the questionnaires that may be employed as diagnostic tools include:

  • State-Trait Anxiety Inventory (STAI)
  • Generalized Anxiety Disorder 7 (GAD-7)
  • Beck Anxiety Inventory (BAI)
  • Zung Self-Rating Anxiety Scale
  • Taylor Manifest Anxiety Scale
  • Hamilton Anxiety Rating Scale
  • Hospital Anxiety and Depression Scale (HADS)
  • Patient Health Questionnaire (PSQ)
  • Patient-Reported Outcomes Measurement Information System (PROMIS)
  • Liebowitz Social Anxiety Scale (LSAS)
  • Social Interaction Anxiety Scale (SIAS)
  • Social Phobia Inventory (SPIN)
  • Social Phobia Scale
  • Social Anxiety Questionnaire (SAQ-130)

Differential Diagnosis

Because anxiety disorders share so many symptoms with other illnesses, doctors must rule out other medical conditions before they can make an accurate diagnosis. Some of the diseases that have symptoms resembling an anxiety disorder include:

  • Dementia
  • Parkinson’s Disease
  • Huntington’s Disease
  • Multiple Sclerosis
  • Anemia
  • Inflammatory Bowel Disease
  • Celiac Disease
  • Non-Celiac Gluten Sensitivity
  • Heart Disease
  • Vitamin Deficiency
  • Diabetes
  • Hyperthyroidism

For patients with a personal history of substance abuse also have to rule out drug intoxication or withdrawal as the cause.

Seeking Help for Anxiety Disorder

woman dealing with trauma being supportedIt is important to understand that clinical Anxiety is a legitimate medical condition, not a sign of emotional weakness. You should not feel ashamed because you need help, any more than you would with other illnesses such as diabetes, cancer, or high blood pressure.

If excessive fear and worry are interfering with your ability to live a normal life, the very first thing you should do is talk to a qualified mental health professional. Once the correct diagnosis has been made, an individualized treatment plan can be made and real recovery can begin.

Treatment for Co-Occurring Disorders

Getting the right professional help becomes even more crucial when Anxiety and Substance Use Disorder present at the same time.

When mental illness and addiction co-occur, successful recovery gets even more complicated. Without the proper treatment plan, the specific difficulties associated with each disorder hinder forward progress.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends just one strategy for this kind of dual diagnosis – Integrated

Under this treatment plan, patients are individually evaluated and treated by a single team of professionals working together, rather than by independent providers at separate facilities.

There are a number of advantages to this approach.

  • When addiction specialists, counselors, mental health professionals, and medical personnel are able to work in cooperation under the mutual umbrella of a shared treatment philosophy, there is a far better chance of a positive outcome.
  • Cooperation, communication, and teamwork mean that any issues are immediately addressed by all parties, making it easier to implement any adjustments to the treatment plan.
  • Providers can treat BOTH conditions as the primary disorder. This is absolutely essential because since both Anxiety and SUD worsen each other, both must be addressed simultaneously. Treating them separately invariably leads to recovery setbacks or even relapse.

Treatment for addiction and these co-occurring disorders leads to improved physical health, increased enjoyment, and an overall healthier lifestyle.

Unfortunately, and despite SAMHSA’s endorsement, most drug and alcohol rehab programs still do not offer integrated treatment, primarily because this approach requires quite a significant commitment on the part of the rehab, in terms of personnel, time, training, and other resources.

As a result, only 3% of patients with a dual diagnosis actually receive the professional treatment they need for both their addiction and their Anxiety.

The Lasting Recovery Approach

As the oldest and most trusted outpatient drug and alcohol rehab program in San Diego, Lasting Recovery employs a treatment strategy that is both evidence-based and wellness-focused. To support your complete recovery, we use science-based treatment strategies and accepted holistic therapies.

Specifically for Anxiety, Lasting Recovery offers Cognitive Behavioral Therapy and Mindfulness Meditation as primary first-line treatments. CBT can help to reduce the symptoms of anxiety that hold you back in your life and contribute to relapses of substance use.

Lasting Recovery – “Where Wellness Begins…”

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