Studies show that 20 percent of individuals diagnosed with an anxiety disorder also have a substance use disorder. Since the symptoms of anxiety may resemble the side effects of alcoholism or drug addiction, distinguishing between the effects of anxiety or addiction can be difficult.

The Anxiety and Depression Association of America estimates that 20 percent of individuals diagnosed with an anxiety disorder also have a substance use disorder. Financial difficulties, health troubles, legal problems and relationship conflicts associated with substance abuse can cause a person’s anxiety to worsen. Since the symptoms of anxiety may resemble the side effects of alcoholism or drug addiction, distinguishing between the effects of anxiety or addiction can be difficult.

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Effects of Drug Use on Anxiety Symptoms

Substance use has a large impact on the psychological symptoms of anxiety. When someone consistently used drugs or alcohol for an extended amount of time, the individual’s body may develop a tolerance to the substance, which means he or she may need to increase his or her intake to get the same effects. This process may ignite a cycle of addiction that can be difficult to defeat without professional treatment.

Most individuals with substance use and anxiety disorders develop these struggles separately, but the combination of addiction and anxiety can be a huge burden on one’s mental and physical health.

Anxiety and Alcohol

When having to deal with stressful days or unnerving situations, it may be tempting to have a glass of wine or beer to calm the nerves. However, drinking alcohol, especially in large quantities and over a long period, can increase an individual’s alcohol-induced anxiety as their body adjusts to the volume of the substance and requires larger amounts to achieve the same effects. At the same time, if the individual ceases drinking, they will also experience negative symptoms from alcohol withdrawal. Anxiety is one of the most common symptoms.

An occasional drink to wind down isn’t necessarily hazardous, though once you start the occasional drinking, you can build a tolerance to the relaxing effects of alcohol. This behavior can make an individual drink more heavily and the stress even more difficult to cope with. Since drinking alcohol has a chemical effect on people, a chemical imbalance occurs due to consistent heavy alcohol use and can result in mental struggles, including anxiety. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), prolonged drinking may cause anxiety in some instances.

Marijuana and Anxiety

Marijuana use is strongly associated with generalized anxiety disorder. As the individual is commonly anxious or worried about circumstances in their life, such as relationships, they may rely on marijuana to relieve these stressful feelings. Marijuana may allow the individual to temporarily relax after a stressful day or during a nervous situation.

However, because the stress relief is only temporary, the euphoric high will eventually dissipate and the symptoms of anxiety often return. Marijuana may make a person feel normal temporarily, so the individual may desire to use the drug more often in order to suppress the feelings of stress. Constant marijuana use to subdue anxious feelings can cause a reliance on the drug to achieve a harmonious chemical makeup within the body. The lack of harmony when sober can cause an individual to experience negative feelings, which can create a stronger desirer use at times that may affect their school or risk their job and relationships. Relying on marijuana also could lead to using more addictive substances, such as opioids or stimulants, to feel calm for longer periods.

Stimulants and Anxiety

Stimulants are not helpful to individuals living with anxiety as these negative feelings are a well-known side effect of stimulant medications. Many children develop an anxiety disorder after taking prescribed stimulants to control their attention deficit hyperactivity disorder. Stimulants excite the central nervous system to release chemicals to send faster messages through your nerves and body. The release of these chemicals and the body’s quicker messaging can lead to more anxious feelings.

College students, even ones with anxiety, may take stimulants to help them stay up late studying or to prevent drowsiness during class or at work. This use may become addictive and lead to a dependence on the drug to function normally. This habit may create more stress by stimulating anxiety symptoms, creating a cycle of stress.

Drug Abuse as a Cause of Anxiety

Individuals struggling with anxiety are at a significant risk of developing an addiction to drugs or alcohol due to the symptoms of the mental illness. As unwanted symptoms develop, individuals who have anxiety may turn to substances to self-medicate and relax, putting the taxing symptoms on hold for a short time. People may use alcohol and drugs as an outlet to escape the reality of anxiety and produce a sense of happiness.

However, when someone becomes dependent on alcohol or drugs, they may experience severe anxiety when they are sober. This uncomfortable situation can lead an individual without prior anxiety to accumulate drug-induced or withdrawal-related anxiety symptoms. The continued substance abuse can lead to worsened anxiety and may also change the electrical connections in the brain. It is possible for an individual to obtain substance-induced anxiety disorder.

Drug Abuse as a Hindrance to the Treatment of Anxiety Disorders

It is possible for anxiety to go undiagnosed when substance use is involved because the effects of alcohol and drugs may mask the symptoms. It is common for an individual to be unaware that they have anxiety if they use drugs or alcohol whenever they feel stressed. For example, if someone drinks on a regular basis to relax, they might not recognize their tension as a symptom of a psychiatric condition. Once they find out they have a treatable mental health disorder, this could be a tremendous relief for someone who has been living a stressful life.

Regular use is often an attempt to self-medicate to escape the symptoms of anxiety disorder. For a successful recovery, treatment for the addiction and also the co-occurring disorder needs to be a priority during treatment.

Statistics on Anxiety Disorders and Drug Abuse

Between 18 and 28 percent of people in the general United States population have an anxiety disorder during any given year. Within this percentage of individuals with an anxiety disorder, there is a 33 to 45 percent occurrence rate for a co-existing substance use disorder.

Alcohol is one of the most common drugs consumed in the United States. A survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2012 showed that about 65 percent of people over the age of 12 reported drinking alcohol in the past year. The Anxiety and Depression Association of America states that 20 percent of people dealing with an anxiety disorder also suffer from some form of alcohol abuse or dependence.

Treating Anxiety and Co-Occurring Substance Use Disorders

Patients with untreated mental health disorders might turn to substance use as a way to temporarily soothe or self-medicate their symptoms. Alcohol and drugs change the brain’s chemistry, which may cause symptoms of anxiety in individuals with substance use disorder.

As with all co-occurring disorders, substance use and anxiety can complicate each other. If one only treats the addiction, it is possible that a recurrence of use will occur when anxiety returns. Also, if an individual only treats for anxiety, his or her continued substance use will most likely cause anxiety to return.

To effectively recover, individuals need to seek treatment for both issues simultaneously. A treatment plan that includes focusing on both issues may allow the patient to achieve recovery from both disorders effectively.

If you are or a loved one needs help or assistance in treatment, The Recovery Village can help. Facilities located in each region of the U.S. have the staff and resources available to provide treatment for substance use disorders and a co-occurring mental health issue. If you or a loved one has general anxiety, call The Recovery Village to speak with a representative about treatment options and the next steps in the recovery process.

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Editor – Devin Golden
Devin Golden has worked for various print and digital news organizations. Devin's family has been affected by addiction and mental health disorders, which is a large part of why he wants to help others who have either directly or indirectly been affected by these diseases. Read more
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Medically Reviewed By – Krisi Herron, LCDC
Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.