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Anxiety is a natural human emotion. Everyone feels anxiety at some point in their lives. Anxiety arises from various causes, including certain events, people, or situations that lead to worry, concern, or discomfort about what the future holds. There are many examples of day-to-day, anxiety-producing events. These may include changing schools, starting a new job, going to a job interview, getting married, having a baby, and many others. In most cases, feelings of anxiety subside soon after the event is over.

However, feelings of intense anxiety turn to terror and become so overwhelming that they lead to panic attacks in other cases. When someone struggles with an anxiety disorder, they experience overwhelming, persistent, and excessive feelings of worry or fear about everyday situations. More often than not, the symptoms are impossible to control and out of proportion to the actual danger that may occur. They can lead someone to actively avoid people, places, or events that may bring about anxious feelings. Some people look to dull the feelings of anxiety through self-medication. When they experience worry or fear, or even panic, they reach for alcohol to help bring about a sense of calm and relaxation. Unfortunately, using alcohol to manage anxiety symptoms leads to a range of additional problems, including the physical and psychological impacts of a substance use disorder or alcohol addiction.

When you have both anxiety and an alcohol use disorder, you have what is referred to as a co-occurring disorder or dual diagnosis. This means you struggle with symptoms from both conditions, and it is important to seek care in an environment where you can learn to understand and manage all of your symptoms as part of one comprehensive treatment program. The most effective dual diagnosis treatment programs consist of a series of interventions, including assessment, detox, therapeutic interventions, and aftercare planning. At a dual diagnosis treatment program for alcohol use and anxiety, you will learn more about how mental health and alcohol use disorder symptoms overlap while practicing the most effective ways to manage both conditions.

What is Anxiety?

Anxiety is more than simple worry or fear. It is a persistent and ongoing struggle that interferes with your day-to-day life. For many, symptoms of anxiety begin as early as childhood and continue into adulthood. There are several types of anxiety disorders, including social anxiety disorders, phobias, generalized anxiety disorders, and separation anxiety. It is possible to have one or multiple anxiety disorders. Regardless of the type of anxiety you struggle with, it is essential to seek professional help at a treatment center, so you safely overcome anxiety and leave treatment with the tools and skills necessary to cope with triggers without turning to substances.

According to the National Alliance on Mental Illness (NAMI), anxiety disorders are the most common illness in the United States. Data shows that as many as 19% of the population of about 40 million adults over age eighteen struggle with anxiety. Like addiction, anxiety disorders are treatable, yet few of those who could benefit from treatment ever seek or receive the help they need. The Anxiety and Depression Association of America (AADA) estimates less than 37% of people who have an anxiety disorder get treatment.

Types of Anxiety

The Diagnostic and Statistical Manual for Mental Disorders lists diagnostic criteria used by mental health providers to diagnose anxiety disorders. While there are several possible diagnoses, five specific types are more common among the population than others.

Generalized Anxiety Disorder

Someone with a generalized anxiety disorder experiences chronic anxiety symptoms. They struggle with feelings of heightened worry and tension regardless of whether there is a reason to feel such emotions.

Obsessive-Compulsive Disorder (OCD)

Someone with obsessive-compulsive disorder experiences recurrent and unwanted thoughts also referred to as obsessions coupled with repetitive behaviors or compulsions. Repetitive behaviors may include tasks such as checking, cleaning, counting, or even hand washing. Compulsions are performed in the hopes of reducing the intensity and severity or even the presence of obsessions. Compulsions are also referred to as rituals, and unfortunately, despite their interference with one’s day-to-day activity, they only provide temporary relief. However, failure to perform them often leads to excessive anxiety.

Panic Disorder

Panic disorders are a type of anxiety disorder characterized by repeated and often unexpected episodes of overwhelming fear. Fear is accompanied by a range of physical challenges, including racing heart, difficulty breathing, stomach problems, and others.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder often occurs after you experience an event that leads to harm or the threat of harm. Examples occur natural disasters, assault, violence, and accidents. Soldiers who serve on active combat deployments experience high rates of post-traumatic stress disorder.

Social Phobias

Social phobias are also referred to as social anxiety disorders. Someone with a social phobia experiences uncontrollable anxiety and feelings of self-consciousness during everyday social situations.

Symptoms of Anxiety

Anxiety is more than a singular diagnosis. It is a group of related conditions, each with common and unique symptoms. The most common symptom experienced across all anxiety disorders is persistent and excessive fear in unthreatening situations. People with anxiety experience a range of emotional and physical symptoms. Common emotional symptoms may include restlessness, irritability, feelings of dread, feeling "jumpy" or tense, and being hypervigilant (always on the lookout for danger). Physical symptoms of anxiety may include shortness of breath, racing heart rate, sweating, fatigue, insomnia, headache, and stomach disturbances.  

Anxiety Disorder Causes and Risk Factors

Research has not provided a singular cause or risk factor that increases one's risk for developing an anxiety disorder. Studies indicate it is likely a combination of several factors, including genetic and environmental elements. Some studies show that anxiety disorders have a genetic connection as some families have multiple individuals with anxiety disorders among relatives. Additionally, research shows that you are at an increased risk for developing anxiety if a first-degree relative struggles with an anxiety disorder.

Anxiety often arises out of environmental or social situations. Some research indicates you may be at an increased risk for developing an anxiety disorder if you experience a stressful or traumatic event. For example, violence, abuse, prolonged illness, or a natural disaster may lead to the development of anxiety.

Understanding Alcohol Addiction

Alcohol addiction, also referred to as alcoholism or more commonly an alcohol use disorder is a disease that is characterized by the inability to reduce or stop drinking alcohol. Someone who struggles with an alcohol addiction will continue to drink despite knowing their drinking leads to harmful consequences. Alcohol addiction is a disease that affects the brain. Long-term struggles with alcohol will lead to structural and functional changes in the brain, some of which may be permanent.

Alcohol use disorders are a struggle faced by many Americans of all ages. The Substance Abuse and Mental Health Services Administration indicates thousands of adolescents and teens, some as young as age twelve, have an alcohol use disorder or “alcoholism.” Data from the National Survey on Drug Use and Health indicates more than fourteen million adults over the age of eighteen and another 414,000 adolescents and teens ages twelve to seventeen had an alcohol use disorder as of 3 years ago.

Alcohol and Anxiety

Depending on the severity of anxiety symptoms, people often turn to a range of self-medication options to help them relax. One such option is alcohol. Unfortunately, chronic alcohol abuse can lead to a range of mental health conditions, including new or worsening anxiety symptoms. In fact, studies have proven that someone struggling with an alcohol use disorder also has difficulties recovering from trauma which can lead to anxiety and anxiety disorders.

When you drink alcohol, it increases the levels of certain neurotransmitters in your body. Two specific neurotransmitters impacted by alcohol use include serotonin and dopamine. Although the increase in the levels of these chemicals provides a sense of relaxation, happiness, and calm in the short term, it can eventually lead to increased anxiety once the effects of alcohol wear off. This is sometimes referred to as alcohol-induced anxiety, and its symptoms can last for hours after your last drink.

Alcohol-induced anxiety is not uncommon. Many people turn to alcohol to cope with symptoms of other anxiety disorders such as panic disorders, social anxiety disorders, and post-traumatic stress disorder. The Anxiety and Depression Association of America indicates approximately 7% of Americans have alcohol-induced anxiety. Using alcohol to reduce or manage the severity of symptoms is not without potential dangers.

Social anxiety disorders are another form of anxiety that frequently contributes to struggles with alcohol. The same report from the Anxiety and Depression Association of America notes that approximately 20% of people who experience symptoms of social anxiety also have an alcohol use disorder. People who have social anxiety struggle to feel comfortable in social settings. Alcohol often helps to reduce feelings of discomfort and increase social capabilities.

Another challenge related to alcohol and anxiety occurs after a night of drinking. Most people who drink to excess will experience a hangover the following morning. Unfortunately, the symptoms of a hangover, such as dizziness, nausea, headache, low blood sugar, and dehydration, may also worsen anxiety symptoms.

The only safe and effective way to address co-occurring anxiety and alcohol use disorders is to seek treatment at a treatment center that specializes in dual-diagnosis treatment. At a dual-diagnosis treatment center, specialists skilled in addressing the unique nature of simultaneously occurring conditions will help you address your symptoms and learn healthier, safer ways to manage triggers. Not all treatment centers are equipped to manage dual diagnosis, so it is important to seek out a treatment center where the staff is trained to address these treatment needs.

Getting Treatment for Alcohol Use and Anxiety Disorder

When you struggle with both a mental health condition such as anxiety and a substance use disorder, it is referred to as having a dual diagnosis or co-occurring disorder. Some statistics show as many as half of those who struggle with a mental illness also experience symptoms related to a substance use disorder. Also, statistics from the Substance Abuse and Mental Health Services Association (SAMHSA) indicated more than 8.5 million adults (or 4% of the population) over the age of eighteen struggled with a dual diagnosis 4 years ago. Dual diagnosis conditions such as alcohol addiction and anxiety share many overlapping symptoms, and the best opportunity for recovery is to choose a treatment program where dual diagnosis treatment is available.

At a dual diagnosis treatment program, your treatment team will work with you to design a plan that addresses all areas of your physical and psychological health. Through comprehensive, evidence-based therapy techniques, you will learn how to identify and change the thoughts and behaviors that have led to maladaptive and addictive behaviors, such as using alcohol to self-medicate. Another significant benefit to choosing a dual-diagnosis treatment program is learning how to identify triggers. When you struggle with anxiety, simple day-to-day situations or obligations can be triggering. Learning how to manage triggering places, people, or events without using alcohol is a vital part of recovery from both an anxiety disorder and an alcohol use disorder. Learning about and how to use healthy coping strategies to handle triggers is a vital part of ongoing recovery and relapse prevention.

If you or a loved one struggles with a dual diagnosis like anxiety and an alcohol use disorder, seeking dual diagnosis treatment is a vital part of your recovery. Although treatment of any kind is an important first step, completing a treatment program that addresses the needs of only one condition increases your potential for a relapse in symptoms and a return to using alcohol to cope. Not all treatment programs are designed to treat dual diagnosis conditions, and therefore, it is vital to find one where your treatment needs will be met.