woman coping with both a substance addiction and a co-occurring anxiety disorder

How Anxiety and Addiction Affect One Another


Sober Recovery Expert Author

woman coping with both a substance addiction and a co-occurring anxiety disorder

It was an otherwise ordinary afternoon with no unusual stress. After work, I stopped at a grocery store in Seattle. I grabbed a cart and joined the crowds rushing down the aisles.

I reached for an item on the shelf when a sudden wave of dizziness hit me followed by sharp stabbing pains in my chest. My heart was pounding loud enough that everyone must have heard it. My head was spinning a mile a minute. I couldn't breathe, there was no other sound...just my heartbeat.

Does a person's anxiety trigger substance abuse or vice versa?

Everything faded in the distance. I nearly passed out. My whole body was shaking. I braced myself against the shopping cart before almost collapsing. By this time the manager had been alerted and people swarmed around me. The paramedics were called because they were sure I was having a heart attack.

Maybe I was dying. That's what it felt like.

But, I wasn't dying, I had just endured my first panic attack. My life changed forever that day. That was over 20 years ago and I have lived with panic attacks ever since.


Anxiety and addiction seem to go hand in hand. Although they are two separate afflictions it's common for people to battle both simultaneously. My first panic attack was early in recovery. Although I had experienced anxiety for as long as I could remember, I had never had panic attacks before that day in the grocery store.

Thankfully, they are not all that severe.

Researchers have found that the origins of addiction for many are rooted in social anxiety. It's estimated that 20 percent of people with a social anxiety disorder also suffer from alcohol abuse or dependence. And, it's common for people with a social anxiety disorder (and other anxiety disorders) to drink or use drugs to self-medicate. But, it becomes a vicious cycle because when the buzz wears off, the anxiety returns.

This is how it started for me at age 13. I didn't know the uneasiness I felt was called anxiety. My friends and I would joke that we needed some more "liquid courage" at parties. Drugs and alcohol were everywhere in high school so when I felt anxious, it was an easy fix. I felt the gnawing uneasiness melt away, and drugs and alcohol became my best friends.

Identifying Anxiety

Everyone feels anxious at times. It's also normal to experience some degree of anxiety during different stages of recovery. However, if your occasional anxiety becomes chronic or debilitating, interferes with your daily life, or causes you to self-medicate, it may be time to take a closer look at your symptoms.

In 1987, psychiatrist and researcher Dr. Michael Liebowitz published The Liebowitz Social Anxiety Scale (LSAS) designed to measure how social anxiety affects people in their daily lives. The self-test is not meant to diagnose anxiety or another mental health condition, and you should always consult your doctor or therapist for an official diagnosis.

A Closer Look

  • Anxiety disorders are the most common mental illness in the U.S.
  • 40 million adults in the United States age 18 and older, or 18.1% of the population are living with anxiety.
  • Though highly treatable, only 36.9% of anxiety disorder sufferers receive treatment.
  • Individuals with an anxiety disorder are 3 to 5 times more likely to seek medical attention and 6 times more likely to be hospitalized for psychiatric disorders than those who don't suffer from anxiety disorders.
  • Disorders stem from compounded risk factors including genetics, brain chemistry, personality, and life events.

Effectively managing anxiety can help optimize your recovery and prevent relapse. It's important to realize that it's not a sign of weakness to admit to struggling with anxiety. Some people suffer in silence due to the stigma.

You are not alone, that's for sure.

Coping Strategies

Whether you're experiencing anxiety for the first time in recovery or have been battling it for years, there are coping strategies and treatments available.

Some of my personal favorites are:

  • Unplugging from the news
  • Trying not to overload my schedule
  • Exercising to burn off excess adrenaline
  • Getting plenty of sleep
  • Minimizing sugar and caffeine

"Let me think about it" has become a part of my vocabulary. I make "mini amends" with others right away to avoid obsessing about what may simply be a misunderstanding or miscommunication. It's easier to sort things out with people than to lose sleep worrying.

I rarely go into large grocery stores anymore but if I'm feeling courageous enough to venture inside Costco, I'll definitely be wearing my aromatherapy essential oils necklace. It allows me to discreetly sniff calming Lavander in the checkout line. Cooking and baking help me relax, and journaling has also been helpful over the years.

Some find deep breathing, Yoga, mindfulness, CBT (Cognitive Behavior Therapy), and support groups all useful in combating anxiety. Others find that volunteering helps them get outside of themselves and not be so self-conscious.

Sometimes just meeting a friend for coffee and talking through life or attending a recovery group meeting helps ease the pressures of life. There are apps available for relaxation and stress reduction. You need to find what works for you and be willing to try things that may be outside of your comfort zone.

In more serious or acute cases of anxiety, medications may be indicated. There is a particular class of habit-forming medications used to treat anxiety called benzodiazepines, but these should be used with extreme caution. The goal for medication use in treating anxiety should be short-term and combined with counseling and close medical supervision.

A Personal Note

You will likely experience some anxiety alongside your recovery. There's a part in the Serenity Prayer that talks about accepting the things we can not change. We do not necessarily have to embrace our anxiety. Sometimes it can just feel like that pesky kid brother following us around. What we can do is strive to live our best lives in spite of it.

If you or someone you know struggles with anxiety or panic disorder, you can look at a directory of anxiety-and-panic-disorder treatment centers or call 800-772-8219 to discuss more options.

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