Addiction and mental illness often coexist for various reasons. Sometimes, the symptoms of undiagnosed mental illness can push someone to the point where they seek out ways of feeling better, until they reach addiction. Sometimes, the circumstances surrounding the addiction paved the way for symptoms to develop that ultimately led to a diagnosis.
Either way, people who suffer from alcohol use disorder or a form of drug abuse are likely to have a mental illness as well – a study funded by the National Institute on Drug Abuse discovered that people who are diagnosed with what is considered a ‘severe mental illness’ were 4 times more likely to be a heavy drinker (daily consumption beyond the recommended maximum of three drinks), 4.6 times more likely to consume other drugs at least ten times in their lifetime, and at least 5.1 times more likely to be daily smokers than the rest of the population.
Among the many mental disorders this study identified, mood and anxiety disorders were the most common. There is a link between addiction and anxiety, potentially due to similar issues with neurotransmission, or due to similar risk factors. To identify the link and understand why anxiety continues to play a major role in addiction recovery, it’s important to examine the relationship between anxiety and addiction.
Nothing but Fear Itself
Fear is normal, and a part of our natural response to certain stimuli. Fear is not cowardice or a matter of morality, it’s an instinct. How we choose to act on our fears is usually within our power – those who overcome their fears or act against them for some greater good are lauded and called brave.
But there are times when fear is too pervasive and insipid to simply overcome through willpower alone. In other cases, it doesn’t have to be especially powerful, but begins to wear someone down through its constancy.
Anxieties manifest as phobias and as other anxiety disorders, such as generalized anxiety, social anxiety, panic attacks, post-traumatic stress, and obsessive-compulsive disorder. Each of these issues is drive by fear – phobias are fears so powerful that they are debilitating and leaves someone preoccupied with their fears despite no present trigger, and OCD is a condition characterized by compulsive behavior driven by an obsession triggered through irrational fears, such as a fear of germs, fear of a personal conspiracy, or fear of unknown and unseen retribution.
Addiction feeds on anxiety. Many who struggle with fear also fear getting treated. Anxieties are very difficult to deal with, and any form of mental illness comes with a strong stigma attached to it. Thus, some are damned if they do, damned if they don’t – without the right help, they spend a lifetime struggling to fit into a world that doesn’t understand their anxiety, and with the right help, they feel they will be ostracized, or perceived weak.This produces even more worries, more anxieties, more fears. All this fear causes stress, peaking through panic attacks and episodes of extreme hyperventilation, when the body reacts violently to the perceived stress it’s under on a consistent basis. Drug use can mellow out the fears, but without addressing the root cause. Like a band aid on a faucet, addicts are compelled continue self-medicating with addictive drugs to stem the fears, only for them to come back stronger after each high, left unaddressed and bottled up inside. Eventually, what started out as a mild anxiety gets worse, and what was already severe can become unbearable.
Addiction and Anxiety
The vicious cycle of addiction involves fear and guilt, especially the fear of relapse and the guilt of being addicted. To many, despite evidence to the contrary, addiction is still something very personal defined by choice and responsibility. Some people continue to tell themselves that their behavior is entirely their fault, and that the fact that they can’t stop without help confirms that they’re weak.
This self-destructive thinking further feeds fears related to inadequacy, hopelessness, and powerlessness, coupled with the urge to use again as a way to deal with all this emotional stress.
At the root of all this is the fear of relapse. The crux of addiction treatment is to help addicts find ways to avoid using again. But if they are not at peace with themselves and confident in their abilities to stay sober, they’re much more likely to relapse. That relapse renews a slew of debilitating fears and pulls someone deeper down the cascading spiral of addiction.
Overcoming anxiety is crucial to overcoming relapses and moving forward in recovery. Recovery, when coupled with a diagnosable illness or emotional and behavioral issues that border on a diagnosis, must address both the addiction as well as these issues. Anxiety can be treated through medication, but the most important part of anxiety treatment is effective therapy. Through professional help, an addict can make progress towards overcoming fears and anxieties, with medication if needed.
Anxious About People
Recovery is not just about no longer using drugs, but it’s also about building a new life for yourself. This can be especially scary because it often involves a series of encompassing changes, from the way you live to where you live and who you live with. Part of slowly adjusting to regular life outside of rehab and other treatment facilities is learning to trust others again and learning to trust yourself.
This is much harder to do when you’re preoccupied with anxieties around being with other people. Fear that they will hurt you, talk smack about you behind your back, and hold low opinions of you are all common thoughts to have, especially when meeting new people. These thoughts can make recovery extremely difficult if left unchecked. You must speak with a professional if you’re constantly afraid, especially of opening up to others.
Do You Need Help?
There’s being anxious, and then there’s an anxiety disorder. It’s best not to try and diagnose yourself off the internet – if you think you need help, go and find a professional psychiatrist and/or doctor, and get the opinion of a medical expert. Be sure to mention that you’re a recovering addict, as that is important when making a diagnosis.
Based on what the doctor says, the path forward will be very different. Treating an addiction is one thing, but when coupled with a mental illness, treatment has to take both into consideration at the same time. Either way, anxiety and addiction are often treated together, and the key will be staying committed to the recovery process.