- Content Reviewed By:
- Andrew McKenna - JD
- Deputy Director of NCADD Westchester
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Anxiety and substance use disorder are closely linked in multiple ways. In one context, it’s common for people who are suffering from anxiety disorder to self-medicate with alcohol, prescription (non-prescribed) benzodiazepines, and other drugs. In another, prolonged and untreated substance use disorder can lead to changes in the brain’s chemistry that lead to increased anxiety and subsequent panic attacks.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that nearly seven million American adults struggle with co-occurring substance use disorder and mental illness. At the same time, more than 25 percent of adults living with serious mental illness also have a substance abuse issue, of which anxiety is one of the most common.
If you or someone you care about is battling panic attacks or anxiety disorder related to alcohol or drug use, it’s imperative that you seek dual-diagnosis treatment that offers quality and effective care for both conditions.
Anxiety Disorder and Panic Attacks: Signs and Symptoms
There are many different types of anxiety disorders, including but not limited to:
- Generalized Anxiety Disorder (GAD) – Chronic worry and excessive anxiety with no discernible cause
- Obsessive-Compulsive Disorder (OCD) – Recurring unwanted thoughts and obsessions that interfere with quality of life and daily behavior
- Panic Disorder – Characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress
- Post-Traumatic Stress Disorder (PTSD) – Serious long-term anxiety associated with a singular or repetitive traumatic event
- Social Anxiety Disorder – Overwhelming anxiety and excessive self-consciousness in everyday social situations
While each one of these types of anxiety disorder is associated with substance use in its own unique way, panic disorder and attacks can be particularly dangerous and destabilizing and triggered by episodes of alcohol or drug abuse.
Signs of A Panic Attack
While each person’s panic attack symptoms will be different, some of the common signs may include, but are not limited to:
- Fast or Racing Heartbeat
- Inability to Breathe
- Excessive Perspiration
- Nausea and Vomiting
- Dizziness and Lightheadedness
- Tingly Sensation
It’s hard enough to go through these symptoms sober, but they can be incredibly disorienting and frightening when you’re under the influence of drugs or alcohol. If these panic attacks persist, it’s important to work with a doctor and therapist to explore treatment and management options. Often, panic attacks must be treated interdisciplinarily to address the physical and mental aspects of the condition.
How Do Drugs and Alcohol Cause Panic Attacks?
Alcohol and drugs cause panic attacks through a variety of physiological and neurobiological changes. Each substance can precipitate panic attacks in its own way, depending upon chemical makeup, effects on brain function, the amount used, frequency, and other factors:
Although alcohol is meant to “calm the nerves” and has a sedative-like quality through the release of the neurotransmitter GABA, the brain and central nervous can experience an alarmed or excited state when the GABA wears off.
This is especially true for individuals who are struggling with alcohol use disorder experiencing withdrawal. It’s not uncommon for panic attacks to occur alongside delirium tremens (DTs), as well as hallucinations and delusions.
Prescription and Illicit Drugs
Different types of prescription drugs will cause panic attacks in different ways. Excessive use of stimulants, in particular can mirror the effects of a panic attack, and the anxiety associated with thinking you’re having a panic attack can actually lead to one.
Opioids and benzodiazepines (benzos) can also cause panic attacks during the withdrawal period when they’re taken to excess, as can illicit street drugs like heroin, cocaine, crystal meth, and others.
Substance-Induced Anxiety Disorder: What Is It?
Substance-induced anxiety disorder is a pattern of behavior characterized by intense, persistent anxiety and/or panic attacks that are brought on by the excessive or abrupt cessation of a specific substance. It can either be brought on by excessive use of substances or during the acute withdrawal process. It’s important to realize that if you had anxiety prior to using substances, even if they amplify your pre-existing condition, it cannot be characterized as a substance-induced anxiety disorder.
Causes of Substance-Induced Anxiety Disorder
While each person develops substance-induced anxiety disorder through their own unique circumstances, the condition is primarily caused by changes in neurochemistry brought on by the excessive use of drugs. Imbalances in the brain’s natural chemicals can trigger anxiety and many other types of harmful behavior. Some drugs cause acute anxiety episodes during use, and others can cause prolonged episodes weeks after you stop taking them.
Some of the primary symptoms of a substance-induced anxiety disorder include, but are not limited to:
- Intense and persistent fear that things will get worse and never get better
- Insomnia and other sleep issues
- Memory problems and inability to concentrate
- Feeling a loss of control
- Feeling like you’re going to go crazy or die
- Extreme weight loss due to intestinal distress
- Extreme changes in body temperature and racing heartrate
- Having trouble breathing, trouble swallowing, or chest pain
Substance-induced anxiety disorder can be diagnosed by your healthcare provider. They will inquire about your illicit and prescription substance use history, as well as your symptoms, medical history, and other factors in their determination.
Treating Substance-Induced Anxiety Disorder
Like other types of co-occurring substance abuse and mental health issues, substance-induced anxiety disorder must be treated by addressing the substance use and anxiety separately yet simultaneously. This includes some combination of:
- Medical Detox and Withdrawal Management
- Cognitive Behavioral Therapy (CBT)
- Group Therapy and Individualized Counseling
- Dialectical Behavior Therapy (DBT)
- Eye Movement Desensitization and Reprocessing (REBT)
- Rational Emotive Behavioral Therapy (REBT)
You can either get help through your care provider or through an alcohol or drug rehab center. Depending on your care needs, you may need inpatient or outpatient dual diagnosis treatment that offers flexibility and quality of care.
Use our Dual Diagnosis Directory for Anxiety and Substance Use Disorder
We have created a directory that can be filtered to your location for Dual-Diagnosis also referred to as co-morbidity and co-occurring.