Did you know that there’s a significant relationship between anxiety and addiction … and that understanding that connection can help to facilitate healing?
In this post, we’ll explore the correlative connection between the mental health condition of anxiety and the behaviors associated with substance abuse.
First, let’s talk about the nature of anxiety and how it manifests. Anxiety is defined as “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome”. Common physical symptoms include excessive sweating and a racing heartbeat.
Though we all feel this way sometimes, anxiety moves into the realm of disorder when it interferes with everyday functioning. For example, anxiety may stop someone from leaving their house or getting into their car.
In psychiatric terms, Anxiety Disorder is “a nervous disorder characterized by a state of excessive uneasiness and apprehension, typically with compulsive behavior or panic attacks”.
In Anxiety Disorder, you experience both internal apprehension and visible, external distress. You feel intense inner discomfort and may have troubling physical symptoms such as hives and hyperventilation.
Internal Conflict and Anxiety
Another colloquial definition of anxiety is “emotional bouncing up and down”. This bouncing happens when you’re trying to duck a so-called “unacceptable” emotion such as anger or grief.
There’s a constant sense of internal conflict as your true feelings fight with your socialized beliefs:
- “I feel angry at my father because he lied to me.”
- “But I can’t feel angry at him because good sons don’t get angry with their parents.”
- “Well … but I do feel angry at him. He covered up an important truth.”
- “Don’t feel that way. It’s too dangerous. Just get over it!”
As a result of this push-and-pull between your real feelings and your beliefs, you feel unsettled and ungrounded.
When additional stress is piled atop this subterranean anxiety, you move into panic mode. Think of panic as an acceleration of the emotional bouncing back-and-forth state that is anxiety. Panic is a revving up of your fight-or-flight response.
What do you do when that happens? Most likely, you’ll attempt to avoid the feeling. After all, no one likes to feel the kind of physical and emotional discomfort characterized by anxiety.
Anxiety, Depression, and Addiction: They’re All Connected
As the co-founder of The Clearing (an inpatient rehab program focused on healing core issues), I’ve seen two mental health conditions affecting our Participants more than any others: anxiety and depression.
I’ve seen two mental health conditions affecting our Participants more than any others: anxiety and depression
Research shows a strong link between these two mental health conditions. As The Anxiety and Depression Association of America’s Facts and Statistics page notes, “Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.”
Likewise, there’s a clear connection between mental health conditions like depression and anxiety and addictive behaviors. In fact, most people with a substance addiction also have a concurrent mental health condition. This is called Dual Diagnosis, and it’s strikingly common.
According to the National Alliance on Mental Illness (NAMI) website’s Mental Health By The Numbers page, “Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5%—10.2 million adults—had a co-occurring mental illness.”
But how do anxiety and depression contribute to addiction? Let’s examine the nature of these conditions to see how both can fuel substance abuse.
Anger, Avoidance, and Trauma
One definition of depression is “anger turned inward”. When you no longer feel that you can express your anger and you turn it inward, depression is the result.
Why is the anger there in the first place? Because a hurt is present. You don’t want to work with the hurt (because it feels awful!), so you cut yourself off from that pain.
Now you’re not feeling your anger or your hurt. And as you know, the frantic energy of internally bouncing back and forth between those two blocked feeling states is anxiety.
When you decide that you’re not going to feel, you set yourself up to feel down and anxious.
Anxiety and depression go together; both are about blocked-off emotions. When you decide that you’re not going to express and you’re not going to feel, you unknowingly set yourself up to feel down and anxious.
This is compounded when you experience trauma. In traumatic situations, you’ll likely shut down your overwhelming emotional response … and then do your best to avoid ever feeling that way again.
In a recent interview titled The Link Between Trauma and Addiction: Part 2, I spoke about this connection between past trauma and present anxiety:
“Now, every time stress comes up in my life that is similar to that [past trauma], this part of me comes forward. It’s providing a lot of anxiety …. It’s an unhealed part that goes, ‘Oh my gosh …. We’re in another one of these [hurtful] situations just like when I was seven. Oh my gosh.’”
Where Addiction Comes Into the Picture
How do you deal with that frightened feeling? That’s where the addiction comes into play. When that anxiety trigger comes up, you don’t want to feel it, so you numb it.
So you drink or take pills (or get really busy, or create a dysfunctional relationship), and it works!
You stuff and deny your feelings in an attempt to escape the pain that they cause you. Consciously or unconsciously, you say to yourself, “I don’t want to feel this anxiety, stress, and panic. So, I’ll find something that helps me to stop feeling these things.”
Chances are that you’re not trying to hurt yourself or others, or get addicted to drugs. You’re just seeking out a way to lessen your mental and emotional pain.
So you drink or take pills (or get really busy, or create a dysfunctional relationship), and it works! You feel better. The weight of your painful feelings lifts … for a little while at least. But the relief is temporary, and it carries unwanted consequences.
Decrease Anxiety by Dealing with Hurt and Anger
Fortunately, you don’t have to stay trapped in this cycle. Instead, you can choose to address the emotional pain that’s been plaguing you.
As I explained in the blog post and video Understanding Anger and Addiction, you can use the “Anger, Hurt, Loving” Model:
The steps are as follows:
- Learn constructive ways to express your anger and express it.
- Give yourself permission (or receive permission from a trusted other) to feel the hurtful episodes and other emotional pain.
- Apply love to the parts inside of you that hurt.
(Note that while you can move through this model yourself, it’s extremely helpful to have a trained counselor guide you, especially at the beginning.)
When you’ve offered love to the frightened, wounded parts of yourself, you’ll find that you are able to heal.
Changing your emotional patterns requires courage … but the good news is, it works. As you complete this process, you’ll find your anxiety and urge to use addictive substances decreasing … and a world of possibilities opening up.
Joe Koelzer is the co-founder and CEO of The Clearing, a 12 Step Alternative residential addiction treatment program especially for individuals with Dual Diagnosis. He has years of counseling experience and a master’s degree in Spiritual Psychology from the University of Santa Monica. In co-founding The Clearing, Joe realizes his dream of creating and sharing the innovative Spiritual Psychology approach with others in a structured clinical setting.
