A person who has a dual diagnosis (also referred to as co-occurring disorders) has two separate illnesses, which need to be treated simultaneously.
It starts as a flicker deep in your stomach. Your palms begin to sweat. Your eyes flick from side to side as you look for a way out. And all the while, a voice deep inside tells you that the worst thing that can happen will happen, and it will start right now.
This is anxiety, and it’s a relatively common part of daily life. We push our bodies and our minds to the limit, and sometimes, that means we put ourselves in dangerous situations we should escape. Anxiety reminds us to protect what’s important.
But anxiety can also appear with no prompt, alerting us to dangers that don’t exist and that we can’t avoid. If left untreated, excessive anxiety can make almost everything about our lives harder. That’s especially true when anxiety is paired with addiction.
When Is Anxiety a Problem?
Doctors are reluctant to classify natural thoughts and feelings as part of a disease process. Our emotions are valid, and without them, we would all be so calm that we just wouldn’t enjoy our lives. But there are times when feelings of nervousness and stress are so extreme that they interfere with our routines and our successes.
Writers for Medical News Today suggest that anxiety shifts from helpful to harmful when it becomes uncontrollable, unreasonable, and unwarranted.
For example, we all feel a little anxious when we’re driving a car during a torrential downpour. We might grip the wheel a little tighter and clench our teeth as we peer through the windshield. When we arrive at our destination, we might do a happy dance.
Someone with anxiety might grow so nervous at the thought of rainy driving that it seems necessary to:
- Check weather reports compulsively.
- Replace windshield wipers weekly.
- Cancel plans if the sky appears grey.
- Stay home when it’s raining.
- Walk home from work if it starts to rain.
It’s not the feeling of nervousness that is unusual here. It’s the scope of the emotion. It changes the way you feel and act. That’s part of an anxiety disorder.
The National Alliance on Mental Illness says there are many different types of anxiety disorders, and each has unique symptoms. But most cause the following issues:
- Nervousness or wariness
- Reactivity or jumpiness
- Digestive distress
Some symptoms are triggered by a situation. During intense stress, someone might sweat or twitch or feel short of breath. But others, like wariness or reactivity, may always be present.
Anyone can have an anxiety disorder, and the National Institute of Mental Health says close to 20 percent of adults have one. But the issues are slightly more common in women than in men. In the last year, 23.4 percent of women had an anxiety disorder, while only 14.3 percent of men did.
What Are the Risks?
If anxiety is normal, and it only becomes an issue when the feelings are too strong, someone with an anxiety disorder should be able to snap out of it and grab control, right? At one point, that’s what we believed. Now, we know that these disorders don’t get better without treatment, and ignoring them can lead to dire consequences.
Anxiety tends to strengthen, and that can lead people to shift their behavior in response. Someone with a small flicker of fear in a crowd can develop a full-blown panic attack in a movie theater, and without help, the person could also struggle in a room with just four people in it.
These conditions can be extremely debilitating, and they can take almost all the joy out of life.
Anxiety can also lead to other disorders.
The Anxiety and Depression Association of America says people with anxiety are two to three times more likely to develop substance use disorders. In some, addiction comes first, and in others, the order is reversed. But the link between the two conditions remains.
When anxiety and addiction combine, they tend to strengthen one another. Symptoms grow severe very quickly, and that can lead to significant distress and an inability to do things the person once loved.
Addictions can also blind people to the cause of their distress, and they may not realize that anxiety is even a problem for them. They may think sobriety will solve all their problems, but they may be unable to make that change a reality.
Anxiety Can Be Treated
Anxiety can persist despite a person’s hopes and dreams for freedom. It’s hard to see your way out of the problem without help, but treatment can make a big difference.
Unfortunately, per the Anxiety and Depression Association of America, less than 40 percent of people with these disorders reach out for help.
Those who do can benefit from:
- Individual counseling. Therapists can use cognitive behavioral therapy or another form of structured treatment to help you understand how your anxiety is triggered and how you can change your thoughts so you can make better decisions.
- Group counseling. You’re not the only person with an anxiety disorder. Others have the same concerns, and they may have techniques you can learn from. Together, with the help of a counselor, you can learn more about how to heal.
- Alternative therapy. Yoga, massage, and acupuncture all show promise in helping people to cope with distressing thoughts so they don’t act out in destructive ways.
- Support group work. For many people with addictions, talking to others in recovery is remarkably helpful. Alcoholics Anonymous and other similar groups give you that connection while allowing you to learn from your peers.
- Medication management. Some types of anxiety stem from chemical imbalances inside the brain, and addictions can make those changes more profound. Medications can correct the damage, and that can leave you feeling calmer.
Researchers say anxiety and addictions so often come together that doctors should screen all of their clients for one problem when the other appears. Treatment plans don’t necessarily need to change when addiction is present. The techniques you use to curb your anxiety triggers are similar to those you’ll use to avoid the urge to relapse to drugs.
But you may have a higher risk of severe mental illness if you’re both anxious and addicted. For that reason, your doctor may recommend that you get care on an inpatient basis, so you’re surrounded by support around the clock.
How Long Does It Take to Recover?
You might be surprised at how quickly your therapy takes hold. Some people find they can apply their techniques within just a few sessions, and when they do, they can feel their worries slipping away.
But full recovery from addiction and anxiety can take time to achieve. You may feel yourself sliding back into bad habits when you’re under pressure, and sometimes, you may feel like you’re not moving forward at all.
Your doctor is your partner as you recover, and you might stay in touch for months or even years. You may always have a little bit of work to do to stay healthy and happy and calm. But stick with it, and you’ll find that your life gets better.