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Anxiety Disorders & Addiction | Dual Diagnosis Prevalence, Symptoms, Risk Factors, & Treatment

Published on May 4, 2021
Anxiety Disorders & Addiction | Dual Diagnosis Symptoms & Treatment

Anxiety and addiction are two of the most commonly diagnosed psychiatric disorders in the United States. Many people who experience anxiety disorders also develop an addiction, and vice versa

When someone experiences both disorders simultaneously, they may have a dual diagnosis

Genetics, stress, and traumatic experiences increase the risk of experiencing anxiety disorders and addiction. A dual diagnosis often requires comprehensive treatment that addresses both the anxiety disorder and the substance use disorder. 

Prevalence Of Anxiety Disorders & Addiction

The National Survey on Drug Use and Health reported 9.5 million Americans experienced an anxiety disorder and substance use disorder (SUD) as of 2019. 

Both anxiety and addiction are associated with significant changes in similar areas of the brain. This is one of the possible reasons for the high prevalence of comorbidity (co-occurrence) between addiction and anxiety disorders. 

According to the American Psychological Association (APA), about half of all people who seek treatment for addiction or anxiety have co-occurring disorders. The APA also reported that 2-5 of every 10 people with anxiety or depression also have an addiction. 

Symptoms of Anxiety Disorders & Addiction

Feelings of fear, stress, or uneasiness can be a normal reaction to stress or a potential threat. However, people with anxiety disorders experience an overwhelming amount of fear that can interfere with daily life. 

Common anxiety disorders include:

Symptoms Of Anxiety Disorders

Each anxiety disorder has its own criteria and symptoms for an official diagnosis by a healthcare professional. However, most anxiety disorders share similar traits and symptoms, including:

  • excessive worry or anxious thoughts that are difficult to control
  • anxious thoughts or beliefs that interfere with daily life
  • rapid heartbeat, muscle tension, or shortness of breath
  • avoiding specific people, places, or objects that are associated with a fear

Symptoms Of Addiction

Most drugs, including alcohol, increase levels of the neurotransmitter dopamine in the brain. High levels of dopamine can cause significant changes in the reward circuit of the brain. This can lead to the characteristic signs of drug or alcohol addiction. 

Although addiction affects everyone differently, common signs include:

  • compulsive drinking or drug use despite negative consequences
  • difficulty stopping or slowing down drinking or drug use
  • withdrawal from family and friends
  • drug or alcohol tolerance or withdrawal symptoms
  • intense cravings
  • changes in mood or behavior 

Substances can also cause changes in the brain that can worsen symptoms of anxiety or panic. This can occur while under the influence of drugs or alcohol or during withdrawal periods. Substance-induced anxiety symptoms usually disappear shortly after treatment. 

People who are dual-diagnosed may experience any combination of signs and symptoms from both disorders. 

Risk Factors 

With co-occurring disorders, one does not necessarily cause the other but having one can increase the risk of developing the other. 

Several risk factors, including genetics, health, and environment can influence the development of co-occurring disorders. Similar to addiction, mental health disorders are associated with changes in brain chemistry. 

This could mean someone with an anxiety disorder is more vulnerable to the effects of drugs and alcohol. Unfortunately, it is common for someone with an untreated mental illness to self-medicate with drugs or alcohol. 

Certain substances, like marijuana, may also increase the risk of developing a mental illness. The risk is higher with substance abuse in adolescence because the brain is still developing. 

Dual Diagnosis Treatment For Anxiety & Addiction

Experiencing an anxiety disorder along with addiction may seem overwhelming but treatment is possible. Treatment requires comprehensive care that addresses both addiction and other mental health conditions.

Comprehensive treatment involves a team of doctors and specialists that work together to treat both disorders simultaneously. Psychiatrists, psychologists, and addiction specialists are just a few of the healthcare professionals that may be involved in treatment. 

Depending on your individualized needs, treatment may include:


Medical detox prepares you for treatment by helping you through the difficult drug or alcohol withdrawal process. Detox is an important step in dual diagnosis treatment because withdrawal symptoms can trigger or worsen symptoms of anxiety. 

Inpatient/Residential Treatment 

Residential treatment programs are long-term treatment options that provide you with mental health and addiction professionals. These programs usually offer a daily schedule that may include healthy activities, support groups, family therapy, and behavioral therapy. 

Outpatient Treatment

Outpatient programs are more flexible than inpatient programs and allow you to travel to scheduled treatment sessions. This program is most effective for those who have a positive support system of family members and peers. 

Behavioral Therapy

Behavioral therapy is a key component of treatment and targets behavior patterns associated with addiction and other mental illnesses. Each form of behavioral therapy aims to change negative thoughts, beliefs, and behaviors. 

Different methods of behavioral therapy include:


Behavioral therapy and other therapies are sometimes paired with medication when treating anxiety disorders. Many drugs used to treat anxiety disorders and panic attacks, including the benzodiazepine Xanax, are highly addictive. 

For this reason, professionals may choose an antidepressant or other non-addictive medication. Selective serotonin reuptake inhibitors (SSRI), like Paxil or Prozac, can be effective in treating anxiety. Some research has shown other drugs, like Topamax, can be beneficial in treating both anxiety and addiction. 

If you or a loved one wants more information on dual diagnosis treatment, Ark Behavioral Health can help. Contact us today to speak with a specialist and learn more about our treatment options. 

Anxiety & Addiction FAQ

Is Cocaine Addiction Associated With Anxiety Disorders?

Cocaine addiction is associated with anxiety disorders. In some cases, cocaine addiction and anxiety disorders co-occur or overlap at the same time. In other cases, cocaine addiction may lead to anxiety. Cocaine’s effects on the brain may be a factor in the development of anxiety.

Learn more about Anxiety Disorders & Cocaine Use

Do Anxiety Disorders Frequently Co-Occur With Meth Addiction?

Anxiety disorders are one of the most common co-occurring conditions with meth addiction. Short-term drug use can cause several adverse reactions, including anxiety. Long-term use can lead to severe anxiety, paranoia, and even psychosis.

Learn more about Anxiety & Meth Abuse

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

American Psychological Association (APA) - Mental Illness and Drug Addiction may Co-Occur Due to Disturbance in the Brain's Seat of Anxiety and Fear
National Alliance On Mental Illness (NAMI) - Substance Use Disorders
National Institute On Drug Abuse (NIDA) - Comorbidity - Addiction And Other Mental Illnesses
National Institute Of Mental Health (NIMH) - Anxiety Disorders
National Library Of Medicine - Anxiety and Substance Use Disorders: A Review

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