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  • Panic Disorder & Addiction | Symptoms, Risk Factors, & Dual Diagnosis Treatment

    Panic Disorder & Addiction | Symptoms & Dual Diagnosis Treatment

    Panic disorder is an anxiety disorder that consists of intense fear with no real threat present and repeated panic attacks. A person with a panic disorder must also exhibit behaviors in response to or in anticipation of further panic attacks.

    People with panic disorder are more likely to also struggle with drug and alcohol addiction. They may try to use substances to self-medicate intense symptoms. Additionally, many drugs like hallucinogens, ecstasy, methamphetamine, and marijuana can bring on panic and anxiety.

    Panic Disorder & Addiction Triggers & Symptoms

    A panic attack may occur in response to situations that others may find harmless, although not all the time. Some triggers are more obvious than others. 

    Example triggers of panic disorder include:

    • speaking in front of a group
    • meeting new people at a party (social anxiety disorder)
    • places you’ve had panic attacks before (agoraphobia)
    • riding an elevator or escalator
    • driving 
    • riding public transportation
    • death of a loved one
    • end of a relationship
    • sexual assault
    • physical, emotional, or mental abuse

    To know whether you or a loved one is having a panic attack or not, there are some symptoms to lookout for. Substance abuse can make these symptoms more intense. 

    The symptoms of panic disorder and substance use disorder may include:

    • irregular heartbeat
    • difficulty breathing
    • chest pain
    • terror
    • anxiety
    • nervousness
    • shaking
    • sweating
    • lightheadedness
    • dizziness
    • chills
    • hot flashes
    • nausea
    • paranoia
    • feeling detached from oneself
    • poor motor coordination
    • worry about additional panic attacks

    Panic Disorder & Addiction Risk Factors

    Genetics is one of the major risk factors for both panic disorder and addiction. If someone in your family struggles with one or both, you have a higher risk of having it as well. 

    Biology can also play a role. Feeling an intense fear in a non-dangerous situation causes stimulating neurotransmitters to flood the brain and put your body in fight-or-flight mode. 

    This is normal during a dangerous situation but when it’s a non-dangerous situation, it’s likely because of a brain chemical imbalance.

    Comorbidity & Stress 

    Panic disorder is also a risk factor for substance abuse and addiction. Those with panic disorder are at a higher risk of addiction and may use drugs or alcohol to self-medicate or alleviate symptoms. Unfortunately, this self-medication can make the symptoms much worse.

    Additionally, if you have a drug or alcohol addiction, it can increase the intensity of side effects of panic disorder and the symptoms of anxiety. 

    Stress can also be a risk factor. If you experience high levels of stress in your life, panic attacks can increase as can the desire to use drugs and/or alcohol for alleviating the symptoms.

    Panic Disorder & Addiction Dual Diagnosis Treatment

    It can be difficult to treat both addiction and panic disorder at the same time because of the mental distress both disorders can create. It can also be hard to know what’s a symptom of panic disorder and what’s a symptom of addiction.

    However, there are addiction treatment facilities equipped to help people with co-occurring disorders but the very nature of panic disorder can interfere with recovery, especially if someone is anxious around groups.  When support groups are such a big part of recovery, this can make things difficult. 

    But the mental health specialists who treat these complicated patients have extensive training in dual-diagnosis treatment and know what to use in order to overcome the challenges to recovery.

    Behavioral Therapies

    Behavioral therapy is the foundation for treating both panic and substance use disorders, and can include:


    Medications for both substance abuse and panic disorder can be tricky to find. Your treatment provider likely needs to find something that will help your symptoms but not have a high risk for addiction.

    Benzodiazepines and central nervous system depressants like Xanax and Ativan can seem like a good idea at first because of their calming effects. However, they also have a high potential for abuse.

    Some medications that are good for a dual-diagnosis of panic and substance use disorder include:

    • SSRIs or antidepressants
    • anti-anxiety medications
    • anticonvulsants


    Before medication or treatment at an inpatient or outpatient facility, a healthcare provider is likely to recommend a medical detox to ensure all drugs or alcohol are out of your system. 

    In medical detox, you can be monitored and go through withdrawal symptoms in a safe environment. Any side effects can also be dealt with as they occur.

    If you or a loved one is dealing with drug or alcohol abuse and/or panic disorder, you are not alone. Call our helpline today and we can help you discover the treatment options that are right for you.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.
    Medically Reviewed by
    Davis Sugar, M.D.
    on June 26, 2022
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