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  • Social Anxiety Disorder & Addiction | Effects, Substances, Risk Factors, & Dual Diagnosis Treatment

    Social Anxiety Disorder & Addiction | Effects, Substances, Risk Factors, & Dual Diagnosis Treatment

    Social anxiety disorder and alcohol or drug abuse can go hand in hand and develop into co-occurring disorders

    Social anxiety disorder can either develop because of alcohol/drug use or addiction can develop because someone is trying to mask or self-medicate their social anxiety symptoms.

    For those who feel unsafe in social situations, drugs and alcohol can feel like a cure. Unfortunately, it can lead to even bigger issues like comorbid social anxiety and substance use disorders (SUDs).

    What Is Social Anxiety Disorder?

    Social anxiety disorder or social phobia is a form of anxiety disorder that brings on feelings of extreme fear in social settings. 

    People with social anxiety disorder may struggle to talk to people, make new friends, and attend social events. They fear being judged by those around them.

    Besides substance use disorders, social anxiety can also co-occur with panic disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and other mental health disorders.

    Symptoms Of Social Anxiety Disorder

    Social anxiety disorder can cause unpleasant symptoms that affect a person’s mental health, including:

    • trembling
    • panic attacks
    • raised heart rate
    • sweating
    • constipation
    • diarrhea
    • headaches
    • muscle tension
    • faintness
    • nausea
    • difficulty speaking
    • dizziness

    Effects Of Substance Use Disorders (SUDs) On Social Anxiety

    How substance use disorder affects social anxiety really depends on the substance. Some substances trigger an immediate increase in anxiety levels while others make it go away but only for a period of time. 

    Additionally, if someone tries to quit the substance they use to self-medicate their social anxiety, the anxiety can become worse. This can make them want to go back to drugs or alcohol leading to a revolving cycle of addiction.

    Social Anxiety Disorder & Alcohol

    Social anxiety disorder and alcohol addiction are quite common. Alcohol provides temporary relief from anxiety symptoms, lowers anxiety levels, and reduces social inhibition. But the relief is temporary and can lead to problematic side effects. 

    People under the influence may do things they find embarrassing later and those things can become part of their cycle of anxious thoughts. Anxiety also likely increases as the alcohol wears off. 

    Additionally, what may begin as self-medication for social anxiety can slowly develop into alcohol use disorder/addiction.

    Social Anxiety Disorder & Marijuana

    Marijuana and anxiety disorders are also tied together. Cannabis can have an immediate calming effect that temporarily relieves anxiety. However, high doses of marijuana can trigger anxiety and make social anxiety symptoms even worse. 

    Social Anxiety Disorder & Stimulants

    Stimulants like methamphetamines work by putting the sympathetic nervous system into action. This triggers the fight-or-flight response and the release of adrenaline and makes anxiety last much longer than it normally would.

    Social Anxiety Disorder & SUD Risk Factors

    There are quite a few risk factors for social anxiety and addiction. These factors don’t mean someone will get social anxiety disorder, but they can make it more likely. 

    Some risk factors include:

    • Family history: people are more likely to develop social anxiety disorder if their parents or siblings have it
    • Negative experiences: kids who experience bullying, rejection, or humiliation may be more likely to develop social anxiety disorder
    • Temperament: some kids who grow up shy or withdrawn in social situations may have an increased risk for the disorder
    • Social demands: meeting new people or giving a speech in public can trigger social anxiety symptoms

    Dual Diagnosis Treatment For Social Anxiety Disorder & SUD 

    While there are a variety of ways to treat the dual diagnosis (or comorbidity) of social anxiety disorder and addiction, they must be treated together. Treating them one at a time often makes it difficult to make real progress or achieve lasting results.

    Medical Detox

    The first part of any social anxiety disorder and substance abuse treatment is likely medical detox. During this process, healthcare and treatment providers ensure you have a safe and comfortable environment as you experience withdrawal symptoms. 

    After detox, treatment for both disorders begins in a residential/inpatient treatment center or an outpatient addiction treatment program.

    Cognitive Behavioral Therapy (CBT)

    Cognitive-behavioral therapy is the most common form of effective treatment for addiction and social anxiety disorder. It can be given in either individual or group therapy. 

    During therapy, people learn how to recognize the thought patterns that lead to anxiety and learn new coping mechanisms that can help diminish fear during stressful situations.


    Medications can also help manage social anxiety symptoms. The types of medications used include antidepressants, beta-blockers, and anti-anxiety medications like benzodiazepines.

    Beta-blockers reduce the physical symptoms of anxiety while anti-anxiety and antidepressant medications work directly on the neurotransmitters in the brain. Antidepressants like SSRIs specifically increase the amount of serotonin in the brain to reduce anxiety. 

    Peer Support Groups

    Peer support groups for substance abuse like Alcoholics Anonymous also help with this dual diagnosis. It gives those suffering a place to go where people know exactly what they’re going through. They share stories, receive support, and celebrate milestones together.

    If you or a loved one is struggling with drug or alcohol abuse, there are plenty of treatment options out there. Call our helpline today and we can help you find the right one for you.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    National Institute of Mental Health - Social Anxiety Disorder: More Than Just Shyness
    National Institute on Drug Abuse - The Connection Between Substance Use Disorders and Mental Illness
    National Library of Medicine - Anxiety and Substance Use Disorders: A Review
    National Library of Medicine - Substance Use Disorders and Anxiety: A Treatment Challenge for Social Workers
    National Library of Medicine: MedlinePlus - Social anxiety disorder

    Medically Reviewed by
    Davis Sugar, M.D.
    on June 26, 2022
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