Anxiety is the most common mental health condition in the United States, affecting over 40 million adults.[1] It is also one of the most underserved. For many people, drugs, alcohol, and other destructive means of coping have filled the gap between suffering from anxiety and getting real clinical help. But while these methods may provide temporary relief, in the long run, self-medicating will only end up worsening both anxiety and addiction.
At All In Solutions, we address anxiety disorders as the medical problems that they are, using evidence-based treatment that treats both the anxiety disorder and any concurrent substance use disorder.
What Is an Anxiety Disorder?
Anxiety is a normal human emotion — a response to stress, the unknown, or perceived danger. Early humans relied on anxiety to detect threats and avoid harm, and that response is still wired into us today.
When normal anxiety becomes persistent, disproportionate to the actual threat, and starts to interfere with day-to-day functioning, then you might be dealing with an anxiety disorder.[2] Anxiety disorders are not a character defect or weakness; they are medical conditions with neurological causes that can be diagnosed and treated effectively.
The most common anxiety disorders include:
- Generalized Anxiety Disorder (GAD) — Excessive and persistent worries and fears over a wide range of everyday concerns that you cannot control. People who experience generalized anxiety disorder have physical symptoms such as fatigue, muscle tension, and problems with sleeping.
- Panic Disorder — Recurring unexpected panic attacks accompanied by persistent fear of future attacks and avoidance of situations associated with them
- Social Anxiety Disorder — Debilitating fear of being in social situations or being evaluated negatively by others that limits the ability to form friendships or maintain employment.
- Obsessive-Compulsive Disorder (OCD) — Intrusive and unwanted thoughts (obsessions) that compel someone to perform repetitive behaviors or mental acts (compulsions) in order to relieve their anxiety.
- Phobias — Intense, irrational fear of specific objects or situations
- Post-Traumatic Stress Disorder (PTSD) — Anxiety caused by past trauma.
Recognizing the Symptoms of Anxiety
Symptoms of anxiety disorders can differ depending on the type and severity, but there are many psychological, physical, and behavioral symptoms that they have in common.
Psychological symptoms include:
- Persistent, uncontrollable worry or dread
- Difficulty concentrating or mind going blank
- Irritability and restlessness
- Fear of losing control or having something terrible happen
- Intrusive or racing thoughts
Physical symptoms include:
- Elevated heart rate and palpitations
- Shortness of breath and chest tightness
- Sweating, trembling, or shaking
- Nausea and gastrointestinal issues
- Muscle tension, headaches, and fatigue
- Insomnia and disrupted sleep
- Anxiety or panic attacks: these include a period of intense fear or discomfort that reaches a peak within a few minutes and are accompanied by a racing heartbeat, shortness of breath, lightheadedness, chest pain, numbness or tingling, and an overwhelming feeling of impending doom or loss of control.
Behavioral signs include:
- Avoidance of places that cause anxiety
- Withdrawal from people or activities
- Inability to maintain employment
- Using substances to control symptoms of anxiety.
How Untreated Anxiety Leads to Substance Abuse
The connection between anxiety disorders and substance use is extensively documented in studies on substance use and mental health.
Many people find their own way to cope with anxiety when it is left untreated. Alcohol helps reduce physical arousal when someone is anxious. Benzodiazepines slow down racing thoughts, cannabis produces a calming effect, and opioids provide an overall sedating relief from constant feelings of dread.
These substances provide short-term relief, and that is what makes them so dangerous. Because along with relief, they also open the door for addiction to set in — the brain learns that substance use relieves anxiety and the behavior is powerfully reinforced. Over time, as this pattern continues, tolerance develops, the anxiety worsens as neurological dependence sets in, and the person now finds themself with an anxiety disorder and a substance use disorder, making both harder to treat.[3]
When to Get Help for Anxiety
It is time to get professional help when your anxiety starts to affect your daily life, relationships, and functioning; when you have physical symptoms that are distressing or disabling; when you limit your lifestyle due to avoidance of anxiety-provoking situations; or when you start using alcohol, substances, or other coping mechanisms to avoid or manage your anxiety symptoms.
If your quality of life is affected by anxiety, even if it seems manageable, there is a high possibility that professional treatment can make a significant difference.
When Residential Treatment is Appropriate for Anxiety
Residential treatment for severe anxiety is appropriate only if:
- Outpatient treatment has not been successful, and a higher level of care is needed
- If there is a co-occurring substance use disorder that requires a medical detox and clinical support
- If personal safety is compromised.
In one of these cases, seeking a higher level of care is in your best interest.
Evidence-Based Treatment for Anxiety Disorders
Anxiety disorders are among the most treatable forms of mental illness. Evidence exists for the effective treatment of anxiety disorders across a wide range using a combination of multiple treatment strategies, which usually lead to substantial improvement.
Below are some of the most common and evidence-backed treatments:
- Cognitive Behavioral Therapy (CBT): CBT is considered the gold standard of treatment for people diagnosed with anxiety disorders. Research over the past four decades supports the efficacy of CBT across all of the different subtypes of anxiety disorders.[4] The focus of CBT for anxiety is on examining the distorted thought patterns that lead to anxious feelings and behaviors; identifying new and more positive thought patterns; and developing behavioral strategies to avoid anxiety-provoking situations while developing one’s tolerance of being uncomfortable and of the unknown.
- Exposure Therapy: Exposure therapy, which is a specific technique used within CBT, is the process of gradually and progressively exposing a client to their feared situation, object, or thoughts in a safe and therapeutic environment.[5] By re-experiencing the feared stimuli without experiencing the catastrophic outcome predicted by their anxiety, one’s anxious feelings about the situation can start to decrease. Exposure therapy is very effective for treating people diagnosed with phobias, social anxiety disorder, obsessive-compulsive disorder (OCD), and panic disorder.
- Medication Management: For some people diagnosed with anxiety disorders, medication can reduce the neurobiological arousal that interferes with participation in therapy, providing enough relief to engage fully in treatment. People diagnosed with anxiety disorders are usually prescribed either an SSRI or SNRI, both of which are considered first-line medications for most anxiety disorders.[6] Medication management at All In Solutions is carefully coordinated to avoid medications with abuse potential in clients with co-occurring substance use disorders.
