Paul Kerry , who write for an addiction publication in the UK called Ocean Recovery, has written a comprehensive article explaining the link between addiction and anxiety. Kerry shared that it’s rare for an addiction to materialise from thin air. Instead, addiction is usually caused by deeper psychiatric issues such as anxiety and depression. In this way, the addict uses drugs or alcohol as a way of escaping from the negative thoughts and feelings attached to depression and anxiety. This is known as ‘self-medicating’ with drugs and alcohol.
In this post, Mr. Kelly specifically focus on anxiety and addiction and shares that if the above is true, one might conclude that those who suffer from addiction are not really addicted to substances at all. Moreover, sufferers are actually addicted to the ‘escape’ that’s achieved from their ‘reality’ when drugs and alcohol are consumed.
The signs of anxiety
This ‘escape’ is from the negative thoughts and feelings that are associated with anxiety. These thoughts and feelings include:
The symptoms of anxiety may vary greatly between different people, so it’s essential you are assessed by a psychiatrist or other qualified individual before a valid diagnosis can be made. For instance, if you suffer from anxiety attacks, the treatment you will receive will differ compared to someone who suffers from obsessive-compulsive disorder.
The escape theory of addiction
Drugs and alcohol are the methods of escape, although other methods of escape may arise. These methods could include gambling, playing computer games, paying for sex or spending lots of money on clothes. These addictive behaviours allow the addict to surreptitiously escape negative emotions so that a more comforting ‘reality’ may be experienced.
Heightened anxiety may develop due to genetic reasons. Also, anxiety may be heightened when the sufferer has experienced a traumatic event, particularly during childhood. Drugs and alcohol are then used to combat anxiety.
In fact, even people who do not suffer from clinical anxiety may drink alcohol or use drugs to alleviate milder symptoms of anxiety. This may be why many of us choose to drink alcohol at weekends. Following a busy week of work, having nothing to do at the weekend may generate anxiety, causing many of us to drink moderate amounts of alcohol.
Furthermore, many of us experience anxiety due to the amount of stress generated from modern living. You may enjoy an ‘after work drink’ to help you alleviate anxiety from your life. You thus begin to view substance misuse as a kind of reward for all the hard work you have been doing during the day.
For many people suffering from clinical anxiety, the situation becomes more exaggerated. These sufferers often see drugs and alcohol as their ‘go to’ solution for coping with anxiety. This is why many people refer to addiction as a form of ‘self-medication’.
Dependency develops when drugs and alcohol are repeatedly used to alleviate the symptoms of anxiety. Drug and alcohol use are thus positively reinforced, and it’s then extremely difficult for the addict to ‘give up’ the addiction without suffering from a range of psychological and physical withdrawal symptoms.
Generally, the more anxiety you experience, the more you will want to engage in drug and alcohol use. This explains why those of us who suffer from clinical anxiety are far more likely to develop alcoholism or drug addiction. However, this is a vicious cycle because substance misuse is known to aggravate anxiety. This is known as ‘rebound anxiety’. This means sufferers are trapped in the cycle of trying to alleviate their anxiety, whilst simultaneously aggregating the symptoms of anxiety.
Unfortunately, many people suffering from addiction are completely oblivious to the fact that anxiety is to blame. When you attend addiction treatment, you are taught to recognise anxiety so you may gain a better understanding of the mechanism that gives rise to your addiction.
Since anxiety is a major cause of addiction, it follows that treating underlying anxiety is an effective way of treating the addiction. The approach is thus to treat the causes of addiction, not the symptoms. According to this school of thought, addiction is merely the symptom of anxiety.
During addiction treatment, you will benefit from counselling that helps you understand, recognise and process your emotions so that your de facto response is not to consume alcohol or drugs to cope with these emotions.
Anxiety therapy – Cognitive behaviour therapy
Cognitive behaviour therapy (CBT) is a highly effective form of dual diagnosis treatment for anxiety disorder. CBT is effective for treating a range of anxiety disorders such as social anxiety disorder, panic disorder, phobias and generalised anxiety disorder.
CBT seeks to alter the underlying thoughts and feelings that power anxiety disorder. Specifically, CBT helps us to address distortions in how we view ourselves and the wider world. CBT also helps you develop healthier ways to manage thoughts and feelings that are attached to anxiety. These are known as ‘coping strategies’.
CBT consists of two central approaches. The first approach is behavioural therapy. Behavioural therapy helps you understand how you react to situations that cause your anxiety. Cognitive therapy helps you understand how negative thoughts contribute to anxiety.
CBT assumes that thoughts affect our feelings and thoughts are not affected by the physical situation we find ourselves in. It’s internal perception, rather than the external reality that causes negative thoughts and hence the anxiety.
CBT helps you to identify, deconstruct and reframe distorted beliefs and thoughts so you may continue to live your life without resorting to substance misuse. If you alter the manner in which you think, you can also alter how you feel.
One way CBT achieves this aim is through a process known as cognitive restructuring. This is also known as thought challenging. Here, you are encouraged to identify and then challenge negative thoughts. You are then encouraged to replace these thoughts with positive alternatives that are closer to reality. For instance, anxiety disorder causes the sufferer to perceive situations as more dangerous than they actually are.
CBT sessions ask you to identify what you are thinking when these irrational fears are experienced. You will then be asked to assess the evidence that supports these irrational fears. You will be asked to conduct experiments and look for evidence/counter-evidence that tests the validity of these assumptions your fears are built up. Once you have mapped out negative thoughts and their associated distortions, the therapist will then help you replace them with positive and more accurate alternatives.
Below, we provide a summary of cognitive restructuring:
Identify negative and irrational thoughts and predictions, and their associated cognitive distortions
Look at the evidence that supports or refutes these distortions
Replace these thoughts with healthier alternatives that are more aligned with reality
Exposure therapy and anxiety
Another form of addiction treatment is known as exposure therapy. Situations that trigger anxiety are likely to be avoided. Some situations are impossible to avoid. This means you must learn to cope with these situations and cope in ways that do not involve the consumption of drugs or alcohol. Exposure therapy is about exposing you to the situations that trigger your anxiety. Through the repetition of exposure, you will gain a degree of control over these anxiety triggers. This usually weakens the anxiety-producing effect of these triggers.
During exposure therapy, you are asked to either imagine the anxiety-triggering situation, or you will confront the situation in real-life. Exposure therapy is seldom used in isolation. It is usually employed as part of a wider CBT programme.
Another variation of exposure therapy is known as systematic desensitisation. You begin by exposing yourself to a situation that’s mildly anxiety-producing, and then work your way up to the most anxiety-producing situation slowly and over time. This allows you to challenge your anxiety in a gradual fashion.
Medications to treat anxiety
Another solution is to treat sufferers with medication. Effective drugs known to alleviate the symptoms of anxiety include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). These drugs allow sufferers to live a productive life without drugs and alcohol. These drugs are particularly useful for those who suffer from panic anxiety disorder.
About This Article
This article was written by Paul Kerry at Ocean Recovery Centre.
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CO-OCCURRING DISORDERS AND ADDICTION
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