Anxiety disorders impact nearly 40 million Americans aged 18 or older. This translates into a significant 18.1 percent of the adult population. There are various kinds of anxiety disorders, such as social anxiety disorder (SAD), generalized anxiety disorder (GAD) and phobia. An untreated anxiety disorder can lead to substance abuse. Given below are few scenarios where a person with an anxiety-related condition develops a substance use disorder (SUD) or vice versa:
- Self-medication brings relief to such people from fearful thoughts and excessive worry about impending events.
- Prolonged use of a drug changes brain chemistry that alters the way one behaves, thinks and feels.
- People suffering from social phobia are often prescribed benzodiazepines, which are addictive in nature. Prolonged and consistent use beyond the doctor’s advice results in one getting caught in the cycle of abuse and addiction.
The chances of delayed diagnosis and treatment or misdiagnosis of co-occurring disorders are high due to the complexity and severity of the symptoms. A patient might be treated just for one condition while the other remains hidden. In order to provide complete relief and make the recovery long-lasting, it is imperative to treat the co-occurring disorders simultaneously. Undiagnosed, untreated or insufficiently treated cases increase the likelihood of suicide and death.
For a long time, tranquilizers like benzodiazepines were considered the apt treatment for anxiety. In some cases, even antidepressants are prescribed. Though both anxiety and depression are distinct mental health conditions, both revolve around serotonin, the mood regulator hormone. Currently, the most common medications for anxiety disorders include selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs) and older tricyclic antidepressants.
Apart from medications, there are various therapies that are beneficial in treating co-occurring disorders, such as:
- Cognitive behavioral therapy (CBT): CBT is a combination of psychotherapy and behavioral therapy. Its goal is to identify and understand the root cause of the problem, and improve the way one thinks and behaves.
- Eye movement and desensitization reprocessing (EMDR): It is a revolutionary therapy which is highly effective in the treatment of patients with a trauma or past anxiety. The therapy is based on bilateral stimulation and right/left eye movements, which have the effect of activating the opposite sides of the brain. In the process, emotional experiences that are often the root of a mental health condition are released. The effect is cathartic and the individual feels free.
- Mindfulness: Mindfulness therapy is related to the Zen philosophy of being in the present instead of dwelling either in the future or in the past. Living in the future is the root cause of anxiety and depression, whereas being obsessed about the past is stressful. When a person is mindful, he/she stays active, becomes aware of the surroundings and takes into account current experiences without taking stress by anticipating what lies ahead.
According to the Anxiety and Depression Association of America (ADAA), only a third of people with anxiety disorders seek medical assistance. Anxiety disorders are treatable, provided one seeks timely help. If delayed, it may give rise to an SUD, leading to a more complicated condition – dual diagnosis. It is even more important to treat co-occurring disorders using an integrated approach that requires collaboration across disciplines. This can help in reducing cost of hospitalization and those related to loss of productivity, and improve the overall quality of life.