Anxiety and addiction are two of the most common mental health challenges people face—and they’re often deeply connected. Many individuals who struggle with addiction also experience anxiety disorders, and vice versa. Understanding the relationship between anxiety and substance use is key to healing both issues and achieving lasting recovery.
In this blog, we’ll explore how anxiety and addiction influence each other, the risks of self-medicating, and why integrated treatment is so important.
Co-Occurring Disorders: A Dual Diagnosis
When someone has both an anxiety disorder and a substance use disorder, it’s called a co-occurring disorder or dual diagnosis. This is more common than you might think. According to the National Institute on Drug Abuse (NIDA), individuals with anxiety disorders are twice as likely to struggle with substance misuse compared to the general population.
Effective treatment for co-occurring disorders must address both conditions at the same time. Treating addiction without addressing anxiety (or vice versa) can lead to relapse and ongoing distress.
Co-Occurring Anxiety and Addiction
There are several mental health disorders that commonly co-occur with substance use disorder— anxiety, depression, and bipolar disorder among them. According to the Anxiety and Depression Association of America (ADAA), about 20 percent of Americans with anxiety or depression have a substance use disorder, and vice versa. Common anxiety disorders include:
- Acute stress disorder: severe anxiety following a traumatic event
- Generalized anxiety disorder (GAD): general, everyday concerns are cause for distress
- Panic disorder: spontaneous panic attacks
- Social anxiety: extreme self-consciousness around others
- Obsessive-compulsive disorder (OCD): uncontrollable, recurring thoughts and behaviors
- Post-traumatic stress disorder (PTSD): anxiety following a traumatic event
What Is Anxiety?
Anxiety disorders, defined by the National Institute on Drug Abuse (NIDA) as “varied disorders that involve excessive or inappropriate feelings of anxiety or worry,” are often characterized as persistent and interfere with daily functioning and normal patterns of thought or behavior. Anxiety tends to manifest as more than psychological symptoms and may be expressed in physiological symptoms such as:
- Trembling
- Stomachache
- Nausea
- Headache or dizziness
- Rapid heartbeat
- Sweating or clamminess
Millions of Americans experience some kind of anxiety, so identifying with some or all of these symptoms is not uncommon. Women are also twice as likely as men to have an anxiety disorder, according to the ADAA, though anyone may develop one or be predisposed to have one.
How Anxiety Can Lead to Addiction
Anxiety is more than just occasional nervousness—it can be overwhelming, persistent, and physically exhausting. People with untreated anxiety disorders often feel trapped in a constant state of fear, worry, or panic. To escape those feelings, many turn to substances like alcohol, benzodiazepines, marijuana, or stimulants as a way to cope.
This is known as self-medicating. The substance may provide short-term relief, but over time, it creates a cycle of dependence:
The person uses the substance to calm anxiety
Tolerance builds, requiring more to achieve the same effect
Anxiety worsens when the substance wears off
Withdrawal symptoms may mimic or intensify anxiety
Eventually, the person is not only dealing with anxiety but also a growing addiction.
How Addiction Can Worsen Anxiety
Addiction doesn’t just coexist with anxiety—it can make it worse. Many substances impact brain chemistry in ways that increase anxious thoughts and feelings, especially during withdrawal. For example:
Stimulants like cocaine or meth can cause intense anxiety and paranoia
Alcohol and benzodiazepines may calm nerves temporarily but rebound with heightened anxiety once the effects wear off
Withdrawal from almost any substance often includes symptoms like restlessness, irritability, and panic
This creates a vicious cycle: the more a person uses substances to manage anxiety, the more unstable and severe their anxiety becomes.
You’re Not Alone—Help Is Available
If you or a loved one is struggling with both anxiety and substance use, know that you’re not alone—and you don’t have to manage it on your own. With the right treatment and support, it’s possible to break the cycle, heal from both conditions, and build a healthier, more balanced life through evidence-based and holistic therapies.
