What came first? The anxious egg or addicted chicken?

Funny title about a serious question!

Clinicians are faced with a very important task of vetting out whether or not patients presenting anxiety symptoms had those symptoms prior to their addiction, OR whether they developed them as a result of their addiction.  They also must determine whether the symptoms appeared a result of facing the overwhelming need to change their lives – completely. In fact, new research may make this question easier to answer. It is coming to light that at the root of all types of addiction, there is a desire to self-medicate the pain caused by mental illnesses – that includes painful or disturbing symptoms related to excessive anxiety.

It is difficult to understand how addictive behavior starts for those who are not addicted.  It is also difficult to understand the level of discomfort that anxiety disorders cause, and how hard it can be to cope with anxiety without resorting to self-medicating with potentially addictive substances or behaviors.  However, the facts are clear: addiction and anxiety are closely related, and having one is highly predictive of having another of these conditions.

Individuals who suffer from anxiety disorders are twice as likely as the general public to suffer from addiction to illegal substances or alcohol according to the Anxiety and Depression Association of America.  Similarly, those who suffer from substance abuse are twice as likely to have an anxiety disorder as those in the population who are not addicted.

The link between anxiety and addiction has long been established, but it is still not perfectly clear exactly what causes either condition.  However, the results of these two conditions are inarguable.  Those who suffer from anxiety are at much higher risk of addiction, so treating anxiety may be one of the most effective ways to treat or prevent addiction problems. It’s no secret in the chemical dependency community that anxiety can be the biggest predictor for someone being willing to come to treatment, stay in treatment and maintain long term recovery.

Dr. Kevin McCauley, author and creator of the film Pleasure Unwoven, shares this compelling insight into the relationship between stress and addiction, “The brain, subjected to chronic, severe, unmanaged stress is “fertile soil” for addiction. If a drug comes along at this time of severe stress, the effect and benefit that the drug has for continued survival, will not likely go unnoticed.”

How can we put this knowledge to good use?  The first thing to think about when treating addictive behavior may be the role that stress and anxiety plays in addiction.  If someone is suffering from chronic stress or an anxiety disorder, treating the underlying anxiety issues may  be of use in handling the addiction.  While treating anxiety does not ever take the place of other separate treatments for addiction and addictive behaviors, substance abuse treatment should never take place in a vacuum. 

If we are going to be successful in fighting addictive behavior and creating a better treatment protocol for patients who suffer from anxiety and co-occurring addiction disorders, it is crucial to consider the role that poor coping skills for stress and anxiety play in addiction and offer skills training for stress management.


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