Anxiety Disorders

It is normal for individuals to experience bouts of nervousness or stress from time-to-time. Anxiety disorders, unlike common, passing feelings of anxiety, are likely to cause high levels of emotional and psychological distress, and often interfere with one’s ability to lead a normal and successful life.

Anxiety disorders are not uncommon – especially amongst addicts and alcoholics. Individuals who suffer from anxiety disorders are two to three times more likely to suffer from a substance abuse disorder than members of the general population. Being afflicted with both disorders, regardless of which came first, can quickly become a vicious and devastating cycle. In many instances, the symptoms of one disorder will work to exacerbate the symptoms of another; an individual with an anxiety disorder may turn to drugs or alcohol in order to alleviate overwhelming psychological symptoms.

We at Next Chapter have extensive experience working with patients who are suffering from both anxiety disorders and substance dependency disorders. We understand that in order for one problem to be resolved, both must be thoroughly treated – seeing as they are so closely linked, and oftentimes work to intensify one another. Because of this, we have developed a comprehensive and individualized program of addiction recovery that focuses intently on mental health and past traumatic experience.

Types of Anxiety Disorder

There are several types of diagnosable anxiety disorder.

Generalized Anxiety Disorder

It is common to feel high stress levels on occasion – perhaps before taking an exam, before publically speaking, or before meeting potential in-laws for the first time. Fleeting feelings of anxiety may help us to preform better or meet deadlines more efficiently, and rarely result in serious or lasting impairment. Individuals with GAD, however, tend to feel anxious and stressed out the majority of the time – not just during particularly stressful situations. The worry they experience is intense and overwhelming, and often interferes with their ability to successfully perform day-to-day tasks. These worries may relate to a number of things, ranging from personal health and family functioning to work and financial security. Even minor issues, such as being late to an appointment or forgetting to pick up dry cleaning, can be points of major anxiety, leading to overwhelming feelings of dread.

Those who are afflicted with Generalized Anxiety Disorder will typically experience symptoms (excessive stress and anxiety related to a wide range of daily tasks and circumstances) for 6 months or more. The crippling anxiety they feel throughout the day will prevent them from living healthy and productive lives, interfering with social functioning, work, school, or the completion of menial (but necessary) tasks. Like most other anxiety disorders, GAD can be caused by a wide range of potential factors – from biological predisposition to stressful like events or psychological factors. Those suffering from GAD can often be treated with intensive therapeutic counseling – and, if necessary, with medication.

Social Anxiety Disorder

For individuals with a social anxiety disorder, interacting with others in any capacity will lead to overwhelming feelings of anxiety, stemming from the irrational fear of being unfairly judged, criticized, humiliated, or laughed at. Those who suffer from this specific disorder will often have great difficulty participating in the most menial social tasks, such as eating in public or using public transportation. Most commonly, however, social phobia will occur during (or in the lead up to) performance situations (at work or at school), or social interactions (such as attending a work party or having a meal with friends). While social anxiety disorder is often relatively generalized, it can also be quite specific. One individual may experience severe anxiety during any potential social interaction, while another may only feel anxious when dealing with confrontation or disagreement.

Many individuals who suffer from this specific anxiety disorder will turn to drugs and alcohol in order to self-medicate symptoms, attempting to alleviate the intense psychological discomfort that tends to go hand-in-hand with social functioning. Men and women who suffer from social anxiety will often report that excessive drinking helps them to lessen their nervousness – in reality, however, substance abuse only works to worsen symptoms in the long run. Many individuals will begin abusing alcohol and other chemical substances after the onset of this particular disorder.

Just like other anxiety disorders, social anxiety may be caused by a number of factors. Among the most common are family history, early environment, and learned behaviors. Some individuals will attribute their social phobias to being abused or neglected from a young age, or undergoing traumatic experiences having to do with being publically humiliated or scorned. While psychological treatment is often highly successful in treating social anxiety disorders, medication may be necessary in extreme cases.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder, commonly referred to as PTSD, frequently occurs after an individual has undergone a traumatic event, such as a life-threatening accident, war, assault, or a devastating natural disaster. The individual who underwent the traumatic experience, during which his or her life (or the life of someone close) was in immediate danger, will repeatedly experience overwhelming feelings of intense fear, horror, or helplessness. Those who are afflicted with PTSD will often experience four major types of difficulty:

  • Re-living the traumatic event.

The afflicted individual relives the trauma through unwanted and intrusive memories, which are often tied to overwhelming feelings – both emotional and physical. Often, these unwanted memories show up in the form of recurring nightmares or vivid imagery. The individual may experience increased heart rate or heart palpitations, profuse sweating, or extreme panic when he or she is reminded of the event.

  • Attempting to avoid all reminders of the event.

The afflicted individual will often deliberately avoid people, places, activities, thoughts, and feelings that may conjure unwanted memories of the event. He or she may go to great lengths to avoid these painful memories, to the point where his or her life is being constantly interrupted.

  • Being overly wound-up or on constant high alert.

The individual who is suffering from PTSD will often remain on high alert, keeping on the constant lookout for signs of potential danger. It is not uncommon for the individual to experience extreme difficulties sleeping, especially if he or she has been experiencing recurrent nightmares. Irritability and lack of concentration are also common symptoms.

  • Emotional numbness.

The afflicted individual will often lose interest in activities that were previously enjoyed, unable to find pleasure in much of anything. He or she will often feel emotionally numb – detached from friends and family members; unable to connect.

Many individuals who suffer from PTSD will simultaneously experience additional mental health problems, such as depression or substance abuse. If PTSD persists, unresolved, for a prolonged period of time, additional mental health problems are far more likely to develop.

As far as treatment goes, intensive therapy has proven to be highly successful in treating many cases of post-traumatic stress disorder. Support from family members and close friends is very important, and developing a solid network of recovering peers has also proven to be immensely beneficial. For those who are afflicted with both PTSD and a co-occurring substance abuse issue, comprehensive inpatient treatment often proves vital.

Obsessive Compulsive Disorder

In some cases, anxious thoughts can benefit us – if they are infrequent and rational. For example, we may believe that we forgot to turn off our headlights before heading inside for the evening. We check the headlights once, see that they are off, and return to our normal routine. For the individual suffering from OCD, however, the thought ‘I forgot to turn my headlights off’ may quickly become obsessive, and lead to compulsive and uncontrollable checking. For those who are afflicted with obsessive compulsive disorder, obsessions and compulsions (acts that are performed in order to help alleviate immense stress or neutralize obsessive thoughts) are present – and will severely interrupt normal daily functioning.

Those who are suffering from the symptoms of OCD will often feel a great amount of shame and guilt regarding their uncontrollable need to carry out compulsions. These feelings of shame can add additional stress and anxiety, and work to exacerbate the disorder, therefore exacerbating the shame in turn – eventually, this will lead to a vicious cycle of compulsion and psychological consequence. Many afflicted individuals will attempt to keep their symptoms private, which may lead to a delay in professional diagnosis. Many untreated OCD sufferers will turn to drugs and alcohol as a means of self-medication, which can in turn lead to substance dependency disorders. In most cases, intensive therapeutic treatment is an effective form of treatment.

Panic Disorder

Those who are afflicted with panic disorder will experience frequent panic attacks, coupled with a range of physical symptoms. These symptoms may include shortness of breath, difficulty breathing, dizziness, chest pain, and profuse perspiration. These panic attacks are both recurrent and highly disabling, causing major interruptions in the ability to carry out normal, day-to-day activities. Panic disorders are most commonly characterized by:

      • The presence of recurrent and unpredictable panic attacks.
      • Continuously worrying that a panic attack will take place (at least a month after experiencing one).
      • Changes in behavior relating to the fear of undergoing another panic attack (such as avoiding scary movies, exercise, or anything else that could potentially increase heart rate).
      • Anxiety revolving around perceived implications of the anxiety attack (such as fear of an undiagnosed medical problem). Irrational fear of dying, going crazy, or losing complete control of bodily functions.

Most often, panic attacks will peak within 10 minutes of their onset, and could last for up to half an hour. After experiencing a panic attack, an individual will likely feel physically exhausted and emotionally drained. Panic disorder can occur at any stage in life, but it is most common amongst men and women in their late 20s and early 30s. Many individuals who suffer from an undiagnosed and untreated panic disorder will turn to drugs and alcohol as a means of self-medication. Panic disorders can often be fully resolved with intensive therapeutic treatment. If a panic disorder and substance dependency disorder are co-occurring, each must be treated comprehensively in order for both to be eradicated.

It is important to remember that substance dependency disorders and anxiety disorders are separate entities, and must be treated as such. Treating substance abuse, no matter how thoroughly, will not eliminate an underlying anxiety disorder. In order to reduce the chance of relapse and improve the chance of leading a fulfilled life of inclusive recovery, it is important that addiction and anxiety disorders are treated thoroughly and simultaneously. There are many well-established, effective, and lasting therapeutic treatment methods to help individuals overcome both substance abuse and underlying psychological disorders.

We at Next Chapter utilize many of these methods, including Cognitive-Behavioral Therapy, EMDR, Somatic Experiencing, and Psychodrama. We treat each individual and each disorder separately, and work hard to uncover all contributing, underlying causes. If you suffer from an untreated anxiety disorder, there is help available. Please feel free to call us today for more information.

My journey (and growth!) of these last several months has been tremendous, and I could not be more grateful to Next Chapter and all involved for your part in helping me to open my eyes and heart to a self-awareness I have not had in a very, very long time. I took your suggestions from our first initial conversations of getting back to 12 step meetings, counseling and my own inward continued journey. I express genuine, true heartfelt thanks for that
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