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Co-Occurring Anxiety & Substance Use Disorder

Anxiety disorders are mental health conditions characterized by excessive fear and worry.1, Many who struggle with anxiety disorders may also experience a co-occurring substance use disorder.1, Anxiety disorders and SUDs, pg. 102 This may be due to using substances to self-medicate for anxiety symptoms, substance use disorders leading to anxiety symptoms, or genetic factors.2 Whatever the cause, there are treatment options that can help you manage co-occurring anxiety and substance use disorders. Understanding how anxiety and addiction interact, how treatment can help, and how to access treatment can be an important first step for achieving recovery.

What Are Anxiety Disorders?

Anxiety disorders are a type of mental health disorder characterized by excessive fear and worry.1 Women are twice as likely to experience anxiety disorders than men.1 The chance someone will experience an anxiety disorder at some point in their life is about 30%.1

What Are the Different Types of Anxiety Disorders?

The three most common anxiety disorders that co-occur with substance use disorder include generalized anxiety disorder, panic disorder, and social anxiety disorder.1,

  • Generalized anxiety disorder (GAD): Excessive anxiety and worry about a wide range of everyday topics, such as living, finances, relationships, or work/school performance.1, 
  • Panic disorder: Abrupt and intense panic attacks that are distressing and often disabling.1 Symptoms of a panic attack may include hyperventilation, palpitations, trembling, sweating, dizziness, hot flashes or chills, numbness or tingling, and the feeling of nausea or choking.1,
  • Social anxiety disorder: Persistent irrational fear of embarrassment and humiliation in social situations.1,

Signs & Symptoms of Anxiety

Anxiety is an emotion that causes feelings of tension, worry, and even physical changes such as a racing heart and increased blood pressure.6 It is a natural response when faced with something worrisome, such as making an important decision, taking a test, or doing something new for the first time. Feeling some anxiety in these situations is normal, and anxiety can even be helpful at times to help us avoid or prepare for danger. But when the worry becomes constant and causes problems in daily life, it may lead to an anxiety disorder, to where anxiety is affecting our normal day-to-day functioning.7

The Relationship Between Anxiety Disorders and Addiction

The relationship between anxiety disorders and substance use disorders is complex, with each disorder modifying the presentation and treatment outcomes of the other.1 Those with co-occurring anxiety and substance use show greater disability, more hospitalization, poorer overall functioning, more difficulties in interpersonal relationships, more severe symptoms, worse health-related quality of life, and poorer treatment response than those with only one of these disorders. 1 The risk of suicidal ideation and suicide attempts are also increased for those with co-occurring anxiety and addiction. 1

Anxiety and substance use disorders are commonly occurring dual diagnoses. 1 Research suggests that co-occurring anxiety and substance use disorders develop in three intertwined ways.2 The anxiety disorder may lead to the substance use disorder through the method of self-medication; substance use may induce heightened levels of anxiety resulting in an anxiety disorder; or there may be a genetic or hereditary disposition to both anxiety and substance use disorders. 2

How to Treat Co-Occurring Anxiety and Substance Use Disorder

Treating substance use disorders alone is oftentimes not sufficient to address the co-occurring anxiety disorder.1 Likewise, the presence of anxiety disorders makes treatment complicated and can result in difficulties in sustaining abstinence and preventing relapse.1 Thus, treatment may be most effective when it includes interventions that acknowledge and address both the anxiety and addiction symptoms.1

Concurrent treatment of co-occurring disorders and substance use disorders, known as an integrated model of care, is the standard of care for treating people with co-occurring anxiety and substance use disorders.1 This can include a combination of interventions tailored to a person’s individual needs, such as psychotherapy and medication, and may occur in either inpatient or outpatient settings.1 Medications that help with anxiety disorders include antidepressants and benzodiazepines.1 Psychotherapies for co-occurring anxiety and substance use disorders may include:4, Behavioral therapies

  • Cognitive-behavioral therapy (CBT): Helps people learn to cope with situations by challenging irrational thoughts and changing unhealthy or harmful behaviors.
  • Dialectical behavioral therapy (DBT): includes mindfulness and acceptance of current situations and emotional state.
  • Assertive community treatment (ACT): A community-based mental health care that emphasizes outreach in the community.
  • Therapeutic communities: A type of long-term residential treatment that focuses on helping people develop healthy values, attitudes, and behaviors.
  • Contingency management: A type of therapy that encourages healthy behaviors through the use of vouchers or rewards.

Does Insurance Cover Rehab for Co-Occurring Anxiety and Addiction?

According to the Affordable Care Act (ACA), all health insurance plans are required to provide some degree of coverage for medically necessary treatment of mental and behavioral health disorders.5 This often means that insurance will cover some or all of the costs of treatment associated with anxiety disorder and co-occurring substance use disorder. However, this is not guaranteed, as the degree of your coverage may vary significantly. It’s important to reach out to your insurance provider before committing to treatment in order to determine costs.

You can now check to see if your health insurance plan covers treatment through American Addiction Centers by using our verify your health insurance tool. For more information regarding insurance coverage, payment options, and treatment options, reach out to our Admissions Navigators at . American Addiction Centers maintains a strong partnership with a large group of insurance companies at our addiction treatment facilities. Start the journey to recovery and find out instantly using the form below if your health insurance provider may be able to cover all or part of the cost of rehab and associated therapies.

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