Substance-Induced Anxiety Disorder: Treatment Options

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Substance-induced anxiety disorder can severely affect your daily life, relationships, and overall well-being.

The intense anxiety triggered by alcohol, drugs, or certain medications doesn’t just affect your mental health but also takes a toll on your physical health and quality of life. This guide explores various treatment options to help you regain control and find relief.

What is substance-induced anxiety disorder?

Substance-induced anxiety disorder occurs when the use of alcohol, drugs, or certain medications triggers intense anxiety symptoms. This type of anxiety is directly linked to substance use, withdrawal, or exposure, causing significant distress and interfering with daily life.

Symptoms of substance-induced anxiety disorder

Substance-induced anxiety disorder can manifest in various ways. Here are some common indicators:

Physical symptoms

Rapid heartbeat: A fast or pounding heart rate that feels like your chest is racing.
Sweating: Excessive sweating, especially in the palms and feet, even in cool environments.
Tremors: Shaking or trembling in the hands or other parts of the body, often noticeable when trying to hold objects.
Shortness of breath: Difficulty catching your breath or rapid, shallow breathing that can make you feel like you are suffocating.
Dizziness: Lightheadedness or a sensation of spinning, which can make you feel unsteady on your feet.
Nausea: Feeling queasy or having an upset stomach, which can sometimes lead to vomiting.

Emotional symptoms

Excessive worry: Persistent and uncontrollable worry about various aspects of life, leading to a feeling of constant unease.
Panic attacks: Sudden, intense episodes of fear or discomfort, often accompanied by physical symptoms like heart palpitations and sweating.
Irritability: Feeling unusually agitated or easily annoyed, often leading to frustration with minor inconveniences.
Restlessness: Inability to relax or sit still, constantly feeling on edge and needing to move.

Cognitive symptoms

Racing thoughts: Rapid, continuous thinking that can be hard to control, often jumping from one worry to another.
Difficulty concentrating: Trouble focusing on tasks or conversations, feeling easily distracted and unable to complete tasks efficiently.
Memory issues: Forgetfulness or difficulty recalling information, which can affect daily functioning and responsibilities.

Behavioral symptoms

Avoidance: Steering clear of places, people, or activities that trigger anxiety, leading to isolation and missed opportunities.
Compulsive behaviors: Repetitive actions, like checking things repeatedly or pacing, as a way to manage anxiety.
Social withdrawal: Pulling away from social interactions and isolating oneself, often avoiding gatherings and events.

Psychological symptoms

Feelings of doom: A sense that something terrible is about to happen, creating a constant state of dread.
Detachment: Feeling disconnected from oneself or reality, as if you are observing your life from outside your body.
Hypervigilance: Being overly alert and on edge, constantly looking out for danger or threats, even in safe environments.

What drugs cause anxiety?

Various substances can trigger or worsen anxiety or panic disorders. These substances include:

Stimulants

Caffeine: This is found in coffee, tea, energy drinks, and some medications. Caffeine can increase heart rate and cause jitteriness, leading to anxiety. ¹
Nicotine: Present in tobacco products, nicotine can cause temporary relief from anxiety but often leads to increased anxiety over time. ²
Amphetamines: They are used to treat ADHD and narcolepsy. Amphetamines can increase anxiety, especially at higher doses.
Cocaine: This powerful stimulant can cause intense anxiety and panic attacks, particularly during the comedown phase.

Depressants

Alcohol: While alcohol might initially reduce anxiety, it can lead to increased anxiety or panic attacks during intoxication or withdrawal or with long-term use. ³
Benzodiazepines: This drug is used to treat anxiety and insomnia. Benzodiazepines can cause increased anxiety when used long-term or during withdrawal. ⁴

Hallucinogens

Lysergic acid diethylamide (LSD): This psychedelic drug can cause severe anxiety and panic attacks, especially in higher doses or in users prone to anxiety.
Psilocybin (Magic Mushrooms): Similar to LSD, psilocybin can lead to anxiety and paranoia during use.
3,4-methylenedioxymethamphetamine (MDMA): While often used for its euphoric effects, MDMA can cause anxiety or panic during the comedown phase and with repeated use.

Cannabinoids

Marijuana (THC): While some users find marijuana relaxing, it can increase anxiety and paranoia, particularly in high doses or with long-term use.
Synthetic cannabinoids (Spice, K2): These can cause severe anxiety, agitation, and panic attacks, often more intensely than natural marijuana.

Prescription medications

Steroids: Used for various medical conditions, steroids can cause mood swings and anxiety, especially with long-term use.
Decongestants: Found in some cold medications, decongestants can increase heart rate and anxiety. ⁵
Thyroid medications: Over-treatment with thyroid hormones can lead to symptoms of anxiety.

Why do people with anxiety turn to substances?

People with anxiety often turn to substances in an attempt to manage their symptoms and find relief. Here are more reasons why this occurs:

Self-medication

Many individuals use substances to self-medicate their anxiety:

Temporary relief: Substances like alcohol or drugs can provide a temporary sense of calm and relaxation, reducing anxiety symptoms for a short period.
Escape from reality: Substances can offer an escape from overwhelming feelings of worry and fear, providing a brief break from constant anxiety.
Numbing emotions: People may use substances to numb their emotional pain and avoid dealing with the root causes of their anxiety.

Social pressure

Social environments can influence substance abuse among those who experience anxiety:

Peer influence: Social situations where substance use is prevalent can pressure individuals to participate to fit in or feel accepted.
Social ease: Some people use substances to feel more comfortable and less anxious in social settings, helping them engage with others more easily.
Coping with social anxiety: Those with social anxiety might rely on substances to reduce their fear of social interactions and gatherings.

Lack of access to professional help

Limited access to mental health resources can lead individuals to self-treat their anxiety:

Financial barriers: The cost of therapy and medications can be expensive, leading people to seek cheaper alternatives like substances.
Stigma: Fear of being judged or misunderstood may prevent individuals from seeking professional help, driving them to self-medicate instead.
Lack of awareness: Some people might not realize that professional help is available or effective, leading them to use substances as a perceived solution.

Coping mechanism

Substances can become a coping mechanism for managing anxiety:

Stress relief: Using substances to unwind after a stressful day can become a habitual way to manage anxiety.
Routine: Over time, substance use can become integrated into daily routines, making it difficult to break the cycle.
Avoidance: Relying on substances to avoid dealing with anxious situations or thoughts can increase the use of substances over a long period of time. This, in turn, can lead to substance use disorder.

Neurochemical influence

Substances can affect brain chemistry in ways that temporarily relieve anxiety:

Dopamine release: Many substances increase dopamine levels, providing a pleasurable sensation that can counteract feelings of anxiety.
Sedative effects: Substances like alcohol and benzodiazepines have sedative properties that can help calm the nervous system.
Short-term euphoria: Drugs that produce a euphoric effect can distract from anxious thoughts and create a sense of well-being, albeit temporarily.

Diagnosis of substance-induced anxiety disorder

Diagnosing substance-induced anxiety disorder involves a thorough evaluation by a healthcare professional. Here’s what the process typically includes:

Medical history

The healthcare provider will gather detailed information about your medical history:

Substance use history: The doctor will ask about your use of alcohol, drugs, prescription medications, and over-the-counter substances.
Symptoms timeline: You’ll describe when your anxiety symptoms began and if they are linked to substance use or withdrawal.
Mental health history: The doctor will review any past diagnoses of anxiety, depression, or other mental health conditions.
Family history: Information about any family history of substance use or mental health conditions will be gathered.

Physical examination

A physical exam will help rule out other possible causes of anxiety:

General health check: The doctor will assess your overall health and identify any physical issues that might contribute to anxiety.
Neurological assessment: The healthcare provider will check for any nervous system problems that might cause anxiety-like symptoms.

Diagnostic criteria

The healthcare provider will use established criteria to ensure an accurate diagnosis:

DSM-5 criteria: The doctor will determine if your anxiety symptoms developed during or after substance use and if they are more severe than typical substance effects.
Rule out other disorders: The healthcare provider will ensure your symptoms are not better explained by another mental health disorder.

Diagnostic tests

Various tests may be conducted to confirm the diagnosis and rule out other causes:

Blood and urine Tests: These tests will detect the presence of substances in your system.
Electrocardiogram (EKG): An EKG will rule out heart-related causes of anxiety symptoms.
Imaging studies: If necessary, MRI or CT scans will be used to rule out neurological conditions.

Psychological evaluation

A psychological evaluation will provide a deeper understanding of your symptoms:

Structured interviews: The doctor will assess the severity of your anxiety symptoms and their impact on daily life.
Psychological questionnaires: Tools like the Hamilton Anxiety Rating Scale (HAM-A) or Beck Anxiety Inventory (BAI) will be used to quantify your anxiety.

Monitoring and follow-up

Ongoing monitoring will ensure the diagnosis is accurate:

Ongoing assessment: Regular follow-up appointments will track your symptoms and their relationship to substance use.
Treatment response: The doctor will evaluate how your symptoms respond to treatment to confirm the diagnosis.

Does drug-induced anxiety go away?

Medication-induced anxiety disorder can be temporary, but how long it lasts and how it gets better depends on several factors.

Factors influencing recovery

Type of substance: Different drugs affect the body in various ways. Stimulants like caffeine may cause short-term anxiety, while withdrawal from substances like benzodiazepines may cause longer-lasting anxiety.
Duration of use: Long-term use of a substance can lead to more severe and persistent anxiety symptoms.
Dosage: Higher doses of a substance are more likely to cause significant anxiety and take longer for the body to process.
Individual differences: Personal factors like genetics, overall health, and mental health history influence how long anxiety symptoms last.

A combination of these factors will determine how fast your body recovers from drug-induced anxiety. It’s important to remember that everyone’s experience is unique, and recovery times can vary.

How to treat drug-induced anxiety disorder

Treating drug-induced anxiety disorder involves a comprehensive approach:

Immediate steps

Cease substance use: Stop using the substance causing anxiety. Consult a healthcare professional for guidance, especially if withdrawal symptoms are expected.
Detoxification: Under medical supervision, detoxification helps clear the substance from your system safely.

Professional treatment

Professional treatment provides structured support for managing drug-induced anxiety:

Therapy: Cognitive-behavioral therapy (CBT) helps change negative thought patterns and develop coping strategies. Other therapies like dialectical behavior therapy (DBT) or exposure therapy might also help.
Medication: Doctors may prescribe medications such as antidepressants, anti-anxiety drugs, or beta-blockers to manage symptoms. Always follow the guidance of a healthcare provider.

Lifestyle changes

Making healthy lifestyle changes can support long-term recovery:

Regular exercise: Physical activity helps reduce anxiety and improve well-being. Aim for at least 30 minutes of moderate exercise most days of the week.
Healthy diet: Eating a balanced diet rich in fruits, vegetables, and whole grains improves physical and mental health. Avoid excessive caffeine and sugar.
Adequate sleep: Maintain a consistent sleep schedule and create a restful sleep environment. Aim for 7-9 hours of quality sleep each night.

Stress management techniques

Incorporating stress management techniques can help reduce anxiety symptoms:

Mindfulness meditation: Practicing mindfulness or meditation can calm your mind and reduce anxiety. Even a few minutes daily can help.
Deep breathing exercises: To calm your nervous system, practice diaphragmatic breathing. Inhale deeply through your nose, hold, and exhale slowly through your mouth.
Progressive muscle relaxation: Tense and release each muscle group to reduce muscle tension.

Support systems

Building a strong support system is vital for recovery:

Support groups: Joining support groups for substance use or anxiety provides a sense of community and shared experience.
Family and friends: Lean on trusted family members and friends for emotional support. Their encouragement can make a big difference.

Final thoughts

Healing from substance-induced anxiety is challenging. With patience, support, and the right approach, recovery is possible.

Seek help, make healthy changes, and lean on loved ones. If you need guidance, our anxiety treatment program is here to support you every step of the way.

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Sources

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2. Picciotto, M. R., Brunzell, D. H., & Caldarone, B. J. (2002). Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport, 13(9), 1097-1106. https://doi.org/10.1097/00001756-200207020-00006
3. Grayland-Leech, B. (2024, July 10). What are the links between alcohol and anxiety? In N. Washington (Ed.), Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/326597

4. Edinoff, A. N., Nix, C. A., Hollier, J., Sagrera, C. E., Delacroix, B. M., Abubakar, T., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2021). Benzodiazepines: Uses, dangers, and clinical considerations. Neurology International, 13(4), 594–607. https://doi.org/10.3390/neurolint13040059

5. Weiss, C. (2022, March 1). Mayo Clinic Q and A: Decongestants can sometimes cause more harm than good. Mayo Clinic News Network. Retrieved from https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-decongestants-can-sometimes-cause-more-harm-than-good/

Author: Editorial Team
AUGUST 9, 2024