Substance misuse and anxiety disorders: breaking the cycle

People with anxiety disorders often misuse alcohol and substances as a way of coping. A Mediclinic expert discusses what can be done to break this toxic cycle early on and prevent further problems.

Everyone gets anxious occasionally, and this is normal; it’s nature’s way of warning you of danger and risks, motivating you, and helping you to problem solve. However, when the symptoms become so intense and frequent that they interfere with your day-to-day functioning, anxiety is considered a disorder.

Symptoms of anxiety disorders

“Anxiety disorders are extremely common. In fact, they’re the most common of the mental disorders, with up to 30% of people experiencing an anxiety disorder at some point in their lives,” says Dr Ravi Govender, a psychiatrist at Mediclinic Cape Town, who defines anxiety as “excessive fear and worry”. The World Health Organization (WHO) lists other symptoms of anxiety disorders:

• Trouble concentrating or making decisions
• Feeling irritable, tense or restless
• Experiencing nausea or abdominal distress
• Having heart palpitations
• Sweating, trembling or shaking
• Trouble sleeping
• Having a sense of impending danger, panic or doom.

Dangers of addiction

Because most people don’t receive the appropriate help in treating these symptoms, individuals often turn to alcohol and recreational drugs to relax and self-medicate. “But using an unhealthy means to cope with a problem ends up causing even more problems,” warns Dr Govender.

The use of illicit substances and alcohol becomes a quick fix, and the user becomes dependent on this coping mechanism, which only worsens the anxiety – the root cause of the problem. This creates a vicious cycle, where they build up a tolerance and consequently suffer from withdrawal symptoms, creating further anxiety. “As the tolerance and dependence increases, they start going into a state of withdrawal when the substance loses its effect on the body. This further exacerbates the underlying anxiety,” explains Dr Govender.

The cycle isolates the individual and they see no way out other than to continue using drugs and alcohol, putting them at risk of addiction and all the challenges associated with it. The potential damage this can cause to the person physically, mentally, and socially, is far-reaching and sometimes irreversible.

Managing anxiety and substance dependence 

To prevent the problems of addiction, it is important to break the cycle as early as possible. It can be extremely challenging for a person to break their unhealthy patterns of behaviour on their own, and reaching out to friends and family is good when the symptoms of anxiety become overwhelming. The next step is to seek help from a healthcare professional. Treatment for the anxiety might include healthy lifestyle changes, individual or group therapy, and medication, which together will make the symptoms easier to manage.

In terms of the substance misuse, the ability to get sober depends on the severity of the problem. Some people will be able to recover with the help of friends and family, and a support group, while others will need specialist treatment from a healthcare professional and/or clinic.

“Fortunately, there is help out there,” says Dr Govender. “A healthcare professional can help you get out of the cycle. There are ways to help get you off the substance safely and treat the underlying anxiety disorder.”

Mediclinic is prioritising mental wellbeing by making mental health services more accessible to the broader community. We have dedicated mental health units in Welkom, George, Newcastle, Pretoria, Legae, and Cape Town. Smaller in-hospital care options also exist within some of the acute facilities.