Which Came First? Anxiety Disorder or Substance Abuse? The Sometimes Confusing World of Co-Occurring Disorders

It can seem like a true chicken-and-the-egg scenario when considering if anxiety led to substance abuse or vice versa. Every individual is unique, so there is no one answer that can describe everyone’s struggle with addiction and anxiety. However, we can examine the relationship between anxiety and addiction to understand the mechanisms that can affect both.

What Is Anxiety Disorder?

Anxiety disorder is an umbrella term for several mental illnesses. While everyone can, and does, experience anxiety, anxiety disorders are serious mental illnesses. Anxiety disorders include:

  • Panic disorder
  • Generalized anxiety disorder
  • Social anxiety disorder
  • Phobias

While all of these disorders have specific characteristics, all have looming feelings of terror, fear and worry. People with anxiety feel abnormally high rates of fear and discomfort when dealing with regular life activities. These feelings can become overwhelming, and people may change their life or avoid people, places or certain activities to help minimize that discomfort on a daily basis. When day-to-day life is affected, that’s a key sign of an anxiety disorder versus regular anxiety.

Anxiety Disorder and Addiction

Anyone who has done any amount of reading on addiction science has probably heard that addiction is a commonly co-occurring disorder. This means a significant number of people who qualify as having an addiction disorder also qualify as having an additional disorder. The most common co-occurring disorders with addiction are anxiety and depression.

Which Came First: Anxiety or Addiction?

That statistics regarding anxiety and addiction can be startling, but they aren’t helpful in determining a root problem. The Anxiety and Depression Association of America found the following:

  • An estimated twenty percent of people suffering from an anxiety disorder have substance abuse problems.
  • An estimated twenty percent of people suffering from addiction have an anxiety disorder.

So, we can see that the two disorders are very closely tied, but which came first? Truthfully, there’s no answer. The majority of people with these disorders have them independently of one another. This would suggest both disorders are the results of another variable. The variables that may contribute to a dual diagnosis of anxiety and addiction include:

  • Some people are biologically predisposed to both addiction and anxiety. Consider the prevalence of both disorders in your family to better determine if this could be affecting you.
  • Trauma is a tremendous trigger for both anxiety and substance abuse. Someone who has experienced a traumatic event may be at greater risk for this dual diagnosis.
  • A third illness is also a possible link between anxiety and addiction. A physical illness which requires a lifestyle change or pain management can lead to anxiety, depression, substance use (and eventual addiction) and social withdrawal. If an illness is affecting your anxiety or addiction, consult a treatment center that specializes in holistic treatment of co-occurring disorders.
  • Abuse or unhealthy relationships. Unhealthy relationships can lead to anxiety for very obvious reasons. Dealing with emotionally, mentally or physically abusive situations are extremely worry and fear-provoking. Many people experiencing these difficult situations also turn to substances to help cope with their life.

I Have Both. What Can I Do?

The most important thing to remember is you are not alone in battling both anxiety and addiction. While it may be unclear just how you developed both disorders, professional help can help you determine the right course of treatment. Choosing treatment that includes a holistic viewpoint of the mind and body, along with a deep understanding of co-occurring mental disorders is the best way to ensure long-term results. Contact us today to learn more about overcoming a dual diagnosis.

Photo via