It’s not uncommon for individuals struggling with alcohol or drug addiction to also experience mental health symptoms. The age-old question is what influences what? That question is not so easily answered as we’ve seen both the mental health symptoms, as well as the substance abuse symptoms come first. For example, an individual struggling with depressive symptoms self-medicates with alcohol in order to cope with their emotional pain. Alternatively, alcohol is a depressant; therefore, drinking it can lead to the blues. Anxiety symptoms are also often seen with individuals who experience alcohol and drug abuse. Individuals experiencing symptoms associated with high anxiety often self-medicate in an attempt to better function in daily life. Although mental health diagnoses such as depression and anxiety are common amongst those with substance abuse, there’s a specific type of anxiety the addiction treatment industry is becoming more exposed to, social anxiety. In particular, social anxiety and alcohol use have been most commonly linked together.
Social anxiety disorder, or social phobia, is defined as an excessive fear of social situations in many different ways (i.e public speaking, eating in public, talking to strangers or even friends). Symptoms of social phobia include: persistent fear of one or more social situations (fear based on worry about humiliation or embarrassment), exposure to situations incites anxiety or panic attacks, the person recognizes that the fear is unreasonable, these situations are avoided which causes issues in the person’s ability to engage in daily life tasks and occurs without the presence of drugs or alcohol. For example, you’re at the store and unable to find an item you’re looking for; however, you’re not able to ask an individual who works there for help. Or, perhaps more severe, you’re not able to do things that you really might want to do like interviewing for a job, joining an organization, or attending a party.
The National Institute on Alcohol Abuse and Alcoholism (NIH) reports that social anxiety disorder affects 2-13 percent of the U.S. population and 25% of those individuals struggle with severe alcohol use. Primarily, alcohol is used with these individuals in order to ease the fear of situations that they would normally avoid or disengage in. Alcohol is a known substance to reduce social inhibitions when in use, and most individuals agree that they utilize it for this reason. Individuals with high anxiety, and who are expected to be in many social situations, would use more of the substance in order to cope and tend to develop a tolerance. This can lead to addiction or other negative consequences depending on the amount, duration, time, and factors of use.
Research suggests that although alcohol use in anxiety-provoking situations may be identified as a reduction in stress and tension, as a depressant on the central nervous system, it can actually increase long-term stress responses. According to NIH, chronic alcohol use will raise adrenaline levels in the body, elevates heart rate, and raises blood pressure leading to increased physiological anxiety states.
All in all, self-medicating with alcohol to reduce social phobias or social anxiety ultimately has the adverse effect. Effective and evidence-based solutions such as medications and talk therapy should be an individual first line of defense. According to NIH, some studies found that SSRI’s were found to be effective in helping to manage anxiety symptoms, specifically with individuals who have struggled with alcohol use. Also, talk therapy, as well as mental health or addiction treatment with a counselor or therapist was found effective. Lastly, cognitive behavior therapy (CBT) addresses irrational thought patterns and exposure to situations in order to better cope with anxiety.
Author: Stephanie Pruefer, MA, LPC, CADC – Footprints to Recovery – Primary Counselor