1. How Anxiety Works
As humans, we experience stress on a regular basis. No matter what age you are, there are uncontrollable factors in your life that can cause worry.
Whether it’s paying your bills on time, finishing your homework or simply completing a to-do list for the day, everyone can feel some level of anxiety when these situations occur.
Minor forms of anxiety are completely normal and part of human nature, but there are those who suffer from a legitimate anxiety disorder.
Much like those who are diagnosed with depression, anxiety is beyond the person’s control. They experience extreme levels of anxiousness, and it takes some work for them to calm down.
As with most forms of mental illness, some people are genetically predisposed to an anxiety disorder due to their family history.
Other people may develop anxiety later in life for biological reasons or after a certain event.
Anxiety comes from the body overreacting to its “adrenaline response” system. This system is part of every human being and is what helped our ancestors survive.
These chemicals flow through the body to warn a person of danger. The human body evolved so people learned when to fight an enemy or animal, take some time to think about the correct course of action or completely avoid the situation.
This is commonly known as the “flight or flight response”.
These chemical reactions in the body are triggered by specific situations, but for someone who suffers from anxiety these chemical reactions happen sporadically and can become extremely overwhelming.
How is Anxiety Triggered?
To an extent, anxiety is completely normal and every person experiences symptoms to some degree.
Those who suffer from a disorder are often triggered by certain specific events in which the feelings become out of control.
In the brain, there is a portion called the amygdala, which serves as a hub to distribute signals to other parts of the brain or body.
One of the functions it provides is when to alert the person of a present danger that’s based on a distinct fear they have.
These fears can be a feeling of physical harm, but they can also be related to fears related to damaging one’s ego, like failure.
Memories of specific events are stored in the hippocampus. These memories can trigger the amygdala with these fears based on previous events, which are mostly present in someone who suffers from a form of PTSD.
While the individual may have legitimate reasons to be fearful of certain situations or events, sometimes their anxiety kicks in for virtually no reason at all.
There may not be any form of danger physically present or in the near future, but the person’s mind will begin to create fears on its own.
When anxiety strikes, the body begins to prepare to deal with the immediate danger or threat.
Norephinephrine and cortisol begin to flood the system. When this happens, the person will have heightened awareness and reflexes.
This happens because there is an increased flow of blood due to an increased heart rate and more air in the person’s lungs.
Many people will feel somewhat different physically, but someone with an anxiety disorder can experience very specific symptoms.
- Uncontrollable sense of panic, fear and uneasiness
- Shortness of breath
- Heart palpitations
- Unexplainable worry
- Muscle tension
- Difficulty sleeping
- Isolating in order to feel safe
All of the symptoms can vary from person-to-person, but the symptoms don’t go away on their own.
The person often feels trapped by these symptoms and held hostage by them. They may eventually believe that this is normal.
In some cases, the person may turn to alcohol in order to calm their nerves, which can turn into a form of self-medication.
What is a Dual Diagnosis?
Alcoholism can occur for many reasons, but one of the most common factors is that a person suffers from a dual diagnosis.
This is when the person suffers from alcoholism as well as a separate mental disorder and is known as a co-occurring disorder as well.
Many alcoholics feel strange or different from their fellows, but don’t know why. These types of feelings can be very scary and confusing, so they don’t always talk to their doctor or someone else about what’s happening.
This is especially common with adolescents and teenagers. For many years, people believed that alcoholics were choosing to drink.
Up until the twentieth century, doctors and physicians believed alcoholics were hopeless and would need to be locked up in order to prevent them from drinking, but didn’t know why.
Recent studies have shown that alcoholism is a legitimate mental illness that a person cannot control.
Once the person takes a drink, their pleasure system responds abnormally and they begin to crave more.
The person eventually becomes mentally and physical dependent to alcohol.
Due to the recent findings, addiction has been added to the DSM (Diagnostic and Statistical Manual of Mental Disorders), which is the manual that doctors and psychologists use in order to diagnose mental illnesses.
Alcohol for thousands of years and is used for a variety of different reasons.
The use of alcohol has been documented as far back as times of Ancient Egypt, Babylon, the Roman Empire and even spoken about in The Bible.
People have used alcohol to celebrate occasions and different cultures have certain religious beliefs that call for them to drink alcohol as well.
In modern times, people drink alcohol for similar reasons.
Drinking is the norm at parties and other social gatherings.
People celebrate momentous occasions with a toast and the consumption of alcohol.
One of the most common reasons for drinking is to unwind or to calm a person’s nerves.
It’s perfectly normal for a person to have a drink or two after work in order to relax after a stressful day.
Self-Medication with Alcohol
Those who suffer from a dual diagnosis often began drinking because they discovered that their feelings of anxiety lessened once they felt the effects of alcohol.
This can eventually become a routine where the person drinks every time they feel their anxiety coming.
The person’s equilibrium eventually changes and their mind becomes trained to believe that the only way their symptoms can be treated is with alcohol.
This becomes an alcohol dependence, which can later turn into alcoholism.
The problem with most alcoholics is that alcohol became their only solution to solve their problem with anxiety, but eventually it stops working.
How Alcohol Effects Anxiety
Alcohol is categorized as a depressant. When the effects of alcohol run their course, the person’s nervous system begins to calm.
They experience a slower heart rate and can relieve stress from the mind.
People who are shy and introverted may open up and be the life of the party after they have a few drinks because their social anxieties can disappear.
Some alcoholics rationalize their drinking by believing that they only drink in order to socialize with other people, but this can sometimes have negative effects.
How Alcohol Dependency can Increase Anxiety
When a person drinks, it drastically changes levels of serotonin and other neurotransmitters in the brain.
As the person’s body and mind learn to cope with anxiety by drinking, they can become dependent and experience more symptoms of anxiety than ever before.
The person may have only experienced anxiety when attending a gathering with strangers, but those rare fears can turn even more irrational over time.
They can begin to have feelings of anxiety when they’re going to work or simply going to the grocery store.
The individual’s mind will magnify these fears and symptoms of anxiety because the body knows that the person will drink in order to calm their nerves.
Some studies have also shown that those who suffer from alcoholism are unable to recover from traumatic events in a healthy way.
By these memories staying present in the person’s mind with the same amount of worry or fear, the person’s alcoholism may cause them to hold on to the memories rather than letting go and moving on.
Long-Term Alcoholism and Anxiety
Dependency to alcohol can cause a lot of anxiety. Not only will the person become more anxious when they’re going into certain situations, but the mind’s need for alcohol can cause anxiety in itself.
Alcoholism can be broken down to two parts: the mental obsession and physical craving.
After the person takes the first drink, their craving kicks in and they’re unable to stop or moderate their drinking.
The mental obsession is what causes the alcoholic to take that first drink. Many alcoholics would love to stop drinking, but don’t have the power to do so.
Some alcoholics are able to go months, weeks, days or hours without a drink and this may seem like quite a feat.
The problem is that their mind is going haywire without alcohol and this can cause many alcoholics to continue drinking or relapse after a certain period of sobriety.
The alcoholic can begin to feel all of the symptoms of anxiety when they’re presented with the fear that they might not be able to drink.
The thought of going to work or school where alcohol isn’t present or available can cause intense symptoms of anxiety.
Once the person becomes dependent, they will even begin to feel anxious when they are about to run out of alcohol because they’re already worried about how they will obtain more.
An alcoholics mind is severely altered after long-term alcoholism.
The prefrontal cortex of the brain is responsible for impulse control, self-awareness and other decision-making abilities.
When the mind becomes reliant upon alcohol to function, the person will begin to justify and rationalize their drinking in any way possible.
One of the common reasons that alcoholics don’t want to quit is because of the withdrawal symptoms they’ve experienced in the past.
What is Alcohol Withdrawal?
The body has a natural need to maintain homeostasis. It’s constantly trying to balance different systems within the person’s body in order to maintain the person’s well-being.
As a result of long-term alcoholism, the person’s homeostasis had changed and the person needs alcohol in order to feel well. When they stop drinking or alcohol is absent from the system for too long, the person will begin to experience symptoms of withdrawal.
The alcoholic’s body begins to experience a variety of different symptoms because the nervous system and the person’s vital organs go into a state of shock trying to regain homeostasis.
Alcohol Withdrawal Symptoms can Include:
- Body tremors or “the shakes”
How Alcohol Withdrawal can Cause Anxiety
When the person begins experiencing symptoms of withdrawal, one of the first symptoms is their increased heart rate.
As their body tries to regain balance, their heart is drastically being overworked, which is why it can be a potentially dangerous situation.
One of the reasons that the heartrate and blood pressure begin to rise is because of the person’s mind beginning to understand that alcohol is absent from the system, so symptoms of anxiety begin to occur. Anxiety is a fear-based mental disorder, and an alcoholic’s greatest fear is that they won’t be able to drink immediately or they might have to quit forever.
They begin to become fearful of how they’re going to live life without alcohol because they think they can’t be well if they aren’t drinking. Every situation that they believe they can solve by drinking now seems much worse than it actually is.
How to Safely Stop Drinking
Alcoholics often suffer from the delusion that they have control over their situation, which is what makes it difficult for them to ask for help.
Even when the alcoholic does want to stop drinking, they might try to do it alone. What they fail to realize is that alcohol dependency can cause the most uncomfortable symptoms of withdrawal and have the highest possibility of becoming fatal.
This is why quitting “cold turkey” is never a safe option for an alcoholic. If the alcoholic truly wants to stop drinking and begin a new life, they should always consult an addiction specialist first.
A specialist will be able to conduct a physical on the alcoholic and assess how severe the person’s alcoholism is. The person’s condition may be so severe that they can suffer from seizures or major heart complications if they aren’t carefully monitored and medicated.
For those who are severely dependent to alcohol, it’s highly recommended that they go through a medical detoxification process at an inpatient or outpatient treatment facility.
Here, a medical staff will be able to give the person addiction medicines to make the withdrawal process as comfortable as possible. Librium is a common medication used for alcoholics during detox because it helps to prevent seizures, and the facility is able to gradually decrease the dosage until the person is in better health.
Once the alcoholic is ready to attempt a new life free of alcohol, it can be difficult to know where to turn to for the right type of help.
The treatment options can seem overwhelming, so it’s important that they do the proper research before choosing a treatment center. The most common types of treatment centers are inpatient and outpatient, but they’re each designed for different types of alcoholics. Sometimes the alcoholic only gets one shot at recovery, so their sobriety can depend on choosing the right type of facility.
The ASAM Criteria
Treatment for addiction isn’t a “one size fits all” process, so the American Society of Addiction Medicine created a criteria to help addiction specialists guide people to the right type of treatment.
The first step an alcoholic takes toward recovery should be to consult an addiction specialist who is familiar with the ASAM criteria. Since the 1980s, this method has proven to be highly effective in pointing alcoholics towards the right type of treatment.
There are different criteria for both adolescents and adults, which gauges their addiction symptoms based on six different dimensions.
- Withdrawal Potential: Discovering the individual’s history with withdrawal and substance use.
- Biomedical Conditions and Complications: Assessing the individual’s history of health issues as well as current physical condition.
- Emotional, Behavioral, or Cognitive Conditions and Complications: Understanding the individuals thoughts, emotions and psychological condition.
- Readiness to Change: Assessing whether the person wants and understands that they need change.
- Relapse, Continued use or Continued Problem Potential: Exploring the person’s history of relapse and continuous use behaviors.
- Recovery and Living Environment: Discovering what environmental factors may be triggering the persons using and the how it may hinder their recovery.
The Difference Between Inpatient and Outpatient
Outpatient treatment centers are designed for young people and those who have a less severe form of alcoholism.
If an addiction specialists believes that the person’s living situation won’t cause them to relapse and that the alcoholic’s living situation won’t put them in danger of relapse, they’ll be pointed to and outpatient treatment center.
In some cases the person’s living situation can be harmful, so it may be recommended the person enter a sober living while they attend outpatient treatment.
It’s beneficial for these types of alcoholics to be in an environment with other people who have similar experience. Studies have shown that when people with lesser forms of addiction are mixed with people who have more severe cases, there is a possibility of negative effects.
For example, a young person may believe that they can continue drinking until they are older because they see others who aren’t getting sober until later in life. If the person suffers from a severe form of alcoholism and is a danger to themselves or others because of their addiction, it is recommended that they enter an inpatient program. Inpatient is also recommended to those who suffer from chronic relapse.
Here, the person is able to focus on their recovery without the distractions of the outside world. They’ll learn about themselves and how to handle their anxiety in a healthy way without having to turn to alcohol as a part of therapy.
Finding Help and Treating a Dual Diagnosis
Alcoholics who suffer from a dual diagnosis must find a facility that specifically treats these types of individuals.
Anxiety not only causes a person to start drinking and become addicted, but it can also be a source of relapse when it’s untreated.
Untreated mental disorders are the leading cause for relapse in the world today. A treatment center that specializes in treating alcoholics with a dual diagnosis will provide the person with addiction therapy as well as other methods to treat their anxiety.
The person will learn how to deal with their anxiety in healthy ways when they feel the symptoms begin to arise. They’ll teach the person breathing exercises, meditation and other methods to help treat their anxiety.
Sometimes the person’s anxiety is so severe that they’ll need to be medicated. The recovering alcoholic should always talk to an addiction specialist before taking any medications because a narcotic medication may lead them to relapse.
There are non-narcotic medications like Lexapro that treat symptoms of anxiety without the possibility of becoming addicted. As time goes on and the person remains sober, they’ll see that their symptoms of anxiety will begin to become manageable without the use of alcohol.
Their brain will begin to heal and repair connections that were once damaged. The longer the person replaces their old actions of drinking when they feel anxious with healthy actions, the more their cravings and thoughts of alcohol will begin to fade away.
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