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ANXIETY DISORDERS

KEY POINTS

  • There are several anxiety disorders, including generalized anxiety disorder, panic disorders, phobias, and obsessive-compulsive disorders.
  • Anxiety disorders are the most common type of disorder in America today. Stress, anxiety, and worry are embedded in our culture.
  • Women tend to experience anxiety disorders more often than men, particularly panic disorders and phobias.
  • Effective treatment of substance use disorders can also reduce the symptoms and severity of anxiety disorders.
  • Cognitive-behavioral therapy (CBT) has been proven effective for treating both anxiety disorders and substance use disorders.
  • The most effective treatment requires a multidisciplinary treatment team using integrated treatment approaches.

Understanding Anxiety Disorders
Anxiety disorders are a group of mental health (psychological) disorders that include generalized anxiety disorder, obsessive-compulsive disorders, panic disorder (panic attacks), and phobias.  People with anxiety disorders are about 50% more likely to have a substance use disorder and are also at greater risk for having a mood disorder.

Anxiety disorders are complex, and like most mental health disorders, impact the person in multiple ways with considerable differences between individuals.  While anxiety is a negative emotion, it is also often accompanied by worry, a cognitive process of recurrent and intrusive negative thoughts.  Often times, the very experience of having an anxiety disorder creates more anxiety.  For example, a person who suffers from panic attacks often has increased anxiety about having another panic attack in an embarrassing situation, such as at work or in a public place.  Anxiety tends to create more anxiety.

While anxiety disorders may surface without warning or a specific trigger, they rarely go away on their own or without treatment.  Instead, they tend to build and worsen.  Untreated, they can significantly impede a person’s ability to live their life, function, and participate in the normal activities of school, work, raising a family, and having positive relationships.  It is not uncommon for people with anxiety disorders to wonder if they are “going crazy” because the symptoms are disturbing and appear unexpectedly or “out of the blue.”  For some, anxiety disorders can have bizarre qualities, for example, a phobia (which is an irrational fear) of a routine place or event or odd or eccentric obsessions and compulsions.

Not surprisingly, the person experiencing the troubling and often embarrassing symptoms, emotions, and features of an anxiety disorder wants quick relief.  And for many, quick relief sadly comes in the form of drugs and alcohol.  Anxiety disorders can be frightening, too.  For example, nearly every symptom of a panic attack, including rapid heartbeat, shortness of breath, and excessive sweating, are the same symptoms of an actual heart attack.  People truly feel as if they are “going to die.”  To say a panic attack is merely unpleasant is an understatement, as anyone who has experienced one will testify.

For those suffering from anxiety disorders, self-medicating with drugs and alcohol to numb or lesson experiences of panic, fear, and worry is common.  Not surprisingly, using drugs and alcohol to lessen the severity of anxiety disorders often leads to ever-increasing amounts and frequencies of substances that cause dependency problems.  Moreover, the underlying causes of the anxiety disorder are not addressed, and as a result people often find themselves having substance abuse and dependency problems in addition to their original anxiety disorder.  Not surprisingly, the downward spiral often produces further anxiety along with greater substance abuse.

A person suffering from a mental health disorder that at the same time has a substance(s) abuse or dependency disorder is referred to as having co-occurring disorders.  That is to say that at a given time, the person meets the diagnostic criteria for two or more disorders, such as panic disorder and opiate dependency.  This is also referred to as co-morbidity.  Co-morbid or co-occurring disorders are in fact common – and also more complex to treat – as that more than one condition requires treatment, and often both disorders need to be treated at the same time or in succession.

The relationship between substance abuse and anxiety disorders is complex and overlapping.   For example, there are not always clear lines of causality between substance abuse and anxiety disorders.  For some, the onset of the anxiety disorders occurs first, and substance abuse follows, particularly when the individual is self-medicating.

For others, substance abuse – and the many problems that accompany substance abuse – such as legal, job, and family problems – leads to a downward spiral that results or triggers the onset of an anxiety disorder, particularly generalized anxiety disorder and panic attacks.  Frankly, having one’s life destroyed by drugs and alcohol is in itself an anxiety-producing event.

Treating Anxiety Disorders with Co-Occurring Substance Abuse Disorders
At Q Health, we understand the importance of treating the whole person and co-occurring disorders.  Research clearly demonstrates the value and importance of doing so.  Effective treatment with lasting positive, outcomes is possible but requires the knowledge and skills of an expert multidisciplinary treatment team.

The first step in effective treatment is a thorough assessment, which is the detailed process of gathering information and coming to a well-informed, in-depth understanding of the person, their symptoms, challenges, and treatment goals.  Accurate diagnoses and the treatment that follows is only as good as the information it is based upon.   Consistent with best-practices, Q Health uses a multi-stage assessment process and incorporates information from multiple sources, including the client, and when possible, supportive family members, as well as the entire Q Health clinical team.

The Q Wellness Model leverages our on-site, multidisciplinary treatment team comprised of psychiatrists, medical doctors, therapists, nurses, social workers, case managers, nutritionists, and addiction specialists.  Each member of the clinical team brings valuable expertise and perspectives, and working hand-in-hand with the client, builds the foundation for a comprehensive, individualized, research-based treatment plan.

When treating anxiety disorders with co-occurring substance use disorders, research demonstrates the value of cognitive-behavioral treatment (CBT) as the treatment of choice.  In fact, CBT has been proven effective in treating both anxiety disorders and substance use disorders.  In addition, several non-addictive psychotropic medications have proven effective in treating anxiety disorders, particularly antidepressants in the SSRI (selective serotonin re-uptake inhibitor) class.  Other therapies, such as exposure therapy, have also been shown to be effective with panic disorders and obsessive-compulsive disorders.

In addition to treating the anxiety disorder, the Q Health Wellness Model incorporates multiple therapies to effectively treat the substance use disorder through individual psychotherapy, group therapies, family therapy, and complimentary therapies ranging from acupuncture to yoga and creative arts therapies.

Q Health is committed to using evidence-based treatment to develop a comprehensive treatment plan that offers the greatest possibilities for positive client outcomes and lasting success.  This is the foundation of the Q Health Wellness Model.   We partner with each client to develop individual treatment goals and then work together to create a pathway to achieve them.   In addition to treating symptoms and achieving sobriety, our commitment to each client is to provide the pathway, skills, and support to live a fulfilled, satisfying, and productive life.