Anxiety is a major risk factor for addiction. A large study of more than 43,000 adults found that among people with an anxiety disorder, about 15 percent also had a substance use disorder; that’s about twice the rate of addiction in the general population. And that study didn’t include post-traumatic stress disorder, or PTSD, which some studies suggest raise your risk of addiction as high as 50 percent. What’s more, studies have found that in most cases—about 75 percent—anxiety clearly precedes substance use. For example, someone with a social anxiety disorder might find they have a much easier time being friendly at parties if they have a few drinks, then come to rely on alcohol as a social crutch. If you’ve struggled with anxiety, then managing that anxiety has to be part of your recovery plan if you want to stay sober. Here are some ways to keep anxiety from derailing your recovery.
Talk to Your Therapist
If you’ve struggled with anxiety before, there’s a good chance you’ve already talked to a therapist. If not, this would be a good time to do it. Anxiety is affected by a complicated mix of genes, thinking patterns, brain structure, neurotransmitters, childhood experiences, and trauma. Controlling anxiety isn’t just a matter of telling yourself to calm down. It typically requires expert guidance and sometimes medication as well. Even if you have seen a therapist in the past, you may still find it helpful to talk to someone when your anxiety flares up.
Recognize Unhelpful Thoughts
Part of what a therapist will help you with is identifying beliefs and patterns of thought that are making your anxiety worse. The main insight of cognitive-behavioral therapy, the current “gold standard” of psychotherapy, is that our beliefs, not events, cause our emotions. Unfortunately, many of our beliefs and assumptions are irrational and unhelpful. For example, a common cognitive distortion for people with a social anxiety disorder is mind reading. This is the belief that you know what other people are thinking and that it’s usually something bad. As a result, you may be talking to someone at a party and be thinking, “He thinks I’m an idiot and a loser,” despite having no evidence for that belief at all. That kind of thinking certainly makes you anxious at the possibility of future interactions.
Catastrophizing is another common cognitive distortion. This is when you assume some outcome would be awful. When you’re prone to catastrophizing, you immediately jump to the worst-case scenario. An argument with your spouse means you’re getting a divorce or missing a deadline means you’ll get fired and end up homeless. There are a lot of intermediate steps there and most of the time, even the worst possible outcome is not as intolerable as we imagine.
Exercise is good for you in many ways. There is quite a bit of scientific evidence showing that exercise is especially good at reducing anxiety. It does this in several ways: It distracts you from whatever you’re anxious about; it helps relieve tension; it increases the availability of neurotransmitters like serotonin, endorphins, endocannabinoids, and brain-derived neurotrophic factor; and it strengthens areas of your prefrontal cortex, a part of the brain necessary for regulating emotions. Even moderate exercise can reduce anxiety right away and regular exercise can actually produce changes in your brain that reduce your sensitivity to stress.
Get Enough Sleep
When it comes to physical and mental health, sleep is even more important than exercise. There are many reasons getting enough quality sleep is important for recovery and one is that it helps keep anxiety under control. One study by researchers at UC Berkeley put participants in a brain scanner after a normal night’s sleep and again after a night of sleep deprivation. They found that sleep-deprived participants had almost no activity in an area of the brain’s frontal lobe involved with emotional regulation but greatly increased activity in other areas of the brain related to emotions. This suggests that when you’re sleep-deprived, your anxiety is all gas and no brakes. Surveys of the participants indicated that their anxiety levels increased by about 30 percent following one night with no sleep. If you want to keep anxiety under control, getting enough sleep is crucial.
The suggestions above are part of a long-term strategy to manage anxiety. If you need to deal with anxiety quickly, the first thing to try is taking some slow deep breaths. When you’re anxious, it means your sympathetic nervous system is active. This is the fight-or-flight system that increases your heart rate and breathing while narrowing and sharpening your focus. You can counteract this with deep breathing. Deep breathing stimulates the countervailing system, the parasympathetic nervous system, or the rest-and-digest system. The exhale is especially important because a long exhale stimulates the vagus nerve, which activates the parasympathetic system. So, when you feel anxiety coming on, breathe in for a count of four, pause briefly, then exhale slowly for a count of six or eight. This should calm you down enough to use other strategies.
Anxiety in recovery is extremely common. Not only are anxiety disorders common co-occurring conditions, but anxiety, restlessness, and irritability are common withdrawal symptoms, which may linger for weeks or months after acute withdrawal. If you don’t have a pre-existing anxiety disorder, this post-withdrawal anxiety will likely go away on its own but in the meantime, some of the above strategies can help. At Steps Recovery Centers, we know that recovery is a process that goes on long after you leave treatment and we want to be there for our clients whenever they need us. To learn more about our alumni services, call us at 385-236-0931.