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©2006-2011 Deborah Wiig
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Some people have a glass of wine after a long day at work to help "take the edge off," or drink at a party to "loosen up." For most people, alcohol use in moderation is not a problem. However, for people with anxiety disorders, using alcohol or other substances can make anxiety symptoms worse and can even trigger panic attacks.

Co-occurring alcohol abuse and anxiety disorders can make an individual's situation more complex, but the good news is that these disorders are treatable - separately and together.

Are people with anxiety disorders more likely to suffer from alcohol and vice versa?
People with anxiety disorders are two to three times more likely to have an alcohol or other substance abuse disorder at some point in their lives than the general population, and vice versa. It can happen in different ways.

• The alcohol abuse and anxiety disorders may occur independent of one another. However, the symptoms of one can make the symptoms of the other worse.
• An anxiety disorder may lead an individual to use alcohol or other substances to "self-medicate," which does not help and exacerbates their anxiety.
• An alcohol abuse problem can increase anxiety during drinking and/or withdrawal states.
• An alcohol or other substance abuse problem can lead to development of an anxiety disorder. Substance abuse can damage parts of the brain that keep anxiety in check.

Treating substance abuse may not solve an anxiety disorder on its own. Treating both disorders together is often necessary.

What problems can arise from having both disorders?
Having both can have a "vicious cycle" effect. Using alcohol to alleviate anxiety symptoms can cause more anxiety, which then leads to more drinking. People with both disorders have an increased risk of hospitalization, financial and family problems and relapse into alcohol abuse. They risk dangerous interactions between prescription medication and alcohol.

Can both be treated at the same time?
When one disorder is not causing the other, it may be most effective to treat these conditions at the same time. For a substance-induced anxiety disorder, the substance abuse would be addressed first because the anxiety should improve after abuse terminates. You may work with a single doctor or one for each condition working as a team.

What treatments are available for people suffering from both disorders?
Non-medication treatments are often recommended for people with both anxiety and substance abuse disorders because of the increased risk for abuse of medication among substance users. Treatment options include cognitive-behavioral therapy (CBT), individual psychotherapy, group therapy, relaxation techniques and self-help groups.

The use of medication will depend on the specific anxiety disorder a person suffers from (i.e., panic disorder, obsessive-compulsive disorder, etc.), as some medications will be more effective than others for an individual disorder. An antidepressant may be prescribed, often in conjunction with therapy. Benzodiazepines are typically avoided because they can carry an increased risk of abuse, tolerance and physical dependence

Visit ADAA to learn more about treatment options.

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Excerpted and adapted with permission from the Anxiety Disorders Association of America

Page updated April 1, 2010