Anxiety, Mental Illness, and Substance Abuse
It is normal to draw a distinction between anxiousness and anxiety. Fear, dread, and anxiousness can be normal reactions to a stressful or unpleasant situation. However, anxiety as a mental disorder is characterized by the fact that the anxiety symptoms are triggered more easily than usual and is often extreme and unreasonable.
In addition to the psychological experience, such events cause parts of the autonomic nervous system to respond and can trigger a wide range of bodily symptoms such as increased heart rate, sweating, dizziness, upset stomach and more.
Anxiety is a widespread disorder. It is estimated that at least 1 in 13 individuals is affected by an anxiety condition at some point in their life.
A lot of the time, a person’s anxiety grows more and more intrusive over time, sometimes causing the individual to self-medicate with alcohol or drugs. The use of such substances can in some cases feel like the only way to escape once affliction, leading to repeated use and often a dependency.
On the other hand, anxiety has also been known to develop as a result of drug and alcohol abuse or a struggle with other mental illnesses such as depression or schizophrenia.
When a person is living with both an addiction and a co-occurring mental health disorder, the best possible path for recovery begins with comprehensive care that treat both disorders.
Types of Anxiety
There are several types of anxiety:
- Panic Attacks (panic disorders): is a form of seizure that causes a sense of intense fear or discomfort. They occur completely unexpectedly and are not related to any typical situation.
- Phobias: in turn, are characterized by circumstantial anxiety. Someone suffering from this form of anxiety will do their best to avoiding certain situations to reduce their symptoms. Phobias are for specific and clearly defined phenomena – i.e., responding to various animals, insects, heights, narrow spaces, blood, and social situations.
- Generalized anxiety disorder is present all the time, regardless of the situation. It is common for the patient to feel tense and nervous on a regular basis.
- Post-traumatic stress disorder (PTSD) is grounded in one particularly traumatizing event, such as a natural disaster, rape, war, or a bad accident. After such an incident, one re-experience the frightening event, either in dreams or in awake state. One wants to avoid things or situations reminiscent of the event.
Causes of Anxiety
It is often difficult to determine one single factor that causes anxiety and factors that commonly leads to anxiety vary a lot depending on the type of anxiety one has.
Anxiety disorders can be triggered by life experiences, such as traumatic events, however, genetics can also be a huge factor. For some individuals, anxiety may be linked to underlying health issues or other mental illnesses.
Phobias, for example, can occur in people who have experienced something uncomfortable in a particular context. Just being exposed to the same situation again (for example, feeling confined in a confined space) is enough to trigger anxiety.
Anxiety can also be caused by drug abuse or withdrawal from alcohol or drugs.
Symptoms of Anxiety
It is important to determine whether the anxiety is persistent, where the individual suffer from a constant sense of anxiousness, fear, dread, and tension, indicating generalized anxiety.
The occurrence of high intensity anxiety attacks with a short duration (a few minutes) indicates panic anxiety.
Anxiety associated with the thought of a person, a place, or the sight of a place, an object, or an animal, suggests phobic anxiety.
Hyperventilation attacks, that is, breathing too much and too fast because one feels that one does not get enough air, can occur with all types of anxiety, but is most common in phobic anxiety and panic anxiety. With most types of anxiety, a person will experience bodily symptoms such as an increased heartrate, sweating, tremors, dry mouth, nausea, pain and muscle tension.
Treating Anxiety
At StepHouse Recovery, we treat patients as a whole. This includes treating any co-occurring conditions in addition to addiction. Our goal is to help you get control of the anxiety by teaching you techniques that suppress the symptoms. In many cases, these techniques will also lesson triggers and relapses when a patient is facing both anxiety and substance abuse.
Drugs of the type benzodiazepines (known as, for example, Valium® and Vival) are currently often used to treat general anxiety and some special cases of severe panic disorder. However, they are highly addictive, and the addiction can become a bigger problem than the anxiety. When a patient comes to us for help with this issue we try to manage this balance between needed medication and addiction treatment through Medically Assisted Treatment (MAT).
Various forms of psychotherapy also have a good effect on anxiety disorders, especially cognitive behavioral therapy. Our therapist help patients identify inappropriate patterns of thought and gives them the tools to changing these patterns. For example. Phobia exposure treatment is about gradually exposing the patient to what he is afraid of. In this way, the unfounded fear of the particular object will eventually diminish and may disappear altogether.
Eating Disorders and Substance Abuse
An eating disorder is a mental disorder characterized by having an unhealthy and obsessive relationship with food. An individual struggling with an eating disorder has a disturbed perception of the body and food, which can be expressed in different ways e.g. triggered vomiting (bulimia), excessive exercise or failure to eat (anorexia). For convenience, we divide eating disorders into three different types; anorexia, bulimia, and overeating disorders. But the individual’s experiences cannot always be placed in one category, as the eating pattern of a person can change overtime. Some go through all the variations of eating disorders in different order, while others live with one form (e.g. anorexia) all the time.
Among people with eating disorders, there is a higher incidence of other psychological difficulties than we see in the general population. In anorexia there is an increased incidence of depression and anxiety (e.g. generalized anxiety, symptoms of obsessive-compulsive disorder and social anxiety). Symptoms of anxiety may be present before getting the eating disorder, and in some cases, symptoms of both depression and anxiety may continue after they have recovered from the eating disorder. In the case of bulimia and overeating, we see an increased incidence of anxiety, depression, personality disorders and substance abuse. At a rate five times higher than the general population, up to 50 percent of individuals with eating disorders abused alcohol or illegal substances According to the National Eating Disorders Association (NEDA). Most commonly used in these cases is drugs that are known for their appetite-suppressing side effects, such as heroin and cocaine.
Eating disorders usually occur during adolescence. This is especially true for anorexia and bulimia, while over-eating disorder more commonly develop in adulthood. Anorexia and bulimia are about ten times more frequent in women than in men.
Eating disorders increase the risk of a variety of health problems, and compared to other psychiatric disorders, anorexia is the one that has the highest mortality; the risk is four to ten times higher than in the rest of the population.
Causes of Eating Disorders
Eating Disorders are generally believed to be related to low or oscillating self-esteem and problems with knowing and dealing with problematic and complex thoughts and feelings. The abuse of power can be seen as a symptom of emotional conflicts either inside the person or between the person and the environment. For many, the eating disorder functions as a survival strategy, a creative adaptation in a demanding life situation. However, The causal link behind an eating disorder is complex. Both psychological, social and genetic factors are involved, and various predisposing, triggering and maintaining conditions are described.
Instead of studying isolated risk factors, researchers have become more concerned with studying mechanisms and vulnerability models. In these models one sees eating disorders as a result of the interplay between inheritance and the environment. Recent research suggests that there is a genetic predisposition to all eating disorders. It can therefore be an interaction between hereditary factors and the environment that determines whether one gets an eating disorder, other mental disorders, or both.
It is common to distinguish between predisposing, triggering and maintaining factors.
Predisposing factors
- Genetics
- Personality (negative self-image, perfectionism)
- Family relationships
- Trauma and physical, mental, or sexual abuse
- Cultural conditions, such as weight shaming
Triggering factors
- Losses and conflicts
- Bullying, especially comments on weight and appearance in adolescence
- Obesity as a child
- Early puberty
- Great performance requirements
- Changed living conditions, such as relocation
- Dieting
Maintenance factors
- Family conflicts triggered by the eating disorder
- Negative reactions from the environment
- Mental symptoms due to malnutrition and underweight
Symptoms of an Eating Disorder
Below are some characteristics of eating disorders. All the symptoms do not have to present simultaneously in a person for it to be an eating disorder. It also does not mean that if a person has some of the characteristics, he or she has an eating disorder.
Regarding food: Preoccupied with food, eating less, preferring to eat alone, choosing low calorie food, irritable and stressed around meals, changing behaviors associated with food (such as cutting the food into many pieces, moving it around on the plate or smearing it out), throwing and hiding food (in napkins, pockets, etc.), leaving the table just after the meal and creating noise (which can “hide” the person from vomiting), overeating, vomiting, denying hunger when the person is obviously hungry, drinking very much to subdue hunger.
Mood and behavioral symptoms: Weighing themselves often, excessive physical activity, misuse of laxatives, wearing big clothes to hide body, problems sleeping, general irritability, social withdrawal, insist that you are too thick when obviously not, sad and stubborn, extreme fear of weight gain.
Physical symptoms: Extreme weight loss, weight fluctuations, weight gain, lack of or irregular menstruation in girls, dizziness, fatigue, abdominal pain, low body temperature, poor blood circulation, cold hands and feet, swollen cheeks and hair loss.
Treatment for Eating Disorders
At StepHouse Recovery we treat individuals who suffer from both addiction and eating disorders. Treatment for an eating disorder is critical due to the possibility of further medical complications if the disorder continues. Our behavioral health treatment offers patients psychotherapy for both illnesses. When it comes to the eating disorder, our clinical staff helps patients change the way they think and feel about food, exercise, and themselves.
The goal of psychotherapy is to reduce or stop the symptoms of an eating disorder by helping you change the way you think and the way you behave. It can also help you learn some good coping skills.
Cognitive therapy helps you replace the negative thoughts with positive ones, change some of the things you do, help you understand your feelings, and gain more control over them. There are several forms of cognitive treatment that we offer. Interpersonal therapy affects the way you relate to other people. Family therapy helps everyone in the family better support one another, helping the afflicted heal. Nutrition counselling and stress counselling are often given together. You will learn about food and how the body uses it. You also learn sensible ways to cope with your feelings when you are stressed.
Depression and Substance Abuse
Depression is a condition characterized by bad mood, lost interest and enjoyment, energy loss and increased fatigue. Other symptoms may include guilt or poor conscience, subconscious thoughts or impaired self-esteem, thoughts of suicide, difficulty concentrating, psychomotor disorders (restlessness, restlessness, agitation or inhibition), sleep disturbances, impaired appetite or weight loss.
Depression is a common affliction and often goes hand in hand with substance abuse disorders. In fact, it is well known that alcohol is used as self-medication for mental problems. Not everyone who has mental problems has a formal diagnosis. Individuals who do not use medication, therapy, or change their lifestyle to cope with their disorder often use alcohol or other drugs to self-medicate the feeling of stress, depression or anxiety. Some patients who are already in treatment even sometimes find that the help they receive is not sufficient and attempt to cope with the problems by using alcohol or drugs.
On the other hand, misuse of alcohol and drugs can in itself cause short-term and long-term behavioral problems or psychological problems. In spite of the fact that alcohol may have some positive effects on anxiety and depression symptoms in the short term, it may, in the longer term, help maintain or enhance the disorders.
Needless to say, when a patient is seeking treatment for either substance abuse or depression, evaluating if the patient has a co-occurring disorder is crucial. At StepHouse Recovery we specialize in dual diagnosis treatment and always assure our patient proper and comprehensive treatment for both substance abuse problems and any other mental health issues.
What can cause depression?
An individual who suffer from depression has, in many cases, experienced events that are described as painful, hurtful, or shameful prior to developing the disorder. The incident can be a loss, a violent incident, or an accident. But it can also be related to one’s own expectations of others or oneself.
Negative emotions directed at the individual himself or herself may have arisen as a result of disappointments and losses in childhood, poor regulation of self-esteem, rage directed at the individual, and feelings of helplessness and hopelessness are typical. By “repeating” negative experiences, the subconscious vulnerability will sometimes form the basis of depressive episodes.
However, not everyone who has had negative experiences develop depression or other mental illnesses. So genetic and environmental factors also plays a role.
Symptoms of Depression
Depression is not always perceived as a disease. Neither by yourself, the people around you or by medical personnel. The symptoms are not always obvious. People with depression often hide their illness instead of seeking help. Everyone feels down sometimes, but depression is something more. Some symptoms of more severe depression includes:
- Loss of pleasure in normal activities, such as sex or hobbies.
- Sleep disturbances
- Tiredness and lack of energy
- Reduced appetite or increased cravings
- Unexplained physical problems, such as pains or aches
Treatment for Depression
Antidepressant drugs are used in severe cases of depression that does not pass by itself. However, the effect of such drugs are modest.
Here at StepHouse we find that psychological treatment is the most important element of managing depression. The most common psychological technique used at our treatment center for depression is called cognitive behavioral therapy.
Here one tries to identify involuntary negative thoughts and thought structures, which really is what the depression is all about.
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