Social Anxiety Disorder And Substance Abuse
Social anxiety disorder can lead to substance abuse. Drugs like marijuana, benzodiazepines, and alcohol are sometimes used to self-medicate anxiety and other symptoms. Treatment programs are available for these co-occurring disorders.
Research has established a link between anxiety disorders, including social anxiety disorder, and substance use disorders (SUDs).
However, many people living with both social anxiety and addiction aren’t aware of this link.
It’s vital that doctors and other care providers get a full medical history from people with an SUD so that dual diagnosis treatment can be provided if necessary.
What Is Social Anxiety Disorder?
Social anxiety disorder (SAD) is a mental illness that causes feelings of intense fear in social situations and even social phobia.
In the past, social anxiety disorder was considered similar to shyness. However, those with the disorder feel exaggerated fear that is very different from feeling shy.
Most people with SAD don’t seek treatment, or they may live with the health condition for years before seeking treatment. Others may not know they even have the condition.
Symptoms Of Social Anxiety Disorder
More intense than general shyness, social anxiety disorder is marked by strong feelings of fear related to being judged, rejected, or humiliated by people.
For some, this only happens when among large groups of people, like at parties, whereas for others, even social interactions like talking to a family member can trigger these feelings.
Here are some symptoms of social anxiety disorder:
- sweating, blushing, or trembling
- rapid heart rate
- feeling your mind “go blank”
- rigid posture
- low self-esteem
- speaking softly
- panic attacks
- fear of being negatively perceived
- feelings of self-consciousness
- avoiding people or social gatherings
Can Social Anxiety Cause Addiction?
Research does indicate that anxiety disorders (like social anxiety disorder, generalized anxiety disorder, and panic disorder) can lead to substance abuse.
People with undiagnosed social anxiety disorder might attempt to self-medicate with drugs or alcohol. This is usually young adults, because this is when SAD often first appears.
On the other hand, symptoms of addiction (such as chronic intoxication and withdrawal) and detox can look and feel a lot like an anxiety disorder.
To fully understand the comorbidity, more research needs to be done. Luckily, its prevalence makes it a topic of interest to the medical and science communities.
Commonly Abused Substances With Social Anxiety Disorder
Someone experiencing the uncomfortable symptoms of social anxiety disorder might turn to alcohol or drugs to self-medicate.
This might include using substances at work, at school, or during other everyday activities.
One recent study showed that about 18% of people with an SUD also met the criteria for an anxiety disorder. Adolescents with an SUD are more likely to abuse substances.
Alcohol And Social Anxiety Disorder
For people with a diagnosed or undiagnosed anxiety disorder, alcohol might seem like a good option for overcoming stressful symptoms.
After all, alcohol is widely used in the U.S. and is readily available at restaurants, parties, and other places where symptoms might occur for people with social anxiety.
The “social lubricant” is a depressant that can increase feelings of confidence and decrease feelings of tension and anxiety.
However, alcohol addiction is fairly common, and alcohol is the third most common cause of preventable death in the U.S., according to government statistics.
It is easy to see how this readily available substance could be abused if someone is experiencing extreme anxiety on a regular basis.
However, using alcohol as an emotional crutch can quickly lead to patterns of abuse and eventual dependence on the substance to function in social environments.
Marijuana And Social Anxiety Disorder
A recent survey of 43,000 adults showed that drugs are chosen slightly more often over alcohol as a coping mechanism by people experiencing symptoms of social anxiety.
The study also showed that marijuana was the most common drug of choice for self-medicating purposes.
Many people experience a feeling of relaxation or even euphoria when using marijuana, which could be particularly appealing to people with social anxiety.
While medical cannabis is gaining acceptance by the medical community, it’s important to remember that any mind-altering drug is susceptible to abuse and can have negative consequences of use.
Benzodiazepines And Social Anxiety Disorder
Benzodiazepines are central nervous system depressants that are sometimes prescribed to treat anxiety and insomnia and to prevent seizures.
Benzodiazepine use for the purpose of self-medication has been found among people with anxiety disorders.
As drug use continues, tolerance can develop, which is a risk factor for drug addiction and overdose.
With growing awareness of the link between anxiety disorders and substance abuse, other forms of social anxiety and addiction treatment can be considered.
Prescription medication names for benzodiazepines include the following:
Substance Abuse Triggers For People With Social Anxiety
Triggers for people with social anxiety disorder can range from having to give a speech in public to simply attending a public event or having a conversation with a friend.
Other triggers include:
- starting a new job
- trying to make new friends
- attending a graduation
- having difficult conversations with family members or peers
- being the center of attention
- having small talk
- receiving criticism
- speaking with an authority figure, such as an employer or law enforcement
When overwhelming feelings arise, using drugs or alcohol to cover them up might seem like a good solution.
However, it doesn’t address the underlying anxiety, including why it’s there and how it can be managed in a healthy way.
Substance use can morph into abuse for some people. Drug and alcohol use disorders come with their own health risks, including serious ones like overdosing.
How To Manage Social Anxiety And Addiction
Many people with both addiction and social anxiety disorder don’t know that they have it, but they are able to identify the associated strong feelings of fear and anxiety.
No matter how long you’ve been experiencing severe anxiety, it’s never too late to learn healthy coping mechanisms.
Here are some healthy methods for coping with anxiety:
- slow breathing and other breathing techniques
- progressive muscle relaxation
- scheduling your “worry time” (and setting a time limit! Five to ten minutes is a good range.)
- “forest bathing,” spending time in nature
- yoga nidra, a combination of yoga and meditation that promotes deep relaxation
Remember to be gentle with yourself. It’s not your fault that you didn’t learn how to cope in a healthy way with anxiety, and your efforts to do so should be celebrated.
Treatment For Social Anxiety Disorder And Substance Abuse
Treatment options are improving for people living with social anxiety disorder and co-occurring substance abuse.
Among the most successful methods is cognitive behavioral therapy (CBT). CBT helps people change their behavior through changing their thoughts.
Family therapy is also very effective, in part because social anxiety and addiction have a genetic link. Group therapy can be helpful for forming support groups as well.
Co-occurring disorders are fairly common and have been a topic of research in recent years. Dual diagnosis of both conditions is important for a complete recovery.
Getting Help For Addiction With Co-Occurring SAD
Social anxiety and addiction often go together, but it can be difficult for people to know that they have these co-occurring disorders.
At Spring Hill Recovery Center, we always start with a full medical history to determine any underlying conditions that could be contributing to alcohol or drug abuse.
If you or a loved one is living with co-occurring disorders, call us today to learn about our wide variety of treatment options to meet your unique needs.
- Journal of Anxiety Disorders – Correlates of treatment seeking in individuals with social anxiety disorder: Findings from a nationally representative sample https://www.sciencedirect.com/science/article/abs/pii/S0887618522000895
- National Center for Biotechnology Information – Substance Use Disorders and Anxiety: A Treatment Challenge for Social Workers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775646/
- National Institute of Mental Health – Social Anxiety Disorder: More Than Just Shyness https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness
- National Institute on Alcohol Abuse and Alcoholism – Alcohol Facts and Statistics https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
- National Library of Medicine – Medical Marijuana https://medlineplus.gov/ency/patientinstructions/000899.htm
- U.S. Drug Enforcement Administration – Benzodiazepines https://www.dea.gov/factsheets/benzodiazepines