We all experience anxiety from time to time. It might show up as a knot in your stomach before a difficult conversation, a racing heart before a big exam, or a persistent worry that lingers throughout the day. In a world full of challenges and uncertainty, anxiety is a natural response—but it’s also an uncomfortable one.
At first glance, anxiety can feel terrible or even dangerous. But over time, we can learn to view it as a signal—an alert that something might require our attention. With practice, we may even learn to relate to anxiety more as an occasional nuisance than as a debilitating force.
Anxiety and Addiction: A Complicated Relationship
Managing anxiety is tough on its own—but when combined with addiction, it becomes even more complex. Interestingly, both anxiety and the emotional triggers that lead to relapse can be seen as signals. As Jon Kabat-Zinn’s Mindfulness-Based Relapse Prevention (MBRP) approach highlights, learning to notice these signals without automatically reacting to them can be a powerful path to recovery (Reichenberg & Seligman, 2016). This same principle can apply to anxiety.
Five key insights about the connection between anxiety and addiction:
1. Substances Are Often Used to Self-Medicate Anxiety
Thoughts, emotions, behaviors, and physical sensations tend to occur together (Tolin, 2016). A person may worry about the future, feel anxious, begin pacing, and develop a tight knot in the stomach. These sensations are unpleasant—and our natural instinct is to avoid them.
For people who struggle with addiction, one common avoidance strategy is substance use. This process is called self-medicating—using substances to numb anxiety, even though it’s ultimately an unhealthy coping mechanism (Jongsma, Peterson, & Bruce, 2014).
2. After Self-Medicating, Seeking a High Becomes Tempting
Once someone begins using substances to manage anxiety, the temptation to return for the euphoric “high” can grow stronger. Some may even rationalize continued use with thoughts like, “I already relapsed—might as well enjoy it.” What starts as avoidance can spiral into deeper substance dependence.
3. Withdrawal Symptoms Can Trigger More Anxiety—and Use
Withdrawal is not only physically difficult—it also causes emotional distress, including anxiety, irritability, and restlessness. Other symptoms may include hand tremors, nausea, and increased heart rate (APA, 2022). Understandably, someone trying to avoid these uncomfortable states may return to substance use just to make the distress stop (Jongsma, Peterson, & Bruce, 2014).
4. Exposure Therapy Can Help Reduce Anxiety
One evidence-based way to treat anxiety is exposure therapy, which gradually introduces a person to anxiety-triggering thoughts, sensations, or situations in a controlled way. Over time, the intensity of anxiety decreases—a process called habituation (Zinbarg, Craske, & Barlow, 2006).
This therapeutic approach mirrors the principles of mindfulness-based relapse prevention: learning to sit with discomfort and observe it, rather than react impulsively (Reichenberg & Seligman, 2016).
5. Relaxation and Coping Skills Also Support Recovery
In addition to exposure therapy, other tools—like deep breathing, progressive muscle relaxation, and mindfulness practices—can help reduce anxiety and improve emotional regulation (Jongsma, Peterson, & Bruce, 2014).
Conclusion
Understanding the relationship between anxiety and addiction gives us a deeper appreciation of how emotions influence behavior—and how people can move toward healing. Whether through mindfulness, therapy, or skill-building, we can learn to respond to anxiety rather than run from it. And in doing so, we take one more step toward long-term recovery.
References
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- Jongsma, A. E., Peterson, L. M., & Bruce, T. J. (2014). The Complete Adult Psychotherapy Treatment Planner (5th ed.). Hoboken, NJ: John Wiley & Sons.
- Tolin, D. F. (2016). Doing CBT: A Comprehensive Guide to Working with Behaviors, Thoughts, and Emotions. New York, NY: The Guilford Press.
- Zinbarg, R. E., Craske, M. G., & Barlow, D. H. (2006). Mastery of Your Anxiety and Worry (2nd ed.). Oxford University Press.
- Reichenberg, L. W., & Seligman, L. (2016). Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders. John Wiley & Sons.
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