Authored by Chris Schumacher | Medically Reviewed by Dr. Elizabeth Drew,
Last Updated: March 25, 2026

Alcohol is the most common form of self-medication for social anxiety and generalized anxiety. It works quickly to reduce inhibitions and calm nerves, which is why so many people rely on it before social situations or to wind down at night.

The problem is that alcohol creates rebound anxiety during withdrawal. What calms you at 8 PM creates panic at 3 AM. Long-term use can cause permanent changes in your baseline anxiety levels, making you more anxious overall than you were before you started drinking.

Benzodiazepines like Xanax, Ativan, and Klonopin are often prescribed specifically for anxiety, which makes the line between appropriate use and misuse incredibly blurry. They’re effective in the short term, which is exactly what makes them so addictive, but the problem is, tolerance builds quickly.

The dose that worked last month doesn’t work this month. Withdrawal creates severe anxiety that can last for months after stopping. Many people take them exactly as prescribed and still develop physical dependence that’s difficult to break.

Marijuana occupies a complicated space. Some people find it genuinely helpful for anxiety. Others experience increased anxiety, paranoia, or a creeping dependence on it to feel calm. Regular use can blunt your ability to cope with anxiety naturally, leaving you less equipped to handle stress when you’re not high.

Opioids and stimulants are less commonly used specifically for anxiety, but people might find  they help. Opioids provide emotional numbness that feels like relief from constant worry. Stimulants can create false confidence that temporarily masks social anxiety. Both create severe rebound anxiety during withdrawal that can be worse than what you started with.

When addiction treatment ignores anxiety, you get sober but the anxiety that drove your use is still there, untreated and overwhelming. Without coping skills for managing anxiety, relapse becomes likely. You leave treatment and immediately start searching for something, anything, to quiet the constant noise in your head.

The anxiety becomes a justification. You tell yourself you need something to function, to sleep, to leave the house. Sometimes that justification leads right back to the substance you just quit.

When anxiety treatment ignores addiction, the results are equally problematic. A therapist might prescribe anxiety medication without fully understanding your history with substances. Benzodiazepines prescribed for panic attacks become your new addiction. Talk therapy for anxiety doesn’t address the brain changes that occurred during active substance use or the triggers that have become deeply embedded.

The substance use continues to undermine any progress you make on managing anxiety.

Both conditions need treatment simultaneously. This is called integrated or dual diagnosis treatment. It addresses the relationship between the two conditions rather than treating each one in isolation as if they exist independently.

Treatment starts with detox and stabilization when necessary. Getting substances out of your system while managing withdrawal anxiety requires medical support. This is when you begin to separate substance-induced anxiety from an underlying anxiety disorder, though the distinction often remains unclear for weeks or months.

Medication management becomes important. Non-addictive medications for anxiety like SSRIs, SNRIs, Buspar, or Vistaril can help regulate your baseline anxiety without feeding addiction. If benzodiazepines are necessary in the short term, they’re prescribed carefully and monitored closely with a clear plan for tapering off.

Therapy approaches like Cognitive Behavioral Therapy (CBT) work for both anxiety and addiction. You learn to identify triggers for both conditions and develop coping skills that don’t involve substances. Many people discover that trauma underlies both their anxiety and their substance use, and processing that trauma becomes essential to recovery.

Building new coping skills takes time and practice. Mindfulness and breathing techniques for managing acute anxiety. Exercise, sleep hygiene, and nutrition that support both mental health and recovery. Healthy social connections and support systems. Learning through experience that anxiety can be managed without substances, even when it doesn’t feel that way at first.

Recovery is possible when you have both anxiety and addiction. You don’t have to choose between being anxious and being addicted. Both conditions can be managed effectively with proper treatment.

Many people in recovery successfully manage anxiety disorders. It takes time to learn new ways of coping, and those new ways don’t feel natural or effective at first. Your brain needs months, sometimes longer, to heal and relearn how to regulate anxiety on its own.

Anxiety might get worse before it gets better, especially early in recovery. That’s normal and expected. Your brain is adjusting to functioning without the substance it’s been relying on. Progress isn’t linear. There will be good days and difficult days, sometimes in the same week.

Having both conditions doesn’t make recovery impossible. It makes treatment more complex, but complexity doesn’t mean failure.

Having both anxiety and addiction is incredibly common. You’re not weak for struggling with both. You’re not making excuses or looking for a way out of taking responsibility for your substance use.

Treatment that addresses both conditions exists and works. Peace Valley Recovery specializes in dual diagnosis treatment because we understand the relationship between anxiety and addiction. We know that treating one without the other sets people up to struggle.

You don’t have to keep living in this cycle where anxiety drives you to use and using makes your anxiety worse. Call us at (215) 267-0411 or contact us online to talk about treatment options that address both conditions simultaneously.

You deserve treatment that sees the whole picture, not just pieces of it.