Anxiety disorders are so prevalent in the United States that words like “anxious” and “anxiety” have become part of the public lexicon. Even among those without diagnosable conditions, it’s common to hear these words used to describe normal, everyday mood states and experiences.
For those with a diagnosed or diagnosable anxiety disorder, it’s also not uncommon to live with depression, alcohol abuse, and certain medical conditions. It’s important for mental health professionals to know that people with anxiety disorders may be more at risk for certain issues.
According to John Forsyth and Georg Eifert, authors of the book, “The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobia, and Worry Using Acceptance and Commitment Therapy,” depression is the most commonly co-occurring issue among those with anxiety disorders.
It is characterized by a persistent, enduring low mood state, in which people often describe feeling empty, numb, and hopeless. Depression can make people lose interest in things that once mattered to them (a symptom called anhedonia), and can also leave people feeling so drained, fatigued, and exhausted that even getting out of bed feels impossible.
It can also cause sleep difficulties and insomnia. Left untreated, depression can lead to suicidal thoughts, ideations, and behaviors.
“Given the way anxiety and fear can get in the way of a meaningful life activities, it’s not surprising that people start to think and feel that life is no longer enjoyable or worth living, write Forsyth and Eifert.
Forsyth and Eifert created “The Mindfulness and Anxiety Workbook for Anxiety” in part as a counter to approaches they’d seen that seemed to make big promises about “fixing” or getting rid of anxiety, but consistently failing to deliver.
“Virtually all people with anxiety problems engage in similar strategies to cope with their anxiety—strategies that have not worked very well and have caused more problems in the long run,” they write.
One such strategy, which they say is most common among men but also prevalent among women with anxiety disorders, is to self-medicate with alcohol.
According to Forsyth and Eifert, one in four people with an anxiety disorder use alcohol to cope with their symptoms. Alcohol use is an effective avoidance tactic because it really does decrease anxiety symptoms and may numb psychological pain temporarily.
But unfortunately, when the alcohol fades, the symptoms are back and they are often worse after drinking than they were at the beginning.
Because anxiety disorders and alcohol abuse can be so intertwined, some treatment providers will address the anxiety first in hopes that it will help with the substance abuse. But many providers will require clients with substance abuse issues to get clean and sober before working with them, and may refer out to a 12-step, intensive outpatient or other program for recovery.
People who struggle with anxiety may be more likely to experience other health issues including headaches, digestion issues, irritable bowel syndrome, insomnia, chronic pain, and eating disorders.
It’s important for providers to recognize when one or more of these issues is co-occurring with anxiety because these issues can be themselves a source of heightened anxiety and panic. Even when managed properly and appropriately, health concerns can cause a great deal of distress and it is important to be aware of how they may exacerbate anxiety symptoms to determine the best course of treatment.
Certain medical issues can also trigger anxiety or panic symptoms and can make people who don’t actually have an anxiety disorder believe that they do. According to Forsyth and Eifert, these can include thyroid problems, seizure disorders, asthma and other respiratory or heart conditions, and withdrawal from substance abuse.
“Before Aasuming that you have an anxiety disorder, it’s important to talk with your doctor and have a full medical workup to help determine whether there’s a physical cause for your problems. You can also think of this as a good way to take care of yourself,” write Forsyth and Eifert.
Once medical issues are ruled out or diagnosed, clients with anxiety disorders will have a much better sense of that with which they are dealing and can determine the appropriate steps to take with their treatment team.