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The Mayo Clinic defines social anxiety disorder as a chronic mental health problem in which normal daily interactions spark irrational anxiety and fear including for those in the LGBT community. The condition, also called social phobia, can involve several potential signs including the following:
- Extreme fear of being judged or embarrassed
- Crippling self-consciousness about speaking up
- Anxiety when talking or being the center of focus
- Avoidance of social situations and interactions
Social phobia symptoms can manifest as nausea, sweating, trembling, confusion and shaky voice, and the disorder is often associated with low self-esteem, hypersensitivity and substance abuse. If left untreated, social anxiety can make an addiction worse and complicate a recovery.
Co-Occurring Addiction and Anxiety
In 2006 a study published in Comprehensive Psychiatry found a high prevalence of co-occurring alcoholism and social anxiety (more so than other anxiety disorder). Several studies highlight the relationship between anxiety disorders and substance abuse including the following:
- Addictive Behaviors journal argued in 1998 that anxiety disorders often precede substance abuse.
- Alcohol Research: Current Reviews in 2012 cited studies that said comorbidity rates for alcoholism and social phobia are up to nine times the norm.
- Archives of General Psychiatry stated in 2011 that self-medicating anxiety with drugs and alcohol confers a substantial risk for substance abuse.
- The same Archives study also found a correlation between self-medicating substance abuse and incident social phobia.
Women have higher rates of comorbid anxiety and substance use disorders according to the Journal of Clinical Psychiatry in 2006 and the Archives of General Psychiatry in 1997, which is worth noting since women also have higher rates of social anxiety disorder
Social Anxiety and Addiction Risks
Co-occurring social anxiety and substance abuse in the LGBT community can present several particular risks including the following:
- Compulsion to get high before entering into a social situation
- Excessive substance abuse at home away from others
- Lack of friends to identify and address a substance use disorder
- Intoxication often fulfills a person’s fear of embarrassing behavior
- Certain drugs like amphetamines can increase anxiety and tension
Professional rehabilitation is the most effective way to treat addiction and mental health disorders, but social anxiety also makes people less likely to seek outside help.
Social Anxiety and Rehabilitation
A 2009 study published in Addictive Behaviors stated that people with social anxiety are less likely to participate in addition treatment, and those who do were four to eight times more likely to say the anxiety interfered with treatment activities. Alcoholism Treatment Quarterly published a study in 2010 that noted similarly relevant findings including the following:
- Approximately one in five of alcohol-dependent adults also suffer from social anxiety.
- Social anxiety makes addicts less likely to speak in treatment and find recovery sponsors.
- Addicts with social anxiety in treatment are also less likely to engage in group therapies.
- Women with social phobia fared less well in 12-step programs than socially phobic men.
- Comorbid women were 1.5 times more likely to relapse than non-socially phobic women.
For people with co-occurring addiction and social phobia, the data highlights the need for personalized treatment plans, which might include the following:
- Facilitate positive support structures early in the treatment process
- Empower patients with social skill and relationship training
- Assist patients in using these social skills to find a recovery sponsor
- Address unresolved trauma or unconscious internal conflicts
- Utilize gender-specific therapies and recovery tools for female patients
Rehabilitation centers can provide integrated treatment for social phobia and addiction, and professional help is particularly important for people who abuse benzodiazepine-class drug like Xanax, Klonopin and Valium. Benzodiazepines, which are commonly prescribed to treat anxiety, are meant for short-term use to avoid a physical dependence. Addicts who quit using the drug too abruptly can face longer lasting and more pronounced withdrawal symptoms including potential fatal seizures.
Addiction and Anxiety Treatment
Integrated treatment for comorbid addiction and anxiety can entail several potential therapies including the following:
- Detox under medical supervision in a safe and comfortable environment
- Tapered withdrawal for benzodiazepine addicts with gradual dosage reductions
- Mental health screenings to diagnosis co-occurring mental health disorders
- Cognitive Behavioral Therapy to treat unhealthy and maladaptive thought patterns
- Motivational interviewing to help patients find personal catalysts for change
- Basic life skills tools for managing stress, anger, anxiety and interpersonal conflict
- Strategies to identify and neutralize triggers for drug cravings and anxious thoughts
- Holistic options such as hypnosis, yoga, meditation, massage and breathing exercises
The Addiction journal in 2002, the Journal of Clinical Psychology in 2006 and the Annals of Behavior Medicine in 1999 all published studies that verify the importance of aftercare support groups for LGBT people. Recovering addicts with anxiety disorder histories need to engage aftercare recovery groups for lasting support in a local setting.
Do you or an LGBT loved one struggle with substance abuse and anxiety? Let us help. Our admissions coordinators are available 24 hours a day to answer questions and to discuss potential symptoms, treatment options and rehabilitation facilities. The Affordable Care Act (ACA) deemed addiction and mental disorder care an essential health benefits, and most insurance policies now cover treatment. We can check your policy for exact benefits. Our helpline is toll-free, so if you need assistance, please call now.