What is the relationship between panic disorders and addiction?

Background

Panic attacks occur frequently and without warning. They even can begin during sleep. Over time, persons with panic disorder may begin to avoid situations they believe can trigger a panic attack or may, for example, stop leaving their homes because they fear that no place is safe.

Symptoms

People with panic disorder are plagued by feelings of impending doom. The symptoms of panic disorder also include sweating, chest pain or pressure, irregular heartbeat, shortness of breath, a feeling of choking or being smothered, dizziness, a sense of unreality, a tingling sensation in the hands or feet, chills, flushing, nausea, a pressing desire to escape, and difficulty sleeping.

According to the Anxiety Disorders Association of America, approximately 6 million adults in the United States experience panic attacks each year. Women are twice as likely to be affected.

How Panic Disorder Can Lead to Addiction

The symptoms of panic disorder can be extremely uncomfortable and overwhelming, so many people with the disorder turn to drugs and alcohol to relieve their symptoms. This action is known as self-medicating. Central nervous system depressants, such as alcohol, marijuana, and opiates, are commonly used to self-medicate. Long-term use of any of these substances can lead to addiction.

Over time, people who use drugs or alcohol to self-medicate will build up a tolerance to the drug, so that they will eventually need to increase the amount of the substance to get the same effect. For example, a person who may at first be having a drink or two to relax at the end of the day may find that, eventually, three, four, or more drinks are needed to feel relaxed. A person who began taking one pain pill a day to relieve symptoms of panic disorder may need to take two or three pills a day to get the same relief.

Self-medication also can lead to other problems. That is, the relief from self-medicating is temporary, the side effects of long-term drug or alcohol use can be severe, and the underlying cause of the panic disorder is ultimately not treated.

How Addiction Can Lead to Panic Disorder

Panic disorder also can be caused by substance abuse. Certain substances, such as caffeine, tobacco, cocaine, and methamphetamine, can trigger panic attacks. Panic disorder symptoms caused by substance abuse may include irregular heart rate, flushing, dizziness, sweating, and difficulty sleeping. These symptoms can last long after the effects of the drug wear off, which often makes the person want to use the substance again.

Additionally, withdrawal from alcohol or opiates can cause symptoms of panic disorder. Panic disorder symptoms caused by alcohol or opiate withdrawal may include sweating, rapid heartbeat, dizziness, flushing, and difficulty sleeping. Therefore, a person who is self-medicating to avoid symptoms of panic disorder may be increasing his or her risk of a panic attack through substance abuse and subsequent withdrawal.

The Anxiety and Panic Disorder Cycle

Panic disorder and substance abuse often coexist in a vicious cycle. Although central nervous system depressants are often used to relieve panic disorder symptoms, the symptoms of panic disorder escalate when a person discontinues the depressant drugs and experiences withdrawal symptoms. This leads the person with the panic disorder to repeat the self-medicating behavior. When panic disorder is caused by addiction, the panic that is caused by the substance abuse is often further “treated” by using and abusing the substance.

Bibliography

Anxiety Disorders Association of America. “Panic Disorder and Agoraphobia.” ADAA. Anxiety Disorders Assn. of America, n.d. Web. 29 Oct. 2015.

Anxiety Disorders Association of America. “Substance Abuse Disorders.” ADAA. Anxiety Disorders Assn. of America, n.d. Web. 29 Oct. 2015.

Robinson, Jennifer, et al. “Role of Self-medication in the Development of Comorbid Anxiety and Substance Use Disorders: A Longitudinal Investigation.” Archives of General Psychiatry 68.8 (2011): 800–807. JAMA Psychiatry. Web. 29 Oct. 2015.

Smith, John. Co-Occurring Substance Abuse and Mental Disorders: A Practitioner's Guide. Lanham: Rowman, 2007. Print.

Stewart, Sherry H., and Patricia J. Conrod, eds. Anxiety and Substance Use Disorders: The Vicious Cycle of Comorbidity. New York: Springer, 2008. Print.