Some of the most frequently asked questions on message boards and in doctor’s offices when it comes to both panic and anxiety is how certain substances, conditions, and activities are related to anxiety and panic.  These questions are very good ones to ask, yet they are all too frequently dismissed.  Patients are often given very vague answers that do not fully answer their questions.  In this chapter, we will look at how a variety of things are linked to panic and anxiety.

links & factors

Knowing whether a substance, condition, or behavior may be causing or contributing to your anxiety can help you make better choices.  We all want to do what is right for our bodies, and this means ensuring that we are not doing things that can make anxiety disorders worse.  When you know how to keep from exacerbating your condition, you are able to see much better results from therapy and other treatments.

Drugs and Illegal Substances

When it comes to drugs, there are all sorts of health concerns, both physical and mental, that patients should worry about.  Unfortunately, many patients with anxiety disorders have a tendency to self medicate by using drugs to help numb the symptoms that they are experiencing.  This can create a vicious cycle. It can often be hard to determine which condition came first, drug use or anxiety, and patients usually need to be treated for both conditions in order to see benefit.

Both depressants and stimulants can have an effect on anxiety.  Stimulants can certainly induce panic attacks and severe anxiety even in people without an anxiety disorder, and people who have already been diagnosed with anxiety can experience a marked increase in their symptoms.

Depressants can also have a notable effect on anxiety.  Many patients turn to these drugs because they provide a temporary calming or depressing of the central nervous system and the body’s panic response.  Not only is there a risk of overdose, especially with opiates, but there is also great risk of heightened anxiety as the drug wears off.  Patients using depressants often experience a rebound effect of greater anxiety as the drug’s effects wear off, frequently leading to greater use of the drug and higher doses needed to keep symptoms at bay.

Even marijuana, which many believe to be a harmless drug, has proven to have negative effects for patients with anxiety.  While it can initially produce a state of calm or relaxation, marijuana can also cause a state of sudden or instant panic in some people.  Because it affects the hippocampus of the brain, which is an essential part of learning, it is also counterproductive for anyone who is engaging in therapy and trying to learn new skills and coping mechanisms.

The drug MDMA, or ecstasy, is also even more dangerous for patients with anxiety.  Research shows that even a single dose of this drug can damage the part of the brain that is responsible for producing serotonin.  Because a serotonin imbalance has been scientifically linked with many anxiety and mental health disorders, it is safe to assume that MDMA can have damaging effects for anyone with a diagnosis of or a predisposition to anxiety and anxiety disorders.

Another problem with drug use is that it can mask symptoms and signs of an anxiety disorder.  These disorders often respond best to treatment the sooner a patient is diagnosed and begins receiving therapy.  People who abuse substances to mask their symptoms can go years without being properly diagnosed.  Drug use is dangerous in any individual, but for those with anxiety disorders, it is even more so.

Alcohol

alchocol

Alcohol is another commonly sought after “solution” to anxiety and anxiety disorders.  It is a common form of self-medication, as it can help to temporarily alleviate symptoms of anxiety.  As a central nervous system depressant, alcohol does have the short term effect of lowering anxiety, providing a feeling of relaxation, and stopping your body from producing anxiety symptoms.  While this can produce relief for a short period of time, however, alcohol is very counterproductive in the long run.

Alcohol use results in a decreased ability for our brains to handle and cope with anxiety in the long run, because it reduces both the number and function of receptors in the brain that help to alleviate symptoms of anxiety.  Furthermore, the symptoms produced by the body when metabolizing and withdrawing from alcohol actually serve to increase anxiety levels to a point beyond what they were at before the alcohol was imbibed.  In other words, alcohol creates significantly more anxiety than it can treat.

Alcohol can also worsen anxiety in a number of other ways.  Frequent or prolonged use of alcohol can lead to dependency.  This can create a very dangerous cycle where you believe that the only way to alleviate anxiety is to drink alcohol.  As your tolerance rises, your need to consume larger quantities of alcohol increases, leading to greater anxiety and a greater risk of alcohol poisoning and death.

Use or abuse of alcohol can also exacerbate the symptoms of an anxiety disorder.  It is not uncommon for drinkers to experience disrupted sleep patterns, damaged work and social relationships, and difficulties performing essential daily tasks.  All of these things can lead to increased anxiety, which for people who abuse alcohol, can lead to more drinking.  This cycle is incredibly dangerous.

The other major concern with alcohol use is that it can mask symptoms of underlying anxiety disorders.  It is not uncommon for people who frequently drink to mask the symptoms of an underlying condition or for anxiety symptoms to be misdiagnosed as the symptoms of alcohol withdrawal.

Medication (non-psychiatric)

One thing that few patients with anxiety consider is whether or not their medications may be exacerbating the condition.  While psychiatric medications will be addressed in the next section, here, we are looking at both over the counter and prescription medications offered for conditions that are not psychiatric in nature.

For example, few people realize that pseudoephedrine, a common ingredient in cold medications, can actually cause significant anxiety, especially in people who already have an anxiety disorder.  For these patients, pseudoephedrine can actually cause panic attacks or worsened anxiety symptoms.  Use of this ingredient should be limited for people with anxiety, especially since there are equally effective ingredients on the market that do not have stimulant effects.  Many over the counter allergy medicines can also have anxiety inducing or exacerbating effects.  Because of this, it is recommended that you research any medication for possible side effects before taking it.

In addition to over the counter medications, many prescription medications can also cause anxiety.  This is true of medications commonly prescribed for ADHD, chronic fatigue syndrome, and allergies.  It is also true of numerous prescription cold medicines, steroids, and even some medications intended to help with sleep and to help patients stop smoking.  Always ask your physician or pharmacist about the potential side effects of any new drug and let your doctor know if a medication prescribed for you is worsening your anxiety or panic symptoms.  In many cases, there are other options available to you.

Psychiatric Medications

There are many psychiatric medications that can serve to make symptoms of anxiety worse as well.  This is especially true for many of the mood stabilizers used to treat bipolar disorder.  Many common antidepressants can also worsen symptoms of anxiety.  In some patients, these medications can also create symptoms of anxiety in patients who did not previously experience them, which can lead to misdiagnosis and treatment for a condition that is only present as the side effect of another medication.

Anti-psychotic drugs can also cause anxiety.  Before you start taking any psychiatric medicine, it is highly recommended that you research the possible side effects of the drug, many of which can often be worse than the relief that the drug provides.  The risks associated with psychiatric medications will be further examined later in this book, as well as alternative treatments that carry fewer risks and offer potentially greater short and long term benefit.