Stress and anxiety are significant drivers of substance abuse. But what’s the difference between stress and anxiety, and how does each impact the development of addictive behaviors? A new study paper highlights the discovery of important distinctions between stress and anxiety, and reveals that anxiety may be the stronger catalyst for drug or alcohol problems.
What’s the Difference Between Stress and Anxiety?
Stress is often mistakenly used as a catch-all term to describe trauma or anxiety disorders. Although these issues share many of the same physical symptoms, they have different causes and effects. Generally defined as tension or mental and emotional strain resulting from environmental/societal pressure or troubling or demanding circumstances, stress can cause physical and emotional problems and sometimes drive a person to use drugs or alcohol to cope. The temporary stress resulting from external pressures like work and other commitments is different from post-traumatic stress disorder (PTSD), which is an anxiety disorder that can develop after a person experiences a physically or psychologically traumatizing event. People with PTSD and other anxiety disorders experience apprehension or excessive worry about impending events that interferes with daily activities like work and relationships. Their fears often stem from an internal perception of danger without real cause. Studies show that those who have been exposed to trauma at a young age sustain changes in their brain receptors that regulate stress and emotion, which can lead to increased risks for anxiety disorders later in life. Examples of early trauma include chronic exposure to pain or hunger, serious illness, household/family violence, neglect or abuse, parental divorce or the death of a loved one. Early trauma can also increase the lifetime risk for issues such as heart disease, cancer and socioeconomic problems. These life challenges can add to a person’s emotional and physical burden, causing further anxiety. About 20 percent of those who have an anxiety or mood disorder also have a substance use disorder. By the time an individual arrives for treatment, the addiction has often developed due to a long history of “self-medicating” with drugs or alcohol to manage anxiety, which has often not been medically diagnosed or treated. Since some drugs increase or cause symptoms of anxiety, a person with an underlying anxiety disorder who is attempting to self-treat their symptoms may unknowingly be making things worse. Some medications taken for other health issues can also cause or exacerbate symptoms of anxiety (e.g., thyroid drugs, asthma drugs, and some decongestants and cold remedies).
The Lesser of Two Evils
So which poses a greater addiction risk, stress or anxiety? According to the authors of the recently published paper, clinical anxiety is more strongly associated with the urge to drink alcohol than self-perceived stress among heavy drinkers. A 2010 research study reached similar conclusions. In this earlier study, researchers at Medical University of South Carolina investigated connections between different psychological stressors and alcohol cues among heavy drinkers. They found that an acute psychological stressor did not increase the potency of an alcohol cue. Although stress tests showed a general or moderate increase in cravings among all participants during cue challenges, the researchers concluded that no single type of stressor had an acute effect on alcohol craving. While anxiety appears to pose a greater risk than time-limited, external stressors, both stress and anxiety can be a significant threat to a person’s mental and physical health. Since alcohol and other drugs aren’t an effective or risk-free approach to handling difficult feelings, it’s critical to develop healthy coping skills and get help at the earliest signs that stress or anxiety has become unmanageable.