Individuals with anxiety already suffer from a debilitating disorder; those with both addiction and anxiety have it much worse.
Anxiety is typically caused by extremely stressful events in someone’s life, and while some people learn to cope with the stress, others are never able to fully recover, and suffer from constant stress after the event(s). Stressful situations result with an increase in the level of glucocorticoids, a class of neurotransmitters, in the brain (1). Glucocorticoid hormones can induce the expression of genes associated with memory formation, allowing the brain to form strong memories of the stressful event (1). The formation of these memories can disrupt the balance of activity between different brain regions, and lead to abnormal activity in some regions.
One region of the brain impacted by anxiety is the prefrontal cortex. For those of you unfamiliar with the anatomy of the brain, the prefrontal cortex is located towards the front of your head, right above your eye sockets. The prefrontal cortex is responsible for planning, decision-making, emotional regulation, and the development of personality (2).
The way the prefrontal cortex regulates emotional responses is by controlling the activity of the limbic system, especially the amygdala. The amygdala is the region of the brain responsible for processing fear and anger, and the fear response becomes activated in extremely stressful situations.
Abnormal levels of activity in the amygdala have been associated with anxiety, indicating that the amygdala is partially responsible for the fear and stress felt by those who suffer from anxiety (2). In healthy people, the prefrontal cortex can shut off the fear response in the amygdala when it becomes too activated, but in people with anxiety, the amygdala actually decreases the activity of the prefrontal cortex (2).
This is where anxiety ties into addiction. When the activity of a person’s prefrontal cortex is inhibited, that individual’s ability to process information and make good decisions is significantly reduced. This means people who suffer from both anxiety and drug addictions are not able to avoid behaviors detrimental to their health, such as relapsing on their drug of choice. In fact, drug addicts who suffer from high levels of anxiety were found to be much more likely to relapse (2).
The stress caused by anxiety can permanently rewire the brain on the molecular and synaptic levels, making the brain much more susceptible to addiction. For example, the increased levels of glucocorticoids in the brain in anxious individuals can lead to higher levels of dopamine in the limbic system, which in turn makes the reward processing system in the brain more susceptible to drugs (3).
Anxiety and chronic stress are both risk factors for developing an addiction, and given that our culture has extremely high levels of anxiety, we need to be careful about how we learn to cope with the stress we face on a daily basis in order to avoid addiction. We also need to create more resources for those who do suffer from anxiety in our society; otherwise we will continue to see a surge in people addicted to various drugs and unhealthy behaviors.