Phobias are a group of anxiety disorders characterized by an overwhelming fear of an event, action or thing that is often irrational in nature. In many cases, the fear is either of something that is highly unlikely to occur or of something that is largely innocuous.
There is a wide range of specific phobias that patients often struggle with. Some of the most common include social phobias defined by anxiety in public or feeling embarrassed for no reason and the fear of specific thing like air travel or spiders.
When faced with their fear, patients often experience physical as well as psychological symptoms, including:
- Panic attack
- Increased heart rate
- Hyperventilation or shortness of breath
- The urge to flee the situation
In order to manage these uncomfortable and often overwhelming symptoms, many patients attempt to use drugs and alcohol. The idea that having a drink, smoking a joint, or taking a pill will help them calm down can drive them to imbibe beyond moderation. Over time, when the underlying phobia goes untreated and the only coping mechanism is substance abuse, an addiction can develop. This only serves to cause more problems and add another layer of urgency to the need for comprehensive – and immediate – treatment for both issues.
If your loved one is in need of Dual Diagnosis treatment to address a specific phobia or anxiety disorder as well as a substance abuse issue, contact us at the phone number listed above today.
Self-Medication Through Substance Abuse
Why do phobias and substance abuse or addiction so often occur together? Because in the moment of panic, the need to escape the feelings and fear that define the phobia can be so overwhelming that the person very often turns to the thing that they believe will give them the most immediate sense of relief – no matter how potentially harmful that choice may be. There is no sense of moderation, only desperation in that instant, and a drink can quickly turn into several shots or a single sedative can turn into two or three at a time in the hope of quickly eradicating the uncomfortable feelings.
Unfortunately, when this happens repeatedly, the large amount of the substance in question can turn into a serious problem. Initially, the behaviors while under the influence and other issues that arise due to substance abuse can be problematic, but large amounts of any addictive substance used chronically will soon result in a tolerance to the drug, requiring the user to take larger and larger amounts in order to achieve the desired relief from the phobia symptoms.
Five Types of Specific Phobias
The National Alliance of Mental Illness (NAMI) outlines the five types of specific phobias as follows:
- Fear of animals. Fear of insects, domesticated animals, birds, and wild animals fall into this category.
- Fear of nature. This can include anything from a fear of a specific natural disaster or storms to the fear of being in an unstable environment.
- Fear of medical problems. Fears of blood, getting a shot or use of medical needles, or injury in general can fall into this category. Often the phobia is not just about sustaining a medical injury or seeing one’s own blood but in seeing it happen to others as well.
- Fear of a specific situation. Fears of any form of traveling as well as being enclosed in a tight space or tunnel fall into this category.
- Other. This category is wide open and can include fear of any type of bodily sensation, fear of dying, fear of germs, etc.
Effective Treatments for Phobias
NAMI reports that there are a number of evidence-based treatment options for patients who struggle with phobias. These directed treatments can be hugely beneficial in helping patients to learn how to manage their triggers for panic and fear when they are unavoidable, using coping mechanisms that are safe and unrelated to substance abuse of any kind.
Recommended treatments include:
- Behavioral therapy. Addressing a patient’s reaction to a stimulus is the focus of this style of therapy. Adapting behaviors to more suitable, non-destructive responses is the goal.
- Exposure therapy. Exposure therapy is a type of behavioral therapy. This style of treatment exposes the patient to the object of their fear, gradually increasing the length of time or amount of exposure until their symptoms are diminished.
- Systemic desensitization. This style of treatment is largely similar to exposure therapy but incorporates the use of relaxation techniques to assist the patient in limiting fear and anxiety naturally.
- Medications. Even when substance abuse is not an issue for a patient, the use of addictive medications – like benzodiazepines – is largely unnecessary because the therapeutic treatment is so successful. When substance abuse is an issue, inpatient care is recommended to help patients avoid relapse during the initial stages of treatment as they are learning to utilize their coping mechanisms.
Do Genes Cause Phobias and Substance Abuse?+
There is no one single cause for the development of any mental health issue or substance abuse problem. However, it has been noted that if one has a biological parent or a sibling who is diagnosed with a disorder like a phobia or an issue of substance abuse, that person may be more likely to develop either disorder.
It should be noted, however, that having someone in the family who struggles with substance abuse or an anxiety disorder in no way guarantees that another family member will have the same problem. Other issues must also be present, and it is usually a combination of these that create a drug or alcohol disorder or a mental health issue.
Causes of Substance Abuse Disorders and Phobias
Though no single thing can trigger both a substance abuse disorder and a specific phobia, some possible causes can include any combination of the following:
- Genetics. The closer in relationship the family member diagnosed with either disorder is, the more likely it is that one will develop either issue under certain circumstances.
- Permissive environment. When one lives with someone with a phobia or lives in a neighborhood or social group in which substance abuse is frequent or encouraged, it can contribute to the development of either disorder.
- Trauma. Significant trauma – related directly to the focus of the phobia or not – can trigger an anxiety disorder and/or a substance abuse problem, especially when coupled with other triggering causes.
- Access. For drugs and alcohol specifically, having regular and easy access to different substances of abuse can increase familiarity and the likelihood that someone will try it, using it in small amounts frequently, and slowly build their use.
Dual Diagnosis Treatment
Unfortunately, many people who struggle with phobias do not seek mental health treatment for the issue; this is often why they attempt to manage the symptoms on their own using drugs and alcohol. However, those who do seek treatment will almost always experience a lessening of symptoms and many will fully recover from their phobia, according to NAMI.
It is essential, however, that when a substance abuse disorder is a part of the issue that the patient seeks more than just treatment for the phobia. An integrated treatment program that addresses both of the co-occurring disorders is essential.
Why is integrated treatment the most effective option? Often, the two disorders are entwined, making it virtually impossible to successfully treat one without treating the other. For example, if a patient attempts to undergo treatment solely for drug abuse yet still struggles with panic and fear related to the phobia, their urge to drink or use drugs will be inordinately high and almost impossible to resist without direct treatment that provides them with more effective coping mechanisms.
In the same way, if the patient attempts to undergo treatment for a phobia but continues to drink and use drugs, it can have the effect of erasing any progress made in treatment when under the influence and faced with the object of their phobia.
Integrated Dual Diagnosis Rehab: What to Expect
Truly integrated care will offer a variety of therapies and treatments that are designed to offer aid and improvement to the symptoms of both disorders. Though some will be specific to phobias (e.g., exposure therapy, systemic desensitization) and some will be specific to addiction (e.g., detox assistance, relapse prevention), many therapies will provide assistance to both, including:
- Personal therapy. One-on-therapy can provide a starting point for patients where they can work on their overall treatment plan and discuss how things are progressing in treatment as well as come up with actionable plans to address obstacles and challenges as they arise on a daily basis.
- Support groups. Peer support is important. In the therapeutic setting, it demonstrates that no one is isolated in their experience and that others have had both successes and failures in life and recovery. By listening to each other and providing mutual support, all involved can grow and learn how to connect with others in a positive context.
- Alternative therapies. A number of therapies can work to boost the confidence of the patient, improve their socialization skills and peer support, and help them explore new areas of interest that can help to lay the foundation for their new life in recovery.
- Holistic treatments. Lowering stress is a huge part of managing anxiety and decreasing the power of cravings for drugs and alcohol. Yoga, meditation, acupuncture, and other holistic care options can serve to positively impact the patient’s receptivity to other aspects of treatment.
- Aftercare. For both disorders, long-term follow-up care is a crucial part of the equation when it comes to longevity in sobriety. Continued check-ins with a counselor, support groups, alumni groups and activities, 12-Step meetings, and ongoing holistic treatment options on an outpatient basis all serve to provide ongoing accountability and support in recovery.
Connect with the Right Dual Diagnosis Rehab for Your Loved One
Whether your loved one struggles with alcoholism and agoraphobia, marijuana abuse and social anxiety, or benzodiazepine addiction and a fear of flying, they can find the help they need to overcome both disorders through Dual Diagnosis treatment.
There are a number of types and styles of rehabilitation available to choose from. Which one is right for your loved one? It’s an important decision and not one you need to make without assistance. Call the phone number listed above today and find the assistance you need to make an informed choice in treatment programs. We can assist you by matching your loved one to the right program for their needs. Call now to get started.
Further Reading About Substance Abuse Among Those Suffering from Phobias
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.