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How Do You Manage Anxiety in Addiction Recovery?

How Do You Manage Anxiety in Addiction Recovery?

Anxiety is one of the most common mental health problems in the world and it often goes with addiction. The National Epidemiological Survey on Alcohol and Related Conditions, a survey of more than 43,000 people, found that 15 percent of people who experienced an anxiety disorder in the past year had at least one co-occurring substance use disorder--more than twice the prevalence of substance use disorders in the general population.

Conversely, nearly 18 percent of people with a substance use disorder in the past year also had an anxiety disorder. As with any mental health issue, treating anxiety concurrently with addiction is crucial for staying sober long-term, as is taking care of your mental health. The following tips can help you manage anxiety while recovering from a substance use disorder.


Anxiety is the mental health issue most likely to be dismissed as no big deal. People might just tell you to relax or calm down or you might even tell yourself that. However, an anxiety disorder isn’t just a matter of being nervous. It often has a physiological component and sometimes requires medication. Often, anxiety has roots in childhood environment or dysfunctional belief patterns and you need help fixing the problem. The following tips are meant to augment therapy, not replace it.

Don’t Avoid Anxiety

When you’re prone to anxiety, your natural tendency is to avoid situations where you might feel anxious. This is particularly true of people who experience panic attacks. Unfortunately, this strategy only shrinks your sphere of comfort to the point where you might be afraid to even leave the house. As hard as it may be, the thing to do is intentionally expose yourself to things that make you anxious in a graduated way.

It’s like doing a workout for your ability to handle anxiety. Your therapist can help you create a plan for doing this in a structured way but you can also look for opportunities to engage in activities that might make you anxious but not too anxious.

Deep Breathing

In the short term, deep breathing is one of the best ways to manage anxiety. There are two reasons it helps. First, focusing on your breathing brings your attention into the present moment, to the sensations you feel when you breathe. You’re not focused on the future or whatever thoughts are making you anxious. Second, taking slow, deep breaths is physiologically calming.

In particular, the long, slow exhale stimulates your vagus nerve, which activates your parasympathetic--or “rest and digest”--nervous system. Although any slow, controlled breathing will calm you down, research suggests that taking six breaths per minute, or one full breath every 10 seconds, helps synchronize respiratory and cardiac rhythms, optimizing calmness and wellbeing.


As noted above, one of the ways deep breathing helps calm you down is that paying attention to the sensations of the breath grounds you in the present moment. You can use this principle with pretty much any sensation though. For example, you can pay attention to just the sensations in your feet or just pay attention to ambient sounds. You can go through all the senses systematically. The more you engage with your immediate environment, the less you worry about the future.


Exercise is great for addiction recovery in at least a dozen ways. High among those is that it helps reduce stress and anxiety. There are a number of ways exercise helps accomplish this. It increases levels of endorphins in the brain, as well as the feel-good neurotransmitter, serotonin. Exercise also increases blood flow to the brain and creates structural changes in the hypothalamic-pituitary-adrenal, or HPA, axis, which is connected to areas of the brain involved with identifying threats and fear.

These structural changes make your brain less reactive to stress and anxiety. Research suggests that 20 or 30 minutes of moderately intense aerobic exercise each day is ideal for improving mental health, but really, any exercise should provide some benefit.

Get Enough Sleep

As with exercise, there are plenty of reasons to get enough sleep in addiction recovery and in life, generally. A major reason for anyone with anxiety issues is that too little sleep worsens anxiety. We’ve long known that anxiety leads to insomnia, but it appears the reverse is also true. Research suggests that sleep deprivation leads to more symptoms of both depression and anxiety.

One study suggests this is because sleep deprivation leads to maladaptive activity in the brain’s anticipatory responses, leading to more rumination and worry. Sleep deprivation also weakens the brain’s prefrontal cortex, which acts as a brake on anxiety. Therefore, it’s crucial to sleep at least eight hours a night. If you have problems with insomnia, talk to your doctor or therapist.

Cut Down on Caffeine

Current research suggests that, on the whole, moderate consumption of tea or coffee isn’t bad for you and it might even have some mild health benefits. However, if you have problems with anxiety, it might be a good idea to cut down on caffeine. The physiological effects of caffeine are identical to those of anxiety.

Even if a few cups of coffee don’t directly lead to an anxiety or panic attack, they raise your baseline of arousal, making you more vulnerable to stress. Furthermore, caffeine has a half-life of between four and six hours, so even if you cut off your coffee at noon, you might still have a lot of caffeine in your system at bedtime. This may keep you awake and cause you to sleep less deeply when you do fall asleep. As discussed above, insomnia and sleep deprivation significantly increase symptoms of anxiety.

Anxiety issues can be challenging to deal with because they are rooted in our primitive survival instincts. They often don’t respond to reason, which can be terribly frustrating. Overcoming and managing anxiety starts with a good therapist. After that, it’s a matter of challenging yourself to get comfortable with anxiety and finding techniques to help you manage it.

At The Foundry, we know that addiction is about far more than physical dependence. Most people have co-occurring mental health issues that need attention if recovery is going to last. That’s why we use a variety of methods to foster mental health, including evidence-based treatment methods, outdoor activity, mindfulness meditation, and healthy lifestyle changes. To learn more, call us today at (844) 955-1066.

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