Anxiety and Early Recovery

In my experience, most people in early recovery struggle with Anxiety. For some, this anxiety predates their use, for others, it is a new struggle. Sometimes this anxiety results in moderate discomfort around people and in social situations; its uncomfortable but manageable. But for some people, this anxiety can be crippling leading them to struggle to simply function in their daily life.

Anxiety is one of the underliers of addiction. In response to anxiety and stress, the brain releases neurotransmitters such as gamma-aminobutyric acid (GABA), serotonin, dopamine, and epinephrine. Substance abuse negatively affects the functioning of these neurotransmitters in the brain. Some of this functioning will return to normal over time but research suggests that some of these mechanisms will never return to full functioning.

The medications commonly used to deal with anxiety, usually benzodiazapines such as Xanax or Klonopin, do nothing to actually treat the problem. They can mask the symptoms for a short period of time but can be damaging long term and do nothing to address the underlying issues. I don’t know that I have ever spoken to someone who has been on these medications long term who has not reported their anxiety increasing over time.

Anxiety can make recovering from substance abuse difficult. Recovering from addiction is not a passive activity; addiction thrives in isolation and inaction. Struggling with anxiety can make it hard to be involved in recovery related activities. Recovery involves engaging with people and often with groups of people. Anxiety can sometimes mean that we don’t get much out of these interactions.

In my experience, holistic treatments tend to be the best long term solutions to anxiety. Sometimes appropriate medications may be recommended in conjunction with these treatments but I find that the majority of people can manage anxiety long term without them. There is no one-size-fits-all solution to anxiety, some will struggle more than others, but there are effective solutions.

I usually begin with guided meditations which tend to be a quick and effective way to lower anxiety. Often in a very short period of time individuals can learn to take the edge off their anxiety with a few simple techniques. I also find that just knowing they they have some control of their anxiety, that they are not totally powerless over it, can reduce overall anxiety.

Many of the more medium to long term treatments for anxiety involve experiential therapy. When someone experiences a situation that makes them anxious and are able to get through it, they are likely to be slightly less anxious the next time they face a similar situation. When anxiety is high, the brain is basically saying “this isn’t right, we need to get out of here” when the opposite is often true. With mild anxiety, simply allowing yourself to stay in uncomfortable situations may be a good strategy for lowering anxiety over time. If your anxiety is more severe, you may need the guidance of someone experienced in dealing with these issues as a guide to avoid making things worse rather than better.

Sometimes the anxiety is a result of past trauma. One of the main symptoms of unresolved trauma is increased, sometimes debilitating, anxiety (often coupled with difficulty sleeping, nightmares, hyperarousal, and other symptoms). Some of the above techniques may help, but to fully deal with the anxiety, it will likely be necessary to address the trauma. This type if anxiety does tend to improve substantially, and relatively quickly, as the trauma is addressed.

When we engage in a recovery program we learn new coping mechanisms. We learn how to deal with stress and anxiety and how to reach out when we need help. In my experience, it is amazing what healthy coping mechanisms and good social support can so for anxiety. These are usually resources we are missing in addiction and struggling to build in early recovery. As we begin to develop these systems, anxiety tends to decrease.

Although the brain of someone with substance abuse issues may never return to full normal functioning in some areas, this does not mean that the person can not return to functioning normally. It is possible to learn to cope in ways that can take the place of the missing neurochemical responses. Dealing with anxiety can be difficult, it is likely going to take some work, but it can be done.


Jeff Harrolle, LPC

Thrive Counseling & Trauma Therapy