Anxiety And Substance Use: Why People Self-Medicate
Anxiety is one of the most common mental health challenges people face, and it doesn’t always look like panic attacks or constant worry. Sometimes it shows up as restlessness, irritability, trouble sleeping, racing thoughts, or a persistent sense that something is “off.” For many, anxiety can feel exhausting and relentless—especially when it interferes with work, relationships, or daily responsibilities. It’s not surprising, then, that some people turn to substances like alcohol, cannabis, prescription medications, or other drugs to get relief.
This is often called self-medicating: using a substance to reduce uncomfortable emotions or manage symptoms without professional guidance. While it can provide short-term comfort, self-medication frequently makes anxiety worse over time and increases the risk of developing a substance use disorder.
What Self-Medication Looks Like In Real Life
Self-medication isn’t always obvious, even to the person doing it. It can look like:
- Having a drink “to take the edge off” every evening
- Using cannabis to calm racing thoughts or help with sleep
- Taking more of a prescribed medication than recommended
- Using stimulants to counter fatigue from anxiety-related insomnia
- Relying on substances socially to feel less awkward or fearful
The common thread is that the substance becomes a coping tool—something a person reaches for when anxiety spikes, stress builds, or emotions feel unmanageable.
Why Anxiety Can Drive Substance Use
Anxiety can create a powerful urge for immediate relief. Substances can seem appealing because they work quickly and don’t require vulnerability, appointments, or learning new skills. There are several reasons this pattern develops.
Fast Relief Feels Like A Solution
Many substances alter brain chemistry in ways that temporarily reduce tension, fear, or discomfort. Alcohol may slow down an overactive nervous system. Cannabis may create a sense of calm or detachment. Benzodiazepines can rapidly reduce panic symptoms. That quick shift can feel like proof that the substance “works,” reinforcing the behavior.
The problem is that fast relief isn’t the same as healing. Anxiety often returns once the effects wear off, and the person may feel compelled to use again—sometimes more than before.
Anxiety Can Be Physical, Not Just Mental
For some people, anxiety is experienced primarily in the body: tight chest, upset stomach, sweating, shaky hands, headaches, muscle tension, or shortness of breath. These sensations can be scary, especially if someone doesn’t understand they’re anxiety-related. Substances can dull those sensations quickly, making them feel like an easy fix.
People Use Substances To Avoid Triggers And Emotions
Anxiety often has triggers—conflict, social situations, trauma reminders, pressure at work, or fear of failure. When someone uses a substance to cope, they may avoid confronting the underlying trigger. Over time, their tolerance for discomfort can shrink, and anxiety can become more intrusive.
Self-medication can also be a way to avoid emotions like grief, shame, loneliness, or anger that are intertwined with anxiety. Instead of processing those feelings, the person learns to numb them.
The Anxiety-Substance “Loop” That Makes Things Worse
Self-medicating tends to create a cycle:
- Anxiety rises
- A substance provides temporary relief
- The substance wears off
- Anxiety returns—often stronger
- Cravings or urges increase
- Use becomes more frequent or intense
This happens for several reasons:
Rebound Anxiety And Withdrawal
Many substances can cause rebound anxiety—a surge of anxious feelings as the body readjusts. Alcohol is a common example: it may feel calming initially, but as it leaves the system, sleep quality drops, mood becomes more unstable, and anxiety often increases the next day.
With repeated use, the body may develop dependence. When that happens, a person may experience withdrawal symptoms that mimic or intensify anxiety, such as restlessness, irritability, nausea, sweating, rapid heartbeat, or panic sensations.
Changes In Brain Chemistry
Over time, frequent substance use can change how the brain regulates stress and pleasure. The brain may become less responsive to natural calming strategies, making everyday anxiety feel more intense. This can lead to using substances not only to “feel good,” but just to feel normal.
Increased Risk-Taking And Regret
Substances can reduce inhibition and impair judgment. People may say or do things they wouldn’t otherwise do, leading to conflict, embarrassment, or consequences that fuel more anxiety. That regret can become another trigger, reinforcing the need to use again.
Common Substances People Use To Cope With Anxiety
Different substances can appeal to different anxiety symptoms:
Alcohol
Often used to relax socially or fall asleep, but it disrupts restorative sleep and can worsen anxiety over time.
Cannabis
Some people find it calming, while others experience increased paranoia, panic symptoms, or brain fog—especially with higher-THC products.
Benzodiazepines Or Sedatives
Can reduce acute anxiety, but carry risks of tolerance and dependence when used outside medical guidance or long-term without a clear plan.
Stimulants
Some people use stimulants to keep up with responsibilities when anxiety causes fatigue or poor sleep. However, stimulants can increase heart rate and restlessness, intensifying anxiety symptoms.
Healthier Ways To Treat Anxiety Without Self-Medicating
Anxiety is treatable, and relief doesn’t have to come with long-term costs. Effective approaches often include:
Therapy That Builds Coping Skills
Cognitive behavioral therapy (CBT), exposure-based approaches, and trauma-informed therapies can reduce anxiety by teaching people how to relate differently to fearful thoughts and triggers.
Addressing Sleep, Nutrition, And Nervous System Regulation
Improving sleep routines, reducing caffeine, practicing breathing techniques, movement, and mindfulness-based strategies can help calm the body’s stress response.
Medication With Professional Oversight
For some, medications like SSRIs or other non-addictive options can reduce baseline anxiety and make therapy more effective. This works best when monitored by a qualified provider.
Support For Both Anxiety And Substance Use
If someone is stuck in the self-medication cycle, integrated treatment that addresses both anxiety and substance use together can be especially helpful. Treating only one side often leaves the other driving relapse.
When To Reach Out For Help
If substance use is becoming a primary way to cope with anxiety—especially if tolerance is increasing, quitting feels difficult, or anxiety worsens without it—it’s a sign that extra support could help. There’s no shame in needing care. Self-medication is often a survival strategy that outlived its usefulness, and with the right tools and support, people can learn safer, more sustainable ways to feel calm and in control.
If you are searching for a rehab for yourself or a loved one, consider Align Recovery for drug rehabilitation in Northern California.
