Example of Dual Diagnosis

Alcoholism and Anxiety

As mentioned previously in the mental health section, there are many mental health problems which are not necessarily perceived as being “severe” but can have severe implications on a persons recovery from addiction, for example anxiety.
Anxiety disorders
According to the Anxiety Disorders Association of America, those with high anxiety are two to three times more likely to have problems with alcohol or other drugs than the general public.

The substance abuse problem may become the more obvious problem. If the person receives treatment for the substance abuse issue and treatment for the anxiety problem is not given, the chances of long term recovery are slim.

The Anxiety Disorders Association of America states that 20% of people with a social anxiety disorder have a substance abuse issue. If a person with an unknown social anxiety disorder is advised by professionals to attend AA meetings or support groups it may be a very difficult task due to the
nature of the issue.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (2000) defines a Social anxiety disorder as:

“A marked and persistent fear of one or more social and performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Exposure to the feared social situation almost invariable provokes anxiety, which may take the form of a situational bound or predisposed panic attack.”

More simply put, Social Anxiety refers to symptoms such as:
– acute self – consciousness, awkwardness and self-focus
– over-focus on anxiety symptoms such as blushing, shaking and sweating
– frequent embarrassment, feeling different, unwanted and negatively judged

While we all experience some social anxiety when we are in social situations outside of our comfort zones (e.g. attending a wedding where we know nobody), the extremeness of the above symptoms in some cases, and the huge extent to which they negatively affect some people’s lives, are what leads us to diagnose Social Anxiety. For the Socially Anxious person there is a constant fear of being negatively judged – social life is like one long job interview.

Social Anxiety is not the same as shyness (a shy person may not be very confident in social situations, but they don’t necessarily experience a high level of anxiety around them) or introversion (a personality characteristic – some people just like a lot of time alone). Nor are the Socially Anxious person’s social skills necessarily poor, though they generally fear they are (and they may well be out of practice)

For some people these symptoms are experienced in all social situations, for others just in specific but important ones (e.g. meetings, presentations, speeches). Many sufferers manage to mask and cope with the problem to a certain extent, but only at the cost of quite a lot of damage to their life and happiness: they experience constant levels of anxiety, and/or impose serious limitations on their social life, relationships, work, education etc).

Unfortunately, some also try to manage their anxiety using alcohol or other drugs, which in turn can lead to an addiction problem. The loneliness and isolation that is the result of some people’s Social Anxiety problems can lead them to depression and even ultimately to suicide.

this real life story illustrates the issue . . .
Marks Story