Anxiety and Addiction Treatment. Why Treating One Without the Other Rarely Works

Anxiety and addiction co-occur because each condition drives the development of the other.

Anxiety and addiction co-occur because each condition drives the development of the other. The relationship is bidirectional: anxiety creates the conditions in which substance use often begins, and sustained substance use alters brain chemistry in ways that worsen anxiety over time. According to the National Institute on Drug Abuse, people with anxiety disorders are significantly more likely to develop substance use disorders, and the reverse also holds: substance use disorders increase the risk of anxiety through neurological changes that persist well into recovery.

At Jintara, this pattern is consistent. Darren Lockie, founder and CEO: "99% of clients come in with a dual diagnosis. They don't always know to call it that or that they have underlying mental health problems, that they're self medicating with drugs or alcohol." Most people entering treatment did not intend to develop an addiction. They found a substance that reduced their anxiety and used it more often than they planned to. Over time, the substance became part of the problem. Dual diagnosis treatment at Jintara addresses both the addiction and the underlying anxiety concurrently.

Alcohol and benzodiazepines are the substances most commonly used to manage anxiety.

Alcohol and benzodiazepines are the two substances most commonly used to manage anxiety before a clinical diagnosis is in place, primarily because both suppress the nervous system through GABA system activity. For a person living with undiagnosed generalised anxiety disorder, social anxiety, or panic disorder, the sedative effect of either substance can feel like relief. Benzodiazepines are frequently prescribed for anxiety disorders, which means many clients arrive at Jintara physically dependent on a prescribed medication they were taking for a legitimate clinical reason.

The clinical difficulty with both substances is that they suppress anxiety without addressing its source. They do not change the thought patterns, avoidance behaviours, or physiological responses that maintain anxiety. Tolerance develops quickly, meaning more of the substance is needed to achieve the same effect. When either is withdrawn, benzodiazepine-related anxiety or alcohol-related rebound can exceed the levels the person experienced before they began using. This rebound is one of the most common drivers of early relapse, particularly in the first month after leaving treatment.

Stopping the substance does not resolve the anxiety. It reveals it.

The anxiety experienced during the first week of detox is not the anxiety that will persist. For alcohol and benzodiazepines in particular, the NIAAA alcohol withdrawal review notes that withdrawal produces significant rebound anxiety as the brain, deprived of chemicals it relied on for regulation, temporarily overcorrects. This rebound typically peaks in the first several days and settles gradually as the nervous system rebalances. It is a withdrawal effect, not a permanent state.

For people with underlying anxiety disorders, however, symptoms that do not resolve at the same pace as withdrawal suggest that something beyond medically supervised detox alone is present and requires clinical attention. The National Institute of Mental Health identifies anxiety disorders as among the most prevalent mental health conditions in adults, and a significant proportion of people with anxiety disorders have used substances to manage symptoms before ever receiving a clinical diagnosis. Distinguishing withdrawal-driven anxiety from pre-existing anxiety is an early clinical priority at Jintara and shapes the treatment plan from the first week.

Jintara screens for anxiety from the first day of admission.

On arrival at Jintara, every client receives a clinical assessment that includes standardised mental health screening. The GAD-7 is used to screen for anxiety, the PHQ-9 for depression, and the PCL-5 for trauma symptoms. These tools establish a baseline on day one. The same tools are repeated every one to two weeks throughout the program so the clinical team can track whether symptoms are resolving with withdrawal or persisting in ways that point to an underlying condition requiring its own therapeutic attention.

Alongside the screening process, clients attend an early assessment with the visiting psychiatrist, who determines whether supportive medication is clinically indicated during the acute phase of withdrawal. The aim is to have pharmacological support in place before it is needed, if anxiety proves severe enough to warrant it in the first week. Denise O'Leary, who holds a Master of Arts in Counselling Psychology and is a certified EMDR therapist, leads the clinical team that oversees this process from admission. The screening results inform her approach to therapy from the first individual session.

Treatment addresses anxiety and addiction in parallel, not in sequence.

At Jintara, anxiety receives therapeutic attention from the first week of admission, not after withdrawal resolves. Denise O'Leary describes how this looks in practice: "If they're highly anxious or highly depressed, of course, we'll provide some extra support around that." The clinical team monitors anxiety closely, provides targeted support, and begins teaching basic regulation skills that clients can practise while their body is still adjusting to being substance-free.

This matters because anxiety during early withdrawal is often at its highest when a person's capacity to tolerate it is lowest. Teaching grounding techniques, sleep hygiene, and basic cognitive restructuring skills during this window prepares clients to manage the anxiety that remains once withdrawal settles. The treatment program at Jintara is not divided into a medical phase followed by a separate therapeutic phase. The two run concurrently from admission, with the level of therapeutic engagement adjusted to what each client is physically and emotionally ready for in each week of their stay.

Therapy for anxiety draws on CBT skills, emotion regulation, and grounding practice.

The therapeutic tools used for anxiety at Jintara sit primarily within the cognitive behavioural therapy framework. CBT groups teach clients to identify automatic negative thought patterns, examine whether those thoughts accurately reflect their situation, and replace unhelpful patterns with more functional responses. For anxiety, this means learning to spot the compulsive thought loops that generate anxious feelings and interrupting them before they escalate. Denise O'Leary describes the aim: "rewiring thinking processes so they're getting more accurate and more helpful thought patterns, rather than highly biased towards the negative."

Alongside CBT, the holistic therapy sessions at Jintara address the physiological dimension of anxiety directly. Leszek, who holds a diploma in holistic massage from City College of London and brings extensive training in Reiki, meditation, and craniosacral therapy, provides twice-weekly individual sessions. These include meditation instruction and Reiki practice, both of which work with the nervous system to teach grounding and calming techniques that operate alongside thought-based interventions. The SAMHSA Treatment Improvement Protocol, available via the NCBI Bookshelf, consistently identifies integrated treatment addressing both psychological and physiological dimensions as the clinical standard for co-occurring disorder treatment.

EMDR therapy is relevant for anxiety rooted in trauma and is introduced in longer stays.

EMDR therapy is a trauma-focused approach that can be effective for anxiety when the anxiety has its roots in traumatic experience, including complex developmental trauma that developed over years rather than from a single incident. At Jintara, EMDR is delivered by Denise O'Leary, who is certified to Level II of the EMDRIA training pathway. EMDR is not assigned to every client. It requires a period of stabilisation during which the client develops sufficient emotional regulation capacity to engage safely with trauma processing.

For clients in a 30-day program, EMDR is generally not introduced during the first stay. Denise O'Leary is direct about this: "I would not treat PTSD in the first month. It's not realistic. You can't get enough done, and the risk of opening a Pandora's box and making things worse is just too big." For clients who commit to eight weeks or longer and whose anxiety has identifiable trauma origins, EMDR becomes the centrepiece of therapeutic work in the second month, with sessions increasing to 90 minutes and up to four times per week. For 30-day clients whose anxiety is primarily non-traumatic, the focus remains CBT skills, grounding practice, and stabilisation.

Anxiety is manageable in recovery with the right skills established in treatment.

Anxiety is manageable in recovery when the skills established during treatment become part of daily life. This matters because untreated anxiety is one of the most reliable relapse triggers: the person leaves treatment, encounters the same circumstances that originally drove their substance use, and returns to that substance without different tools for responding to what they feel. The admissions team discusses continuing care options with every client before the 30-day program ends.

The skills prioritised at Jintara, including CBT thought management, grounding techniques, sleep hygiene, and physical exercise, are specifically chosen because they translate to daily life outside of residential care. Tong, Jintara's fitness and wellness director, builds physical routines during treatment specifically because maintaining physical activity supports anxiety regulation after discharge. These are routines clients take home and adapt to daily life. Ongoing outpatient counselling with a therapist experienced in anxiety and addiction is also encouraged for clients returning to high-stress environments. The aim is to leave Jintara with both conditions understood, not just the addiction addressed.

Frequently Asked Questions

• Can rehab treat anxiety and addiction at the same time? Yes. At Jintara, anxiety is not placed on hold while detox runs its course. Clinical screening on day one, early psychiatrist assessment, and CBT-based anxiety skills groups all begin from admission. The aim is for clients to leave with both conditions understood and practical tools in place for managing each. Anxiety that proves to be substance-induced typically resolves significantly within two to three weeks as withdrawal settles.
• What happens to my anxiety when I stop drinking? In the first days of alcohol withdrawal, anxiety typically increases. This is a withdrawal effect, not necessarily a sign of a chronic anxiety disorder. Medically supervised detox manages the physical symptoms while the clinical team monitors anxiety levels closely. The clinical distinction between withdrawal-driven anxiety, which resolves as detox progresses, and underlying anxiety that requires ongoing therapeutic attention, is made during the first two weeks.
• Does Jintara treat anxiety disorders? Jintara treats anxiety as a co-occurring condition alongside substance use. GAD-7 screening, psychiatrist assessment, CBT skills groups, grounding and regulation practice, and holistic therapy all address anxiety directly throughout the program. Anxiety disorders with trauma origins may require a longer stay for deeper therapeutic work, particularly EMDR, which is introduced in the second month for clients who stay eight weeks or more.
• What if my anxiety gets worse during detox? Clinical monitoring during detox includes anxiety as a key observation point. Anxiety that escalates beyond expected withdrawal levels is addressed medically and therapeutically. The presence of round-the-clock nursing means that anxiety spikes are assessed promptly, not left until the following day. If medication support is indicated, the visiting psychiatrist is available to review the plan and adjust it.
• Is EMDR used for anxiety at Jintara? EMDR can be effective for anxiety that has trauma origins. Denise O'Leary is EMDRIA-certified and delivers EMDR primarily with clients in longer programs, typically eight weeks or more. For 30-day clients, the focus is on stabilisation, CBT-based anxiety skills, and emotion regulation, with EMDR preparation work where appropriate. The presence of trauma alongside anxiety is assessed during the first weeks of the program.
• What if I am dependent on benzodiazepines prescribed for anxiety? Benzodiazepine dependence with an underlying anxiety disorder is one of the most common clinical presentations at Jintara. Medically supervised benzodiazepine taper is managed by the nursing and psychiatry team. Denise O'Leary's clinical work specifically addresses the rebound anxiety that follows taper, which is expected, temporary, and treated through CBT and grounding practice. The post-taper window, typically three or more weeks after reaching zero, is given dedicated therapeutic support.
• Does Jintara prescribe ongoing medication for anxiety after the program ends? Jintara does not prescribe ongoing anti-anxiety medication as part of the standard discharge plan. The psychiatrist reviews medication requirements for each client individually during admission. Post-discharge, the program focuses on psychological tools, behavioural strategies, and physical routines. Any medication decisions after discharge are made by the client's own doctor at home, informed by the clinical notes from Jintara.
• How do I know if my anxiety will be addressed at Jintara, rather than the addiction alone? At Jintara, anxiety is not a secondary concern. Darren Lockie, founder and CEO: "Everything we do is geared towards mental health and the reasons why they self medicate with substances." The program is built on the understanding that treating the addiction without understanding what drives it produces poor long-term outcomes. Anxiety, in most cases, is part of that picture. To discuss how your specific situation would be addressed, speak with the admissions team.