Anxiety Disorder Treatment for Adults in Washington

The link between anxiety and substance use often starts with self-medication. Alcohol and benzodiazepines calm the nervous system and offer fast, though short-lived, relief from anxious symptoms. Over time the brain adapts to relying on these substances to regulate anxiety, and withdrawal itself raises anxiety—a pattern SAMHSA identifies as a common path toward co-occurring disorders.

Substances people often turn to for anxiety relief:

• Alcohol: Eases social anxiety, generalized worry, and physical tension for a short time
• Benzodiazepines: Prescription anxiety medications (Xanax, Valium, Klonopin) with a high potential for dependence
• Opioids: Produce a sense of calm and distance from anxious thoughts
• Cannabis: May ease anxiety at first but often intensifies it with regular use

Generalized Anxiety Disorder (GAD): Ongoing, excessive worry about everyday concerns—work, health, family, finances. People with GAD often feel keyed up, restless, and unable to unwind, which can make alcohol or sedatives seem like an easy fix.

Panic Disorder: Sudden waves of intense fear with physical symptoms such as a racing heart, shortness of breath, or a sense of impending doom. Benzodiazepines can halt a panic attack quickly, which is part of why they carry a high risk of misuse.

Social Anxiety Disorder: An intense fear of social situations rooted in worry about embarrassment or judgment. Alcohol is a common go-to for feeling more at ease around others—the idea of "liquid courage" captures this pattern well.

Specific Phobias: Intense fear tied to a particular situation or object (flying, heights, medical procedures). Substances are sometimes used to get through situations that trigger the phobia.

Cognitive Behavioral Therapy (CBT) is widely considered the gold-standard approach for anxiety. It helps identify anxious thought patterns, test how accurate they really are, and build new responses to anxiety-provoking situations—skills that hold up well without medication.

Exposure Therapy: Gradually approaches feared situations in a controlled, supportive setting. With repetition, anxiety eases as the brain learns the feared situation isn't actually dangerous. This works well for panic disorder, social anxiety, and phobias.

Mindfulness-Based Approaches build present-moment awareness and help people sit with uncomfortable feelings instead of reacting to them right away. Mindfulness-Based Stress Reduction (MBSR) is especially useful for generalized anxiety.

Non-Addictive Medications: Several medication options manage anxiety symptoms without carrying dependence risk:

• SSRIs/SNRIs: Antidepressant medications that also ease anxiety (Lexapro, Zoloft, Effexor)
• Buspirone: A non-addictive medication prescribed specifically for anxiety
• Gabapentin/Pregabalin: Can lower anxiety for many people without carrying addiction risk
• Beta-blockers: Target physical anxiety symptoms such as a racing heart or trembling

Relaxation Techniques: Deep breathing, progressive muscle relaxation, and guided imagery offer drug-free ways to activate the body's natural relaxation response and ease anxiety symptoms in the moment. A primary care provider or the SAMHSA National Helpline (1-800-662-4357) can help connect you with a clinician who treats both anxiety and substance use together.