By Carrie Potter, M.A., Ph.D Candidate, Temple University, 2015 AKFSA Travel Award Recipient
At the Adult Anxiety Clinic of Temple University (AACT) in Philadelphia, which is directed by Dr. Richard Heimberg, I study the connection between anxiety and physical health problems. One question that motivates me, in particular, is why do individuals with social anxiety do things that put their physical health at risk, such as engage in problematic substance use?
Socially anxious people don’t necessarily use more substances than non-anxious individuals, but they use them in risky ways, like to cope with distress or to fit in with peers. This makes them much more likely to become substance dependent and experience issues with their physical health as a result.
Alcohol and marijuana are the most common substances we see clients with social anxiety using, and it’s often in a self-medicating way. That is the biggest risk sign clinically. Our clients often report things like, “I was just so nervous at the party that I was taking shot after shot because I didn’t know what else to do.” Drinking is an easy thing for them to do in a social situation, especially compared to interacting with other people, and it can make them look and feel like they are “fitting in.” But relying on drinking in this way is a dangerous habit that we want to help our clients break.
Marijuana seems to serve a different function than alcohol does for socially anxious individuals and is more connected to social avoidance; escaping the social world by using marijuana alone. It’s important to work with socially anxious marijuana users on becoming more socially active to decrease their risk of developing marijuana dependence and promote a healthier lifestyle.
People often come to the AACT who have been substance dependent for a large portion of their lives. It takes a physical and emotional toll. It’s important for our field to move toward developing specialized therapy interventions for social anxiety and substance use, so we don’t have to always rely on more traditional substance use treatments, like rehab or meetings. Attending a group meeting for substance use can be very intimidating for somebody with social anxiety, which makes it hard for them to use those types of services.
My advice to anyone with a loved one who experiences social anxiety and problematic substance use is to try to find them a therapist who is well informed about the connection between social anxiety and substance use. Ideally, treatment will target social anxiety and substance use at the same time, because they are so connected that in order to make progress on one front, you also have to work on the other.