Srini Pillay, M.D., Director, Panic Disorders Research Program, McLean Hospital
Question: Can an anxiety disorder be the result of substance use?
Answer: Substance use commonly gives rise to anxiety symptoms. This may occur in situations of acute toxicity, chronic use or withdrawal. Caffeine is often a culprit that gives rise to anxiety symptoms. And in addition to caffeine, other substances, such as nicotine, alcohol and cannabis, may also give rise to anxiety symptoms. For a lot of people, the substances that are alcohol and cannabis seem counterintuitive, because a lot of people use these substances to relax.
However, studies have shown that, eventually, people who use alcohol and cannabis may be prone to develop panic-like syndromes. Cocaine is another substance which, although initially relaxing, may go on to give people anxiety-like syndromes. With regard to withdrawal, withdrawal from any of these substances can also give rise to anxiety disorders. Substances such as cannabis, alcohol and nicotine, when withdrawn, may give rise to anxiety syndromes. In addition, benzodiazepines, such as Xanax or Klonopin, when withdrawn -- give rise to anxiety syndromes.
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