Illegal drugs and Anxiety

A significant number of people coming to Anxiety Care for help, particularly those in their late teens and twenties, present with anxiety and depression that they link to the abuse of ‘recreational’ drugs at some time in their recent past.

It is a human trait to seek out reasons for everything that happens to us, and when adult worry takes over from the, often, rash, ‘nothing can hurt me’ attitude of mid-adolescence it is easy to see how somebody then suffering from anxiety and depression might buy in to the idea that the illicit drugs caused some permanent harm.

Looking at the effects of ecstasy, cocaine, amphetamines and cannabis it is entirely possible that this worry can be well founded.

For example, research suggests that cocaine induces panic attacks in some people and that withdrawal from it includes severe anxiety in the effects. Ecstasy too seems to induce anxiety, depersonalising and panic when taken in large doses and the sought after experience, while on the drug, of feeling at one with the world need not happen if the person involved already has emotional problems. Here the drug might simply exacerbate a prevailing mood. Ecstasy is also notoriously difficult to ‘quality control’, often being mixed with other drugs. In this case, a person with hovering obsessional problems might find themselves in deep trouble if, for example, LSD had been added.

It has been reported that ecstasy helps with obsessional problems and in dealing with addictions, however current research appears to suggest that even a single dose of MDMA (ecstasy) can damage the brain neurons that produce serotonin: the imbalance of which is seen by many workers in this field as a causal problem of OCD. It is not clear if this damage reverses itself once use of the drug has ceased.

There is no clear result here and it is likely that, as with many tailored chemicals, ecstasy varies widely in its effects. However, anything that may cause long-term brain damage, whatever the odds against, is probably not a good option. With regard to obsession, some research also suggests that amphetamine and cocaine usage have strong links with the problem of repetitive thoughts. Amphetamine withdrawal can also induce severe anxiety and depression and again, excessive use may involve brain neuron damage that could possibly be permanent. Taking amphetamines and LSD can also cause hallucinations and paranoia.

Cannabis and marijuana seem to be interchangeable words and refer to the flowers buds and leaves of the cannabis plant. Cannabis/marijuana is often viewed as a totally harmless drug but research, again, suggests that heavy use may make latent or existing mental disorder worse. It has also been suggested that cannabis adversely affects the hippocampus in the brain, which may limit the person’s ability to learn. This would not be useful in any area of life and certainly not when undertaking a programme of exposure or other activity related to overcoming an anxiety disorder that involved reinforcing learnt behaviour.

There seems to be grounds for saying that cannabis/marijuana can cause spontaneous panic in some people. This has been challenged, with one suggestion being that, as anxious or unhappy people might be drawn to the drug as a substitute for medication, their subsequent mental problems would ‘weigh’ any general statistics adversely. This may or may not be true. However, the Australian ‘Anxiety and Panic Hub’ state: ‘For people who are predisposed to spontaneous panic attacks, the marijuana can trigger the predisposition.’

It also seems likely that use of this drug can induce a feeling of ‘loss of control’ if taken in large doses; or if an inexperienced user smokes (or eats) too much at one time. Many people with anxiety problems, and others who may not be aware that they have a potential for anxiety disorder, experience huge alarm or fear when they perceive themselves as being out of control and would never, for example, use LSD or PCP or any hallucogenic that they would be aware of as having a ‘mind altering’ effect. Most would not link such an effect with cannabis/marijuana. Many people with OCD or obsessional symptoms have this problem with control and, in fact, some people coming to Anxiety Care have even expressed an unwillingness to reach orgasm with a sexual partner for fear of losing control.