Anxiety and Avoidance – A Difficult Combination


Are you worried you are drinking too much? Do you worry about your weight but can’t stop yourself from eating your comfort food favorites? When you try to quit smoking, do you find yourself restless and worrying about the future?

If the answer to these questions is yes, you might want to explore whether or not anxiety is playing a role in your decision to use substances or engage in other behaviors that distract from anxiety. Many behaviors that seem to “take up alot of space” in one’s life are ways that we attempt to control and get rid of our anxiety. And, until the underlying anxiety is managed in a different way, it is hard to think about giving up those behaviors! So, in order to make behavior changes, you may have to begin by understanding your own anxiety and how it impacts you.

What is Anxiety

Anxiety is a normal and adaptive emotion that tells us that something in our environment is not quite right. At its core, anxiety is the result of our innate fight or flight response. This response is a physiological reaction that occurs in response to any perceived threat. Thankfully, our bodies have evolved to respond automatically to dangerous situations (like a bear attacking) and the physiological symptoms of anxiety are due to involuntary reactions of the sympathetic nervous system that are activated in response to a perceived threat. Our bodies prepare us for a potential need to fight or flee a situation by increasing our heart rate and breathing.

Small amounts of anxiety can be motivating (how much would you have studied for that test or prepared for that meeting at work if you had no anxiety about how well you would do?). However, in larger doses, anxiety can cause us to perform worse on tasks (like reading that same page over and over, simply unable to take in the information) or it can even be paralyzing. And then, there are times that the system doesn’t quite work the way it is supposed to. What happens when your anxiety thinks there’s a bear chasing you, but in reality there is no bear?

When Anxiety goes Wrong

Unfortunately, sometimes we have an increased sensitivity to perceived threats and our anxiety system puts us on full terror alert, even when the danger is not life-threatening – kind of like a false alarm. The “bear” at these times can be our own thoughts that manifest in worry, such as “what if I get fired?”, “what if my wife doesn’t love me?”, “maybe I said something stupid and all these people will think I’m stupid” etc. The bear can also be our memories of past events, such as trauma. Sometimes these thoughts can be quite obsessive and all consuming.

Our thoughts, feelings, and behaviors are all connected. Each one impacts the other. Our thought that something is dangerous leads us to feel anxiety, which leads to the behavior of avoiding it altogether. Additionally, there are other side effects to anxiety that we tend not to like, such as a flushed face, increased sweat, gastro-intestinal discomfort, dizziness that we might also like to block out or avoid. Many people find that when they use substances of engage in certain activities (like gaming, gambling, eating) that they get some distance from these thoughts and feelings. This desire for distance from anxiety is the nature of avoidance.

Avoiding a situation that might cause us distress feels good – temporarily. That temporary relief reinforces our sense that avoiding the situation was helpful, which really just makes us fear it that much more the next time we need to approach it. Over time, we may learn to manage our anxiety through avoidance strategies (like drinking, eating etc). We engage in avoidance behaviors instead of facing the situations, people, things, places, that might cause us anxiety. This only makes it worse when we need to face these things. Reassurance is another way we feed anxiety and reinforce it. Asking questions for the sake of minimizing our anxiety, even when we already might know the answer, or know that there is no answer, decreases our anxiety in the short-term. However, this only tricks us into thinking that we must know the answer- that having the answer, knowing what might happen, is the key to being able to handle it. Both of these behaviors are actually a disservice to ourselves, because it is impossible to avoid every situation and impossible to always know what will happen.

Anxiety and Addiction

Studies have found again and again that anxiety disorders are related to both alcohol and drug use disorders. Anxiety and substance use disorders are among the most frequent mental health problems in the United States, with lifetime rates of 28.8% and 14.6%, respectively. Studies have also found high rates of anxiety disorders in people who struggle with compulsive gaming, gambling, eating disorders and shopping.

Trying to stop or change your problematic behaviors can increase your anxiety because those behaviors have helped you to relieve the anxiety in the first place. Taking them away or limiting them can result in the anxiety sticking around and even increasing. When you try to go a night without drinking, you end up thinking about all the things you worry about. When you try to limit yourself to only playing your multiplayer online role playing game to 3 nights a week so you can get your homework done, you end up worrying that your are missing out on something or letting your teammates down. You might also be more in touch with your social anxiety as you try to sit with friends in the library.

Remaining in the present moment and accepting our thoughts and feelings, even if they don’t feel good, can be very helpful. While we can’t live a life without anxiety (it is actually impossible to control our thoughts and feelings), we can adjust how we respond to it. Learning to tolerate anxiety is the key to living a full and valued life, in spite of the anxiety.

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