If you struggle with anxiety and are in recovery from a substance use disorder, you know how easily anxiety, if not addressed, can lead to relapse. You also know that an anxiety disorder combined with a substance use disorder is called a co-occurring disorder–and that co-occurring disorders take some finesse to manage well.

A Brief Look at Co-occurring Disorders

We have examined the details of co-occurring mental health and substance use disorders in a previous blog. We noted in that piece that it is not terribly important to expend energy trying to decide if your mental health disorder caused your substance use disorder or vice-versa. Instead, we wrote:

What is important is ensuring that the treatment center you choose to help you overcome a substance use disorder also has the experience and expertise necessary to help you with a co-occurring mental health disorder. Whether you are dealing with one of the many forms of depression, a trauma-induced issue, an anxiety or panic disorder, or another issue, it is essential that you get help so that you strengthen your overall mental well-being while you are also regaining your sobriety and preparing to begin your recovery journey.

We stand by that advice. Co-occurring disorders can be intertwined in ways that are both obvious and subtle. The nature of that entanglement is less important than working to regain your sobriety and to improve your mental health so that your recovery can truly get underway.

Doing that work starts with getting treatment for both kinds of disorders—and then taking steps to maintain your hard-won sobriety and continue to focus on your mental health. This might involve a combination of 12-Step (or other recovery) meetings, regular therapy sessions, and mental health supporting medications. (We want to note that you should be sure your prescribing physician is aware of your substance use disorder so that they can make an informed decision about whether medication is appropriate for you.)

When Anxiety Surges

But even when you are working diligently on your recovery, you can sometimes experience moments of unsettling anxiety that threaten to overwhelm you. Those moments—which can be quite intense and seemingly arrive from nowhere—can pose a real threat to your sobriety. As a result, it is a good idea to have an anxiety strategy on hand.  

We have one to suggest.

The Calming Power of a Gentle Countdown

When anxiety strikes, it can be extremely helpful to take a few deep breaths and then to fully engage your senses in an easy counting exercise:

  • Name five things you can. Any five things will do—and you can do it in your head, though it can be helpful to name them out loud. Don’t rush from object to object. Just steadily identify five things in your field of vision.
  • Name four things you can touch. Again, any four things will do, and a slow, steady approach will serve you best. Identifying four different textures might help you focus on this part of the activity.
  • Name three things you can hear. There is so much sound going on all around us, but often we fail to notice it. What sounds can you hear nearby? What sounds are a little further away? What sound is often present in the background that you generally don’t really hear?
  • Name two things you can smell. Is there a flowering plant or scented candle you can sniff? Is the breeze particularly fresh today? Can you detect the lingering scent of your laundry detergent in your clothing? As with the steps above, take your time and pay attention to things you might not generally focus on.
  • Name one thing you can taste. Sip your coffee or tea or soda (careful with the sugar intake!) or other beverage while lingering on the taste rather than just gulping it down. Is it sweet or bitter or somewhere in between? Unwrap a piece of chocolate—maybe give it a good sniff—and pop it into your mouth. Focus on the taste for a long moment.

Once you have counted down from five, take a few more nice deep breaths. There is a good chance you will be feeling calmer than you were just moments before. If you are still feeling uncomfortably anxious, you can start the exercise over again—breathing deeply to start, counting down as you move through your senses, and breathing deeply to finish.

It’s a Great Technique, But It Isn’t the Whole Answer to Anxiety

We want to be clear. The countdown technique is an excellent tool that can help you get through an anxiety attack with your sobriety intact. But it is not sufficient as a treatment for an anxiety or panic disorder. Those mental health disorders—and others like depression or disorders grounded in trauma—are best handled by consistent, ongoing treatment.

Get Treated for Substance Use and Mental Health Disorders at The Aviary

At The Aviary Recovery Center near St. Louis, MO, we offer personalized treatment for substance use disorders and co-occurring mental health disorders. Lasting sobriety is a key component of better mental health—and good mental health is a key component of sustained sobriety. We are committed to treating both from a place of expertise and empathy. If you are struggling, we are here to help.