The Connection Between Trauma, Anxiety, and Substance Use
Sometimes Substance Use Makes Sense Before It Becomes a Problem
For many people, substance use doesn't begin because they want to destroy their lives.
It begins because something works.
Alcohol quiets the thoughts. A substance helps you sleep. Drinking makes social situations easier.
For a few hours, you aren't thinking about everything you need to do.
Your shoulders finally drop. Your brain finally shuts off. You finally exhale.
When we look at substance use only through the lens of “bad decisions,” we can miss an important question:
What is the substance doing for you?
Trauma and Coping
Trauma can affect far more than memories.
It can influence how someone experiences stress, relationships, emotions, conflict, uncertainty, and safety.
Someone who lives with chronic anxiety or trauma-related activation may spend significant energy trying to manage uncomfortable internal experiences.
Substances can provide temporary relief.
That doesn't mean substance use is the healthiest coping strategy or that it doesn't have consequences.
It means there's often a reason the behavior developed.
Understanding that reason can be an important part of changing it.
The High-Functioning Version Can Be Easy to Miss
Problematic substance use doesn't always match stereotypes.
You may still have:
A successful career. A family. A home. Friends. Responsibilities you consistently meet. You might rarely miss work or experience obvious external consequences.
And yet you may notice alcohol or another substance taking up more mental space than you want it to.
Maybe you find yourself thinking:
“When can I finally have a drink?”
“I deserve this.”
“I just need something to take the edge off.”
“I'll only have one tonight.”
“I need something to shut my brain off.”
When a substance becomes one of the primary ways you regulate stress, anxiety, or difficult emotions, it can be helpful to understand what's underneath that pattern.
Anxiety and Substance Use Can Reinforce Each Other
Alcohol and other substances can temporarily reduce feelings of anxiety.
That's part of why they can become appealing coping tools.
But temporary relief doesn't necessarily address the underlying source of anxiety.
Over time, someone can become caught in a cycle:
Stress builds.
You want relief.
You use a substance.
You temporarily feel better.
Then anxiety, guilt, physical discomfort, sleep disruption, or other consequences appear.
Those feelings create more discomfort.
And eventually, you want relief again.
Simply telling yourself to “have more willpower” doesn't necessarily address this cycle.
Trauma-Informed Treatment Looks at the Function
Trauma-informed therapy asks questions such as:
What happens immediately before you want to use?
What emotion are you trying to change?
What does the substance give you permission to do?
What feels difficult when you don't have that coping strategy?
What experiences taught you that certain emotions weren't safe or manageable?
What happens in your body when you're overwhelmed?
These questions aren't intended to excuse harmful behavior.
They're intended to understand it.
Because understanding the function of a behavior gives us more information about what needs to change.
Where EMDR May Fit
For some people, substance use is connected to unresolved traumatic experiences, distressing memories, or deeply held negative beliefs.
EMDR may be incorporated into treatment when clinically appropriate to address experiences contributing to current emotional responses or coping patterns.
However, trauma processing isn't always the first step.
Treatment planning may include stabilization, developing alternative coping strategies, assessing current substance use, and determining whether additional or specialized substance-use treatment is needed.
Therapy should be individualized to the person's needs and safety.
Moving From Shame to Curiosity
Shame says:
“Why can't I just stop?”
Curiosity asks:
“What happens inside me that makes this behavior feel necessary?”
That second question doesn't remove accountability.
It gives us somewhere to go.
If you're noticing a connection between anxiety, previous experiences, and your relationship with substances, therapy can provide a space to understand the whole picture rather than focusing exclusively on the behavior.
Learn more about Substance Use Therapy HERE, Trauma Therapy HERE, and EMDR Therapy HERE.
And book a free consult with Meghan Hanes HERE.
About the Author
Meghan Hanes, LCSW, is a trauma and substance use therapist providing virtual therapy throughout Oregon. She is trained in EMDR and helps high-functioning adults understand and heal the patterns beneath stress, trauma, and coping behaviors.
