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Alcohol & Anxiety: Relationship, Causes, & Help

Substance use and mental health disorders are often connected in a sense that share similar underlying triggers and overlapping signs and symptoms. As a result, it may be difficult to identify whether a substance use disorder triggered a mental health disorder or vice versa, and as a result it best if both co-occurring disorders are treated simultaneously in a professional treatment program.

Anxiety related disorders are the most common mental health conditions in the U.S., affecting over 40 million adults each year.1

Studies show that approximately 50% of people who suffer from mental health disorders, including anxiety disorders, will also suffer from a substance use disorder in their lifetimes.2 Since upwards of 40 million adults suffer from anxiety disorders each year in the U.S., that means 20 million people could potentially struggle with a SUD as well.1

It is not uncommon for people with anxiety disorders to self-medicate with alcohol or other drugs to mitigate the symptoms of their anxiety.3 However, using alcohol as a coping mechanism to manage anxiety is a temporary fix and may lead to a substance use disorder (SUD) over time.3 Alcohol’s effect on mental health may be significant, and SUDs can creep up on people since they can be progressive in nature. Then a person is left still struggling with whatever prompted them to drink in the first place and also has to contend with a substance use disorder.

Understanding Anxiety

There are different types of anxiety disorders that include:1

  • Generalized anxiety disorder (GAD).
  • Panic disorder (PD).
  • Social anxiety disorder.
  • Phobias.

Each type of anxiety disorder has unique symptoms of its own, but all anxiety disorders have one thing in common: persistent or excessive fear in situations that are not threatening.1

With close to 20% of adults and 7% of children reporting issues with anxiety disorders, it is the most common mental health disorder in the United States.1

Relationship Between Alcohol & Anxiety

There has been substantial research on the bidirectional relationship between anxiety disorders and alcohol use disorders. People with more severe forms of anxiety are at a higher risk of developing a SUD, and therapists should consider preventive interventions for alcohol use disorder (AUD) in people who have severe anxiety disorders and vice versa.4 From a psychological and behavioral perspective, drinking alcohol to cope with negative feelings is a significant marker for current or future problems with alcohol.5

The prevalence of self-medicating with alcohol or other drugs to manage symptoms of various anxiety, ranges from about 21%–24%.3 Perhaps in the short term, using alcohol can help alleviate some symptoms of anxiety; however, over time, long-term use of alcohol as a coping strategy can develop into an independent substance use disorder and can worsen anxiety.3

Does Alcohol Cause Anxiety?

There are many theories to explain the connections between alcohol and anxiety, such as the  substance-induced anxiety model.7 This particular model asserts that anxiety is primarily a result of prolonged, excessive alcohol use.7 Chronic alcohol use can lead to a range of biopsychosocial problems, and anxiety may often be a direct result of these alcohol-related disturbances in one’s life.7 Chronic alcohol use typically involves periods of excessive consumption of alcohol and withdrawal, which can cause changes in the nervous system that can produce or exacerbate anxiety.7 Another concern is that periods of withdrawal from alcohol can induce changes in the brain that cause excessive activity in the limbic system and the norepinephrine system, both of which are involved in the production of panic attacks.7

Social complications of chronic alcohol use are common and may include cumulative issues that can negatively impact important areas in one’s life, like employment, finances, and interpersonal relationships.7 It’s understandable that the interaction between habitual, excessive alcohol use and enhanced life stress can lead to anxiety.7

Alcohol use disorders can cause increased anxiety during a hangover, especially in people who are very shy.8 The term “hangxiety” refers to the correlation of increased anxiety while a person is experiencing a hangover from excessive drinking, particularly in highly shy people.8

When Anxiety Leads to Alcohol Abuse

As previously discussed, attempts at self-medicating symptoms of anxiety with substances like alcohol can sometimes explain the relationship between alcohol use and anxiety disorders.3 While this may bring temporary relief, it can actually make the symptoms of anxiety worse over time.9 In addition, brain changes that can occur in people with mental health conditions may initially enhance the rewarding effects of alcohol use, making the person more compelled to continue using the substance.9

Alcohol & Panic Attacks

Panic attacks are a characteristic of panic disorders.1 They often present as sudden feelings of terror and can occur without warning.1 They can be debilitating, sometimes even mistaken for a heart attack.1 Physical symptoms can include chest pains, heart palpitations, dizziness, shortness of breath, and an upset stomach.1

As many as 25% of people seeking treatment for panic disorders also have a history of alcohol use disorder.10 Yet, drinking to reduce anxiety can have a paradoxical effect over time.10 The perceived initial relief can end up promoting heavier drinking patterns and greater degrees of withdrawal symptoms, causing more anxiety in the long run.10

Getting Help for Alcohol & Anxiety Disorders

Anxiety disorders can range from mild to severe. While mild cases of anxiety may be able to be managed at home with lifestyle changes, some people may need treatment for more severe anxiety disorders or co-occurring SUDs.

Recovery is a process; it takes time to heal from physical and mental health conditions.11 Effective care should include co-occurring or dual diagnosis treatment. Abstinence is often the first phase of the treatment process.11 Sometimes, that can be accomplished at home, but for people with severe alcohol use disorders and co-occurring anxiety disorders, a medically managed alcohol detox in a treatment center may be more appropriate and effective.12

In that scenario, a person will be monitored by healthcare professionals for acute symptoms of withdrawal and may be administered medication for AUD to help manage cravings and uncomfortable withdrawal symptoms.12

Whether at home or in an alcohol treatment facility, it is vital that a person learn healthy coping skills to help manage anxiety. Behavioral therapies can help people develop positive self-talk and build problem-solving and communication skills to facilitate improved interpersonal relationships damaged by their alcohol use and anxiety.12

An integrated model of care for the treatment of substance use and co-occurring mental health disorders has been shown to be most effective.12 This may include medications to manage cravings and/or anxiety, behavioral therapy, family therapy, peer support, and relapse prevention strategies.12 It’s important to remember that treatment should encompass all of a person’s needs, including not only their medical or psychological conditions but also any vocational, social, or legal problems.12

Find Out If Your Insurance Plan Covers Treatment for Alcohol Use and Co-occurring Disorders

American Addiction Centers can help people recover from alcohol use and alcohol use disorders (AUDs). To find out if your insurance covers treatment, including treatment for co-occurring disorders such as anxiety, for you or your loved one at an American Addiction Centers facility, click here, or fill out the form below. Your information is kept 100% confidential. You can also click here to find an addiction treatment center near me.

Alcohol and Anxiety FAQs

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