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Alcohol and general anxiety disorder (GAD) are often co-occurring disorders. Both alcohol and anxiety can cause mental distress and negatively impact your daily functioning. When combined, the results are even more intense than if experienced separately.
Oftentimes, people use alcohol to cope with anxiety. However, this combination can exacerbate a preexisting GAD and lead to even more anxiety symptoms. For this reason, alcohol use and anxiety are heavily intertwined and should be treated simultaneously.
Alcohol affects many different bodily systems. For one, alcohol is a depressant that disrupts your brain's balance and can affect feelings, thoughts, and actions. This is partly due to alcohol’s ability to alter and inhibit neurotransmitters, which inhibit necessary signals from one nerve to the other.1
Two of the neurotransmitters that are affected by alcohol are dopamine and serotonin:
When you drink, your brain releases more of these neurotransmitters. When you stop drinking, serotonin and dopamine are depleted, making it easier to feel anxious.3
Alcohol is an anxiolytic, which means that it may give someone immediate relief from anxiety.2 Although it’s effective, the results are very short-lived. If a person continuously relies on alcohol to soothe anxiety symptoms, they risk becoming dependent.
Alcohol also makes it harder for the brain to control:
As mentioned, alcohol may temporarily reduce feelings of anxiety. However, alcohol should never be used as a way to treat anxiety.
There is a vicious cycle that happens when a person with anxiety drinks alcohol:
In addition, alcohol can cause anxiety attacks. Anxiety, or panic attacks, are the sudden feeling of intense panic and fear. These attacks usually last around 5 to 30 minutes. Although they’re often very scary, they’re generally not dangerous.
Symptoms of panic attacks include:4
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Alcohol-induced anxiety is anxiety that is caused by the use of alcohol. Symptoms of alcohol-induced anxiety include:
Alcohol affects the brain chemical GABA, which, in small doses, can make someone feel relaxed. However, heavy, long-term drinking can deplete GABA and cause panic and tension. When GABA is affected by alcohol, anxiety can ensue.
Additionally, alcohol affects serotonin levels. When someone drinks, their serotonin levels go up, and when they stop drinking, they can crash. This can cause withdrawal symptoms and panic attacks.
Finally, alcohol can cause several physiological symptoms, which can cause anxiety. These include:
Fortunately, alcohol-induced anxiety usually doesn’t last very long. You can typically expect this type of anxiety to be temporary, lasting anywhere from a couple of hours to 28 hours. Of course, this all depends on how much alcohol was consumed.
This type of anxiety is sometimes called “hangxiety,” another name for hangover anxiety. Hangxiety is attributed to the anxiety felt while alcohol wears off and a hangover is coming on. Often, it’s after heavy drinking rather than after consuming small amounts of alcohol.
However, if you notice that your alcohol-induced anxiety lasts longer than the 48-hour time frame, this may point to an alcohol use disorder (AUD). Drinking more alcohol for more extended periods may increase the length and severity of alcohol-induced anxiety.
Sometimes, quitting alcohol rids people of their anxiety, but that’s not always the case. If anxiety is present before or without drinking, you may want to speak with a professional about options and treatment.
Quitting alcohol may not always help with anxiety. It all depends on the type of anxiety you’re experiencing and if it’s prevalent without the use of alcohol.
Quitting alcohol may not help anxiety in two key situations:
However, in many cases, quitting alcohol does help reduce panic attacks and anxiety over time. In some people, quitting alcohol can even alleviate anxiety completely. However, this is more common for people who only experience alcohol-induced anxiety rather than a general anxiety disorder.
When you quit alcohol, people often find themselves having:
It’s important to note that if you have an AUD, you must be careful when quitting alcohol. Going ‘cold turkey’ or quitting abruptly can be dangerous and even deadly.
A person who is an alcoholic and stops drinking cold turkey may experience severe withdrawal symptoms, which include:
As mentioned, withdrawal symptoms can be life-threatening. Over the first couple of days or weeks after an alcoholic quits drinking suddenly after prolonged use, they may develop acute alcohol withdrawal symptoms. This can cause someone to lose consciousness, have seizures, or develop delirium tremens (DTs).
DTs is a severe, life-threatening form of alcohol withdrawal. Symptoms of DTs include:
Because of these potentially deadly symptoms, a person who struggles with AUD should never attempt to quit on their own. Instead, it’s always recommended that they quit under the care and watch of a specialized rehab facility for treatment.
If you or someone you know thinks they’re experiencing DTs or other forms of severe alcohol withdrawal, get emergency help immediately.
If you believe your anxiety is caused or worsened by your drinking habits, you must cut back on alcohol or quit altogether. Some ways to prevent alcohol-related anxiety on a day-to-day basis include:
If you have pre-existing anxiety, the ways to reduce your alcohol-induced anxiety may look a little different. In this case, you may want to:
If you have co-occurring anxiety and alcoholism, you must seek professional help. No one should have to overcome these issues on their own.
Treating these two issues separately may increase the chances of relapse. Ideally, they should be addressed and treated together to ensure neither the anxiety nor AUD triggers one another.
Treatments for co-occurring anxiety and alcoholism include:
Substance-induced anxiety disorder is often treated using group and individual therapy. Groups like Alcoholics Anonymous (AA) can allow addicts with anxiety to connect with others and work toward recovery.
Outpatient treatment may be a good option for dealing with moderate to severe alcoholism. In addition, this type of treatment works well for people with co-occurring anxiety and AUDs who can live a fairly normal life.
Outpatient treatment allows attendees to continue to go to work and live at their homes but requires them to come in for therapy and treatment.
Depending on the level of alcohol use, a person may need to seek more serious treatment. Inpatient treatment, also called residential treatment, is a form of therapy that requires people to stay at the facility full-time. This can be useful for someone who needs help detoxing, has an unsafe home life, or is severely addicted.
In addition to treatment groups and facilities, a psychiatrist may suggest starting anti-anxiety or anti-depression medication. Most outpatient and inpatient treatments will have psychiatrists in-house who can prescribe medication to manage anxiety.
Getting help is one of the most effective ways to overcome a co-occurring alcohol use disorder and anxiety disorder. If you or someone you know is struggling, seek the advice of a professional to get on the road to recovery.
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