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Generalized anxiety disorder (GAD) and alcohol abuse are often co-occurring disorders. Both alcohol and anxiety disorders can negatively impact your mental health and everyday life. When combined, the results are even more intense than if experienced separately.
Alcohol consumption can exacerbate a preexisting GAD and lead to more anxiety symptoms. For this reason, chronic alcohol use and anxiety are heavily intertwined and should be treated simultaneously.
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Alcohol is a central nervous system depressant that disrupts your brain's balance and can affect feelings, thoughts, and actions. It is an anxiolytic, meaning it may relieve anxiety symptoms.2 Although it’s effective, the results are very short-lived.
This effect is partly due to alcohol’s ability to alter the following neurotransmitters, inhibiting necessary signals from one nerve to another:1
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
If a person continuously relies on alcohol to relieve symptoms, they risk becoming dependent.
Alcohol also makes it harder for the brain to control:
Alcohol may temporarily reduce feelings of anxiety. However, drinking alcohol should never be used to treat anxiety disorder.
There is a vicious cycle that happens when a person with anxiety drinks alcohol:
A person with anxiety or panic disorder may also worsen or trigger anxiety attacks or panic disorder when they drink alcohol.
Alcohol can also cause anxiety attacks. Anxiety, or panic attacks, is the sudden feeling of intense panic and fear.
These attacks usually last around 5 to 30 minutes. Although they’re often terrifying, they’re generally not dangerous.
Symptoms of panic attacks include:4
Panic disorder differs from anxiety disorders in that sudden episodes of intense fear or discomfort characterize it. In addition, panic disorder triggers a “fight-or-flight” response, which doesn’t always occur in anxiety disorder.
Unlike panic disorder, GAD is not characterized by sudden, intense bursts of fear. Instead, it entails a continuous sense of unease.
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Alcohol-induced anxiety is anxiety caused by the use of alcohol. Symptoms of alcohol-induced anxiety include:
The gamma-aminobutyric acid (GABA) is a neurotransmitter that inhibits excitatory responses. Alcohol affects the 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 effect can cause withdrawal and panic attacks.
Alcohol can also make physiological symptoms worse. These include:
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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.
Hangxiety is 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.
If you notice that your alcohol-induced anxiety lasts longer than the 48-hour time frame, this may point to a substance use disorder or, specifically, alcohol use disorder (AUD). Drinking more alcohol for 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 exists before or without drinking, you may want to speak with a mental health professional about options and addiction 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 generalized 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 stopping abruptly after excessive alcohol consumption can be dangerous and deadly because of withdrawal effects.
A person who is an alcoholic and stops drinking suddenly — going cold turkey — may experience severe withdrawal symptoms, which include:
As mentioned, withdrawal 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.
Withdrawal can induce panic, cause someone to lose consciousness, have seizures, or develop delirium tremens (DTs).
DTs is a severe, life-threatening form of withdrawal. Symptoms of DTs include:
Because of these potentially deadly symptoms, a person struggling with AUD should never attempt to quit alone. Instead, they should only quit under the care and watch of a specialized rehab facility for professional 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 consumption 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 preexisting anxiety, the ways to reduce alcohol-induced anxiety may look a little different. In this case, you may want to:
Some people use alcohol to alleviate the effects associated with generalized and social anxiety disorder. People commonly drink red wine because it’s linked to more health benefits than most other alcoholic beverages.8
While the occasional glass of red wine can relieve social anxiety and other physical symptoms, you should seek healthier and more effective forms of management for depressive disorders.
Self-medication is potentially life-threatening and can lead to substance abuse. Seek help from mental health professionals if you or someone you love needs it.
Drinking soothing non-alcoholic beverages can help reduce stress and anxiety levels. Here are a few substitutes that promote relaxation, improve sleep, refresh, hydrate, and nourish:
Eliminating heavy drinking as an unhealthy coping mechanism takes time. Here are relaxation techniques and habits you can incorporate to relieve the underlying anxiety quickly:
If you have co-occurring anxiety and alcohol misuse, 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 anxiety and alcohol misuse include:
Substance-induced anxiety disorders are often treated using group and individual therapy. Groups like Alcoholics Anonymous (AA) can allow addicts with anxiety to connect with others, regain control over their lives, and manage feelings in peer-led spaces.
Outpatient treatment may be a good option for dealing with moderate to severe alcoholism. This type of treatment works well for people with comorbid 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. Many online therapy options are available for patients treating substance use disorders and anxiety problems remotely.
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.
Residential treatment can be helpful for someone who needs help detoxing, has an unsafe home life, or is severely addicted.
In addition to counseling and therapy, 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 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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