Anxiety and Alcohol Abuse

Anxiety disorders, such as generalized anxiety, social anxiety, and post-traumatic stress disorder, often make life difficult. For many, alcohol provides temporary relief of anxiety symptoms and is a way to self-medicate. These specific anxiety disorders have an increased risk of co-occurring substance abuse (comorbidity).

While someone may find temporary relief, alcohol can exacerbate anxiety symptoms, making them worse over time. The use of alcohol to suppress anxiety symptoms increases the risk of alcohol abuse and alcohol use disorder.

Anxiety disorders are the most common mental health disorders and affect 40 million adults in the United States every year.

alcohol

What is Alcohol Abuse and Alcohol Use Disorder?

Moderate drinking is one drink per day for women and two drinks per day for men. However, drinking more than this on a regular basis can be a sign of alcohol abuse. Binge drinking (more than four drinks for women or five drinks for men) more than five days in a month constitutes heavy alcohol use. 

Alcohol use disorder is a substance use disorder that occurs when a pattern of alcohol use progresses. For people with anxiety, self-medicating with alcohol often becomes a regular pattern, making the progression to alcohol use disorder likely. Symptoms of alcohol use disorder include:

  • Inability to limit alcohol consumption
  • Spending a lot of time drinking or recovering from alcohol use
  • Experiencing strong cravings for alcohol
  • Needing more alcohol to achieve the desired results
  • Losing interest in once-loved activities
  • Failing to meet work, school, or social obligations
  • Continuing to drink when it causes physical, emotional, or social problems
  • Having withdrawal symptoms when alcohol is not available
trauma

What Are Anxiety Disorders?

Anxiety disorders are serious mental health disorders that cause constant fear and worry. Often, this worry and fear become worse over time. As a result, anxiety problems often have a negative impact on  job or school performance, personal relationships, and daily activities. There are several types of anxiety disorders, including: 

Generalized Anxiety Disorder (GAD)

People with generalized anxiety disorder, or GAD, suffer from persistent and excessive worry. They often become overly concerned about family, health, money, work, and other parts of daily life. In addition, some people experience a constant feeling of an impending disaster or problem, known as catastrophizing. Specific symptoms of GAD can include:

  • Excessive and constant worry and tension
  • Unrealistic view of problems
  • Restlessness and irritability
  • Muscle tension and headaches
  • Difficulty concentrating

It is difficult to impossible for people with GAD to control these feelings. A person receives a GAD diagnosis when they are unable to control feelings of worry for more than six months and experience at least three symptoms.

Generalized anxiety disorder affects almost seven million adults in the U.S. every year. In addition, women are twice as likely to receive a diagnosis.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a serious and debilitating mental health disorder triggered by a traumatic event. It is natural to feel afraid immediately after a traumatic event. The body’s “fight-or-flight” response is a normal reaction and something that most people recover from naturally. When someone continues to experience this stress and fear long after the trauma, they receive a PTSD diagnosis. Traumatic events can include natural disasters, serious accidents, war, rape, or the sudden death of a loved one. Symptoms of PTSD can include:

  • Flashbacks to the traumatic event that can cause increased heart rate and sweating
  • Nightmares
  • Avoiding places, events, or people that trigger reminders of the event
  • Avoiding thoughts and feelings
  • Easily startled
  • Difficulty sleeping
  • Uncontrolled bursts of anger
  • Negative thoughts about self
  • Feelings of guilt or blame
  • Loss of interest in activities or hobbies

More than eight million adults in the U.S. have Post-Traumatic Stress Disorder.

Social Anxiety

Social anxiety disorder, also known as social phobia, is the second most common anxiety disorder and similar to generalized anxiety disorder (GAD). People with social anxiety suffer from intense anxiety and fear when in social situations. Although, this goes above and beyond simple shyness. People with social anxiety believe others are judging, evaluating, or rejecting them. 

People often avoid social situations and contact with strangers. This can make it difficult to attend school, hold a job, and make friends. Social anxiety typically surfaces during the teen years, especially in shy children. Symptoms of social anxiety disorder can include:

  • Rapid heart rate
  • Sweating
  • Blushing
  • Feeling nauseous
  • Avoiding eye contact and speaking softly
  • Intense fear and anxiety around new people
  • Self-conscious, feeling embarrassed or awkward
  • Afraid of judgment
  • Avoidance of public places

Social anxiety disorder affects nearly 15 million adults in the U.S., with the average age of onset occurring during the teenage years.

Panic Disorder

People with panic disorder experience sudden feelings of terror and anxiety without any apparent threat or danger. In other words, these feelings of intense fear can occur at any time, any place, typically without warning. People with panic disorder live in fear of having a panic attack. This fear can be debilitating, leaving many unable to leave their homes, hold a job, or participate in daily activities. Physical symptoms of panic attacks can include:

  • Rapid and increased heartbeat
  • Chest or abdominal pain
  • Difficulty breathing
  • Dizziness and weakness
  • Sweating
  • Tingling or numbness in the hands

Between two and three percent of Americans experience a panic disorder. It’s twice as common in women than in men.

The Link Between Anxiety and Alcohol Abuse

There is a high co-occurrence of alcohol abuse or alcohol use disorder and anxiety in the U.S. Specifically, major studies show that those with anxiety disorders often turn to alcohol to self-medicate. Many with anxiety disorders fail to seek treatment, making self-medication with alcohol an easier option. On the other hand, alcohol abuse can also trigger anxiety disorders. This is especially true when someone suffers from alcohol dependence and alcohol use disorder.

While alcohol consumption may initially help ease the symptoms of anxiety, it can cause anxiety symptoms to worsen within just a few hours of consumption. This increase in anxiety often triggers increased alcohol consumption, creating a vicious cycle.

Alcohol use statistics vary among the different anxiety disorders. For example, the Anxiety and Depression Association of America estimates 20 percent of people with anxiety disorder suffer from alcohol abuse or alcohol use disorder. In terms of PTSD, alcohol abuse and alcohol use disorder is high. Specifically, one study shows over 30 percent of Vietnam veterans have PTSD and 70 percent of them have an alcohol use disorder.

treatment

Treatment Options for Co-Occurring Disorders

When it comes to the treatment of anxiety disorders and alcohol use disorder, professionals face a variety of challenges. A simple alcohol detox program is not enough. Treating only one condition, such as alcohol use disorder alone, increases the risk of relapse. Integrated treatment programs that utilize cognitive behavioral therapy are crucial in order to address both conditions at the same time, reducing the risk of relapse.

When anxiety is a result of drinking alcohol, anxiety symptoms often resolve within a few weeks or months after detox. For anxiety disorders, detox can worsen symptoms. For this reason, it is necessary to be in a safe location with professionals who treat anxiety. Once detox is complete, medical professionals can focus on treating the anxiety disorder.

Resources

“Alcohol Use Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 July 2018, https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243.

“Anxiety Disorders.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.

Carter, Ashlee C, et al. “Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veteran Populations.” Journal of Dual Diagnosis, U.S. National Library of Medicine, Oct. 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474251/#!po=18.2540.

“Drinking Levels Defined.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 26 Nov. 2019, https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking.

“Facts & Statistics.” Anxiety and Depression Association of America, ADAA, https://adaa.org/about-adaa/press-room/facts-statistics.

“Generalized Anxiety Disorder (GAD).” Anxiety and Depression Association of America, ADAA, https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad.

Kushner, M G, et al. “The Relationship between Anxiety Disorders and Alcohol Use Disorders: a Review of Major Perspectives and Findings.” Clinical Psychology Review, U.S. National Library of Medicine, Mar. 2000, https://www.ncbi.nlm.nih.gov/pubmed/10721495.

“Panic Disorder.” Anxiety and Depression Association of America, ADAA, https://adaa.org/understanding-anxiety/panic-disorder.

“Panic Disorder.” MedlinePlus, U.S. National Library of Medicine, 5 Nov. 2019, https://medlineplus.gov/panicdisorder.html.

“Post-Traumatic Stress Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml.

“Posttraumatic Stress Disorder (PTSD).” Anxiety and Depression Association of America, ADAA, https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd.

“Social Anxiety Disorder.” Anxiety and Depression Association of America, ADAA, https://adaa.org/understanding-anxiety/social-anxiety-disorder.

“Social Anxiety Disorder and Alcohol Abuse.” Anxiety and Depression Association of America, ADAA, https://adaa.org/understanding-anxiety/social-anxiety-disorder/social-anxiety-and-alcohol-abuse.

“Social Anxiety Disorder: More Than Just Shyness.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml.

“What Is the Difference between Alcohol Abuse & Dependence.” Hazelden Betty Ford Foundation, https://www.hazeldenbettyford.org/articles/what-is-the-difference-between-alcohol-abuse-and-dependence.

Updated on: September 22, 2020
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Alcohol Rehab Help Writing Staff
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Medically Reviewed
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Annamarie Coy,
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