Alcohol & Panic Attacks – How Alcohol Abuse Can Worsen Anxiety

Alcohol Abuse And Panic Attacks

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There are clear links between alcohol and anxiety, and between alcohol and panic attacks. Alcohol can trigger panic attacks because on a physiological level drinking can cause low blood sugar, dehydration, increased heart rate, and increased levels of stress.

Unfortunately, and clouding the situation to some extent, it has also been established that many people with social and generalized anxiety turn to alcohol as a form of self-medication. As a consequence, this can worsen their symptoms. So while alcohol and anxiety attacks are correlated, it may be that those with anxiety disorders are more likely to drink.

The link between alcohol and anxiety is well-established. But it’s not clear which comes first – is it the alcohol that triggers anxiety, or the panic that triggers alcohol abuse?
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What One Should Know About Alcohol-Induced Anxiety

Does Drinking Alcohol Make Anxiety Worse?

When people use drinking to deal with anxiety and panic, they can experience severe consequences even from drinking eventually. Like other frequently abused substances, the combination of alcohol abuse, hangover, and withdrawal can lead to an increased risk of panic attacks. As a consequence, this kind of abuse can result in both an alcohol addiction and more severe anxiety and panic disorders.

The worst part about the relationship of alcohol and anxiety is that individuals who use alcohol to deal with their nervousness get caught in a cycle – they use alcohol, which increases their anxiety, and then they drink more to deal with that increased anxiety.

Anxiety and alcohol abuse – why does alcohol cause anxiety?

Can alcohol cause anxiety? Absolutely. While some people use alcohol as self-medication, two theories explain the link between alcohol and panic disorders:

  • Tension reduction hypothesis: According to researchers, individuals who cannot cope with stress often become dependent on alcohol to reduce tension. But then, having temporarily experienced less anxiety after drinking alcohol, they begin to think that higher amounts of alcohol will help them deal with higher levels of stress.
  • Biological theory: Some scientists claim that genetics can explain why people abuse alcohol.

Also, physiological changes that occur after drinking can explain why alcohol causes anxiety:

  • Dehydration: When people consume alcohol, they can become dehydrated, because alcohol is a diuretic. This dehydration can cause headaches and dizziness, which can increase the uncomfortable feeling of anxiety.
  • Heart rate and changes in the nervous system: Alcohol also increases the heart rate, which makes people more anxious. Some individuals can even mistake the increased heart rate they experience after drinking for a heart attack, which can then trigger a panic attack.
  • Low serotonin and blood sugar levels: These changes can lead to depression and tiredness, so if one is already suffering from an underlying level of social anxiety, alcohol and its effects on the body will make it worse.
  • Poor judgment: In addition to negatively affecting many bodily functions, drinking can lead to poor judgment. The behaviors that result from this can result in anxiety and panic attacks, either during or after the practices. One of the most dangerous examples of poor judgment, in fact, may be the belief that alcohol helps anxiety – once a person believes that, they’re caught in a cycle.

There is also a relationship between alcohol and anxiety the next day, after a long night of drinking. So in the next two sections, we discuss the effects of hangover and alcohol withdrawal.

Can a hangover cause a panic attack?

Yes, hangovers can trigger panic attacks, due to alcohol anxiety and the physiological and cognitive unpleasantness of being hung over. Also, one of the most common experiences during a hangover is feelings of paranoia, that something bad must have happened because of how bad one feels. Stress headaches can also be a common hangover experience, and these can lead a person who is already slightly anxious to worry that something terrible might be wrong with them, like a brain tumor.

Can alcohol withdrawal cause panic attacks?

In addition to the uncomfortable bodily changes associated with a hangover, alcohol withdrawal itself can cause anxiety, hallucinations, and panic attacks. Heavy drinkers can suffer from severe withdrawal symptoms after drinking, some of which can be life-threatening. These effects can also be dangerous for the people around the drinking individual. The resulting panic attacks and hallucinations can be terrible, and withdrawal seizures can be lethal.

How to stop anxiety after drinking alcohol? Well, the only way to escape from the nightmare is to stop drinking alcohol. But remember, this is something that should be undertaken only with medical help because alcohol withdrawal can be dangerous.

Anxiety & Panic Attacks Explained

Anxiety is defined as fear and insecurity about the future. Generalized anxiety disorder, on the other hand, is defined as a constant state of uneasiness that interferes with people’s everyday activities. Symptoms of this disorder include:

  • Headaches
  • Sweating
  • Hoarseness
  • Stomach problems
  • Fatigue
  • Depression
  • Negative thoughts
  • Insomnia

High levels of anxiety can lead to short but terrifying episodes of panic attacks. People start noticing all the small pains in their body and amplifying them in their minds, and they can also experience:

  • Shortness of breath
  • Detachment from reality
  • Fear of death

Panic disorders can even lead to panic attacks while asleep. Research data shows that 70% of people with a panic disorder experience nocturnal panic.

Can alcohol help with anxiety? The answer to this has to be an emphatic No. Many people who suffer from anxiety or panic disorders may try to use alcohol to deal with their social anxiety, phobias, and panic attacks, but this ends up only making the problem worse.

How To Treat Alcohol Abuse, Anxiety Disorder, And Panic Attacks?

The biggest problem standing in the way of effective treatments for alcoholism and anxiety is that drinkers are unable to differentiate the anxiety caused by their drinking from the anxiety they had in the first place. Unfortunately, alcohol increases any baseline levels of anxiety people might have had – quite literally, pre-existing social anxiety and alcohol don’t mix.

People should also understand that alcohol can trigger anxiety, but it’s just as likely that anxiety triggers drinking. Studies show that people with anxiety disorders are three times more likely to abuse alcohol and/or drugs.

According to the National Institute on Alcohol Abuse and Alcoholism, heavy drinking is defined as 14 drinks for men per week, and 7 drinks for women and people over 65 per week. (One drink = 1 bottle of beer, 1 glass of wine, or 1.5 ounces of a liquor.)

People who drink this much and suffer from anxiety often ask questions during their treatment such as “Does alcohol make anxiety worse?” or “Does alcohol increase anxiety?” They’re hoping the answer is No. It isn’t. Alcohol definitely makes anxiety worse.

Therefore, effective recovery from alcoholism usually saves treatment of anxiety symptoms until after a complete detox. Patients who suffer from anxiety need to learn to cope with stress without alcohol being present. Behavioral therapy often works well to accomplish this, and group sessions are also recommended.

Because there is a link between alcohol, hangover, anxiety, and panic attacks, effective treatment must address all of these issues.
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View Sources
  1. Stevens S, Cooper R, Bantin T, Hermann C, Gerlach AL. Feeling safe but appearing anxious: Differential effects of alcohol on anxiety and social performance in individuals with social anxiety disorder. Behav Res Ther. 2017 Jul;94:9-18. https://www.ncbi.nlm.nih.gov/pubmed/28441522
  2. Phillips P. Pharmacotherapy: anxiety and comorbid alcohol use. Nurs Times. 2016. https://www.researchgate.net/publication/271334024_Pharmacotherapy_for_anxiety_and_comorbid_alcohol_use_disorders
  3. Morley KC, Baillie A, Leung S, Sannibale C, Teesson M, Haber PS. Is Specialized Integrated Treatment for Comorbid Anxiety, Depression and Alcohol Dependence Better than Treatment as Usual in a Public Hospital Setting? Alcohol Alcohol. 2016. https://www.ncbi.nlm.nih.gov/pubmed/26672793
Juliette Siegfried

Juliette Siegfried, MPH

Content Contributor

Juliette has been working in the health communications field since 1991, when she began working at the National Cancer Institute of the National Institutes of Health in Bethesda, Maryland. Her initial campaigns focused on smoking cessation and cancer prevention. Juliette later moved to the corporate side of health communications, including working at Kaiser Permanente, where she designed interactive computer-based training for health education.

Comments

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  • Jacqueline
    This article makes so much sense, I have been searching for so many answers for years and only just came across this after yet another episode today. Thank you kindly
  • Brian
    I’ve cut down on my drinking a great deal and I’m glad, but I am having a couple of panic attacks a day. Interesting article and many of the things described I’ve gone through. Drinking is such a part of social culture, that it’s hard to give it up completely, but I do think it’s the best thing.
    • sta
      how do u handle ur panic attack bro?
  • Dyffrin
    I seem to get the panic attacks exactly 3 days after I have a long night of heavy drinking. So I know there’s a correlation for sure. Is this common?
    • Patrick
      I have been dealing with the same issue and thought I was the only one. I’m typically anxious the next day or 2 but after 3 days I am incredibly anxious and I’m not sure . Could be all the toxins have been completely removed from your system
    • Aleali
      Definitely. Most articles argue that withdrawal symptoms are worst in the first 24-72 hours. I came here because after churning down two bottles of wine a night (I am a woman of low weight) I decided to stop. The following day I had such a terrible panic attack, with intense shaking, palpitations, and pain in the left arm, I thought I was dying. A doctor on the phone had to reassure me that my heart wan’t failing. It’s my second day now and it is still really tough and scary. Good wake up call though
      • Marcy
        I have had this problem too. I have found that extremely low blood sugar is the main problem and drinking Gatorade or having a piece of cake helps. I wish I had known this earlier. I have ended up in the emergency room and they did not help at all. I have spoke with countless doctors about it and it’s almost like they have no interest in helping you. To find out I could have avoided the ER by drinking some sugar is very upsetting. I do not trust the medical community anymore than I trust the government. They want to control you and your money.
    • Ray
      Yes it definitely is
    • Deb
      This is exactly what just happened to me!!! I’m in it right now and trying to understand….
  • Starla
    I used to be able to enjoy drinking with freinds and family. Ive never been a heavy drinker, just 3 to 4 drinks whenever i went out. But now I cant even have one drink without feeling like i cant breath. I instantly start to feel my heart beat fast and I freak myself out. Will I be able to drink again without this happening?
    • Jess
      I get the same problem. I Use to drink every weekend with family & friends. But started suffering from severe panic attacks the day after drinking. I’m now to scared to drink any alcohol atool. which is a big impact because it’s a more social thing for me.
    • M
      What other symptoms do you have I’m having the same issue.
    • Nic
      This happens to me too! I’ve never been a big drinker but lately after 2 drinks I can’t breathe properly and get clammy and have to talk myself out of panic. It doesn’t seem to be allergies because it happens with gin or vodka as well as red wine. I asked my dr & his only response was that because I don’t drink much I’ve lost tolerance for it (not true- I’m not drunk, just can’t breathe ) I’d love to know what’s really going on here!
    • Orsi
      Dear Starla, This is exactly what I am asking…I realized that whenever I have a hard period, kinf of depressed and an elevated level of anxiety, I also have the same symptoms even after having a single glass of beer. 🙁 It might be that our brain chemistry needs some recovery first and then we might have a glass or too without this freaky feeling.
      • Amber
        It’s because b1 (thiamine) is depleted EXTREMELY by even one drink. This is the vitamin that supports heart rate, as well as level of relaxing chemicals in the brain. Start supplementing b1 and you’ll see a hell of a difference. Also Gatorade helps and avoid wines because they have sulfates that make anxiety way worse.
  • Sam
    heavy drinking is defined as 14 drinks for men per week, and 7 drinks for women and people over 65 per week. ????
  • Rob
    I also get the same problems. Didn’t understand how the alcohol was causing them. I figured because I don’t eat most of the time and drink prolly around a dozen drinks in one setting. My panic attacks are always the next day and escalate to the extreme with small attacks the second day. Talking to someone helps calm them down. Especially someone who gets them as well maybe not from alcohol but other matters.
  • Seth
    used to be able to enjoy drinking with freinds and family. Ive never been a heavy drinker, just 3 to 4 drinks whenever i went out. But now I cant even have one drink without feeling like i cant breath. I instantly start to feel my heart beat fast and I freak myself out. Will I be able to drink again without this happening?
  • Elly
    I understand what you’re going through. I’ve suffered from panic attacks for years. Staying away from alcohol and caffeine really helped. I hated giving up chocolate. That also has caffeine but I feel so much better without it. Taking up yoga and learning how to breathe right really helped. And it’s amazing that drinking plenty of water can help anxiety too.
  • Clayton
    Friends, I know fear just like many others in this thread. I had a major panic attack one day while shoveling snow, and I really thought I was dying from a heart attack. After a trip to the hospital, I found out my heart was just fine and I would live. How this all started… Two years ago, I thought it would be great to be a bar manager because I would be right next to the alcohol. I started ass a social drinker, but I found myself drinking more and more as time went on. It started with beer, but two years later I found myself drinking a bottle of Crown every two weeks, plus three cases of beer. My anxiety and panic attacks skyrocketed over the two-year span. Finally I realized something was very wrong with me and my drinking. With help from friends and SATP I quit. Was it scary? Damn right it was…. but after two weeks of sobriety, my panic attacks and anxiety went away. I can’t say this will be the same for you, but there is no harm in trying. The scariest part is stopping and not knowing what will happen if we quit cold turkey. The best decision I ever made, stop drinking, get help, and never forget. I hope this testimonial helps…
    • B
      Thanks Clayton, I had been kinda a party guy for years, and had switched from beer to vodka which went down really easily with fresca. Was at work and had tightness in the chest and shortness of breath. I though I would take a precautionary drive past the hospital and before I knew it my hands were clasping and I went in for what I though was a heart attack. Terrifying After quitting for some 10 months I had a new job but began again, and so did the panic attacks, so sever that I had to leave twice and then stopped coming to work alltogether. Its been a couple of months with out a drink and now I think I may need to change careers alltogether, but am starting with cutting out the alcohol. Did you need medication or anything else, and how are you now? Mel
    • chris
      Thank you very helpful words…
  • Najee
    I’m a 25 year old who just suffered a trip to the emergency after a next day panic/ anxiety attack after drinking way way to much. I’m gonna be truly honest 14 beers a week is considered a heavy drinker, I had over 14 in a day and was still going trying to hang with the college crew still. My panic attack the next day was so bad, I was shaking, sweating, shortness of breath, head was heavy, felt like fainting every 5 seconds, but everything turned out good, vitals and organs were all good, doctor said I was lucky to not have alcohol poisoning, it wasn’t my 1st time this happened but it was my worst time. After these last past days of getting over these withdraw symptoms and doing some meditation, I’m just going to drop the alcohol for a long time and think about what’s important in my life and get to the root of what causes my anxiety instead of trying to throw alcohol on top of anxiety.Wish Everyone the best God Bless
  • Timm Wheeler
    The vicious circle of anxiety and drinking. I’ve recently begun to understand why some people drink in the morning. For some, myself included, it’s to get away from the hangover panic via some liquid bravery. My father, who is a former heavy drinker use to call it the 10am funk. You get up for work not feeling too bad, head to the office to start the day and at 10am, like clockwork, the shakes start. Heart is racing, some cold sweats, dizziness and before you know it you’re in full panic mode thinking your heart is going to stop. I had started going out for lunch to places with a bar and having at least 3 drinks to calm down. That would lead to 3pm withdrawal and by the time I got home it was right into the wine. By 6pm I would be a bottle of wine deep, opening another and feeling calm. I began anticipating the 10am funk and started filling a 12oz orange juice bottle halfway with vodka to keep at my desk. More drinks at lunch, more in the evening and the cycle repeats. Day after day. It s**ks. But here I am, with all of you trying to kick it.
    • Mandi
      I feel you completely, Timm. I am currently trying to get over a weekend bender. I have a drink before I leave for work every morning, then by late lunchtime my heart is pounding and I’m sitting at my desk feel like I’m going to die. I usually run out and buy a carton of pinot grigio, and down it in the parking lot. I have found it to be a good choice, because people can’t seem to smell it on me like they can hard liquor. By 5 pm, I am feeling anxious again and get myself home as fast as I can to begin my nightly drinking. I am feeling good and relaxed by bedtime. That is the only time of day when I feel good. I know this has to stop. I hide this behavior from everyone. I notice if I don’t drink as heavily over the weekend, my Monday morning anxiety isn’t as severe, but I also have trouble controlling the number of drinks I consume once I get started. This really is a vicious cycle. And now after my recent emergency room visit (for what I thought was a heart attack) I have a $2500 hospital bill to worry about.
  • Amanda
    I only drink on the weekends how’s that effecting my anxiety my anxiety also messes with my chest
  • Jake
    This has become more and more of a problem for me. I’m a young adult, age 23. I used to love going out with my friends and get completely blasted. Never had a problem with it. Sleep it off. Now I can hardly handle 1 drink without getting an extreme panic attack. Completely detached from reality. Pounding heart, and shaking like a leaf. I stopped drinking for a whole month. I was totally fine. Just went out with my friends once again, had 3 drinks and totally freaked out. This is tough since this is such a social thing to do. I’m at a loss. Looks like the party is over.
  • Melissa
    Love reading all of these comments. I’m a 48 year old female and I’ve drank beer all my life.. through high school and during my entire marriage. Never suffered any harsh withdrawals. After I got divorced I start dating a man who was a heavy, HEAVY drinker. Well guess who also began drinking liquor? That was almost 12 years ago, but I kept up the habit. Sadly, I remarried 5 years ago and turned my now husband into almost as heavy as a drinker I am. 3 stints in detox, but always went back. As for this anxiety, o can attest to it happening almost as soon as I sober up and lasts for 3-5 days. Sweating, heart pounding, but it is the insomnia that absolutely terrifies me! I am literally fearful to even try and sleep. People suggest sleeping pills or melatonin, but I can’t mentally take ANYTHING for fear that I won’t fall asleep and will be running around like a freaked out zombie for hours. I have experienced this many times and the “solution” is always weak promises to family and friends to only do it again. I recently had 17 days sober, which is tremendous for me, and then blew it again. I’ve never been big into AA, but I need to be. I need to find something to change my life and I just can’t bear the thought of going through this again. I started binging on Tuesday and didn’t stop until Sunday night, so this is my day 2. I am scared… really scared. I will pray for us all. Sorry so long Thanks for reading
  • Jeremiah
    Thank you to all the comments because ots starting to all make sense now. I always thought about the correlation but never really gave it a second look. Now I look back on all my past attacks and see it clearly now. Prayers to all who are going through this and stay strong.
  • Neesha
    It’s so terrible to hear so many of us are suffering. I’ve just had a full blown attack thought it was a heart attack like I ALWAYS think it is. Led here all chilled in bed and bam weird feeling in chest can’t breathe sweating and the panic MUMMMM PLEASE HELP IM DYING MY HEART MY CHEST collapse on the floor hyperventilating. Then I come back round shakey and achey and googling panic attack and chest pain. What did I expect? 2 nights drinking FAR too much, smoking like a chimney, eating pattern all over the place and greasy take away food to try and help the hangover, minimum sleep all weekend and another 2 beers today no water all weekend. The alcohol is defo a trigger for me it makes everything ten times worse 🙁 I feel for everyone in this. We can do this guys we are strong xxx hugs
  • Jonathan
    Well I am glad I found this forum to read and to express my own story. I have not had it as bad as some here, but last Friday I had a bit too much to drink as I sometimes do. On Saturday afternoon I went to play some tennis and really pushed myself. Towards the end I got the panic attack that I had gotten a couple times before. I was scared. I tried to relax myself, but I felt I was getting a heart attack. A friend went with me to the hospital and besides the racing heart rate, all other test were normal. That was a relief, but I realise now that alcohol has been a contributing factor on at least two times as the next day I tried to play tennis in the hot sun and I felt that added to the panic attack coming on. I will make a decision to lessen the amount of alcohol consumed as well as not to push myself the next day. I am not a big drinker as it is usually no more than twice a week. But sometimes I really overdo how much I have more so on a weekend. I am 48 and I guess I have to adjust my lifestyle a bit to ensure I do not experience this as bad as I have. I have had a night panic attack or two. But usually I can relax myself by just trying to breath and relax. But the two times playing tennis the next day after drinking, I was unable to calm myself down as I did in the night. Also, unfortunately several months ago I was playing tennis doubles with a woman partner, when she collapsed and died of a heart attack right there. I was shocked as she did not drink alcohol at all or even eat badly. I believe this has also triggered this anxiety to make it worse on the court. It is since then, when my heart races I began thinking of not wanting to die of a heart attack. This made me think of how unpredictable life is and I began to get more anxious often. But I try to tell myself to not worry about things I have no control of. It helps a bit, but not always.
  • Adam
    It’s nice to read all these stories of honesty. I have suffered with an anxiety disorder for 11 years. It was so bad that I sadly lost my wife, friends and children as I became literally obsessed with death and my typical anxiety symptoms took over my life. My only salvation (well at least I thought it was) was alcohol. No matter how bad my anxiety was, the beer stopped me from caring about my anxiety because I was, for those few drunken hours a day, not worried about dying or constantly cycling my negativity in my mind. My sweating, heart palpitations, dread emotions and dizziness went away. The next day, I would wake with anxiety, hate my life, feel all the physical symptoms come rushing past and could think of nothing else but 7:00pm, when it was socially more acceptable to drink, so that I could take a break from worry.I still drink sometimes, I’m aware of the damage it’s done but as an anxiety sufferer, all of my rational thoughts are destroyed by fear, so a beer seems like a reasonable trade-off.I would never tell anyone what to do with their lives and their bodies but I know 100% that alcohol has fuelled my anxiety and anxiety has fuelled my drinking. If I can control one, I hope one day that the other will take a back seat.Adam, 39 years old.
    • Brandon
      Hi Adam, just read your post I cannot relate more, I’m going through the same thing and it feels like I’m truly dying at times, as I write you now I’m scared to give up drinking For fear of the next three four or five days, As to how I’ll feel, with that said, you made me feel a lot better knowing that my symptoms are going to go to yours and then I don’t have a massive lung problem heart problem etc., Believe me when I say this it came on out of nowhere, never saw it coming
  • Brandon
    Hi guys, I’m so glad I found this forum, I’ll give you my backstory, I was on Reality TV and dealt with a bit of stress, with that being said, I don’t think I can remember, the last time I drank less than seven or eight beers a night, generally only dealing with a little anxiety in the morning otherwise going away, which leads me to three weeks ago, out of the blue I was having a hard time breathing heart was racing I was shaking uncontrollably, my heart would flutter, I truly thought either my lungs were bad all the sudden, or I was having about art attack or leading up to one, I’m not want to go to doctors so with that said I’ve been up during it for three weeks now, still turning down 8 to 10 beers now do the trick, I made a promise to myself that today’s a new day and I stop this nonsense, I don’t know how successful lobby but I sure as heck I’m going to try, I see this as truthfully as I can, I am really really scared but I can’t live like this anymore, I have been curled up on the couch for weeks barely able to go to the store for fear I will not be able to breathe, Or my heart will race, and so on, One last point I should mention, I live in Las Vegas so gambling is everywhere and anywhere 24 hours a day, I believe a lot of this for me and others on the blog year has to do with dopamine suppression as well. I told my wife the other day, I will truly take two broken legs and two broken arms rather than deal with this.
  • CLAUDIO
    Hey! I can relate to the main anxiety & alcohol situation (at the moment I’m traveling very far from my country, alone and in a very party enviroment), so you can imagine the full picture, right?The way I found best to cope with anxiety back home is to have a strong healthy routine on my daily basis. I do my best to eat very clean, go to the gym and try to have a good quality of sleep (earplugs and eyemask). My main objective is to try to have as much control of the situation as I can. And believe me when I say, it helped me a lot. I used to have daily panic attacks, couldn’t get out of my house without my health track and was constantly concern of knowing where the closest hospital was. Nowadays, I feel more confident to deal with the symptons whenever they appear and the amount of triggers reduced very much.The main thing that comes with traveling is that at a certain point, you are gonna lose a bit of that… drinking a bit more, eating poorly and that’s where I am right now. But I’m glad meet guys and wish you all the best in the pursuit of getting better.
  • Sammi
    I am a recovering alcoholic who is now 3 years sober. Towards the end of my very bad alcohol addiction I started suffering full blown panic attacks. The very first one I had came out of nowhere and was by far the scariest thing I have ever gone through. At the time I had no idea that alcohol withdrawal could cause these awful attacks. Now I know that what caused them were from me not drinking for a couple days. I would love to tell my story because it actually came out positive. I want alcoholics to know you have to hit complete rock bottom for you to quit. You make the decision. Mine was a alcohol withdrawal seizure. I had liver disease and had no clue. That happened when I was 30 years old.