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Alcohol and Anxiety − Can a Drink Really Calm Your Nerves?

Last Updated: April 17, 2024

Reviewed by Dr. Ash Bhatt

Alcohol is arguably among the most dangerous substances, not only due to its significant health risks but also because of its widespread availability.

Alcohol’s high accessibility makes it an all-too-common drug used by those struggling with mental health disorders. On the other hand, as a typical depressant, alcohol can also cause feelings of deep sadness that may evolve into feelings of severe nervousness. Alcohol dependence may be present in dual diagnosis but also co-occurring disorders.

Continue reading to learn about alcohol and anxiety, their interplay for health implications, and recovery treatment.

What is Anxiety?

The term anxiety has been associated directly with mental health disorders, yet it’s a common human emotion necessary for survival.

Anxiety is intricately linked to fear, which triggers an immediate fight or flight response to present or imminent danger. Pathological anxiety is when this fear arises in the absence of any threat or disproportionate relation to a threat, preventing an individual from leading a normal life.

Anxiety is a general term to refer to a variety of disorders characterized by excessive worry, fear and apprehension, often accompanied by physiological symptoms and recognized as mental health conditions in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Types of Anxiety

In the last edition of the DSM, obsessive-compulsive disorder or post-traumatic stress disorder are not included in the anxiety disorder chapter. Yet, for the sake of information, all disorders with overlapping symptoms and risk factors with anxiety are included in the chart below:

Type of Anxiety Symptoms Risk Factors
Generalized Anxiety Disorder (GAD) Excessive worry, restlessness, fatigue, difficulty concentrating Genetics, stress, trauma
Panic Disorder Sudden panic attacks, chest pain, sweating, trembling Family history, major life stressors
Social Anxiety Disorder Fear of social situations, sweating, blushing, trembling Genetics, childhood trauma, social isolation
Specific Phobias Intense fear of particular objects or situations, panic attacks Traumatic experiences, genetics
Obsessive-Compulsive Disorder (OCD) Intrusive thoughts, compulsive behaviors, anxiety Genetics, childhood trauma
Post-Traumatic Stress Disorder (PTSD) Flashbacks, nightmares, hypervigilance, avoidance Traumatic experiences, genetics, lack of social support
Separation Anxiety Disorder Excessive fear of separation, nightmares, physical symptoms Genetics, childhood trauma
Substance/Medication-Induced Anxiety Disorder Anxiety due to substance use or withdrawal Substance abuse, medication side effects
Selective Mutism Consistent failure to speak in certain social situations Childhood trauma, anxiety disorders
Agoraphobia Fear of public places, avoidance, concerns about escape Traumatic experiences, genetics

How Alcohol and Anxiety Are Linked?

The evidence of the medical practice shows a clear association between anxiety and alcohol use disorders (AUDs), to the point that up to 50% of individuals receiving treatment for problematic alcohol use also met diagnostic criteria for one or more anxiety disorders.

Let’s address the role of alcohol in dual diagnosis and co-occurring disorders:

Alcohol Use and Dual Diagnosis

  • Alcohol temporarily eases anxiety symptoms by inducing relaxation and reducing inhibitions
  • Individuals may turn to alcohol to cope with distressing thoughts and emotions associated with anxiety
  • Reliance on alcohol for anxiety relief can lead to a cycle of dependence
  • Over time, alcohol dependence can worsen anxiety symptoms and with the risk of AUD

Social anxiety disorder is one of the best examples of alcohol use to ease inhibitions and facilitate social interactions.

Alcohol works as “liquid courage” to face the situation without feeling fearful, overwhelmed or inadequate. However, this situation may cause “hangxiety,” which is anxious or tense feelings during or after a hangover, often due to the effects of alcohol withdrawal.

Alcohol Use and Co-occurring Disorders

AUDs may begin with sporadic drinks that escalate in amount and frequency over time. Young adults and teenagers are especially vulnerable to alcohol abuse due to pressure from friends or peers, experimentation or socializing.

This alcohol use may lead to the development of mental health disorders, such as anxiety due to:

  • Alcohol disrupts hormone neurotransmitters balance, such as serotonin and dopamine linked to mood
  • Chronic alcohol abuse alters the brain structure, increasing vulnerability to anxiety
  • Alcohol abuse compounds mental health risks like trauma, stress and genetics
  • Alcohol-induced changes in brain chemistry and risk factors complicate the treatment

According to research, high alcohol doses induce sadness during intoxication, developing into anxiety during hangover and withdrawal.

Increased alcohol consumption correlates with intensified temporary depressive and anxious symptoms, with over one-third of people struggling with alcohol use disorder experiencing severe depression and/or anxiety that may require medical intervention.

Alcohol and Anxiety − Does Drinking Worsen Anxiety?

Yes, drinking alcohol can and will worsen anxiety symptoms. Long-term alcohol use while suffering from an anxiety disorder may create a cycle of dependency, complicating prognosis and treatment. However, the interplay of alcohol and anxiety is multilayered and the severity of the AUDs depends on the type of anxiety disorder.

For example, research suggests panic disorder typically exhibits a relatively strong association with AUDs, whereas obsessive-compulsive disorder has the weakest relationship with alcohol disorders.

Prevention of Worsened Anxiety Symptoms

When dealing with health disorders that may be caused or worsened by alcohol use, the first and most essential action to take is reducing or eliminating alcohol intake. It’s vital to avoid relying on alcohol as a coping mechanism.

Other helpful prevention tips are:

Stress Management Techniques

Practices such as deep breathing, meditation and progressive muscle relaxation can help you relax and reduce stress levels. Engaging in these activities helps manage anxiety by distracting you from the symptoms.

Healthy Lifestyle Habits

Eating a balanced diet, particularly with “super foods” that support mental health, is highly beneficial for easing stress and improving mood. Regular exercise, a consistent sleep schedule and reduced caffeine and sugar intake can also help reduce anxiety.

Therapy and Counseling

All types of anxiety disorders need to be addressed with therapies, such as cognitive-behavioral therapy (CBT), to identify triggers, learn practical coping skills, and address underlying issues causing or worsening your anxiety.

Medication Management

In some cases, healthcare professionals would need to prescribe antidepressants or anti-anxiety medications to help manage symptoms. Following prescribed medication regimens and attending regular follow-up appointments are crucial for the effective management of anxiety.

Social Support Network

As anxiety disorders are the world’s most common mental disorders, finding a solid support network will be accessible and relatable. Support groups provide encouragement and assistance in managing anxiety episodes and support across your recovery journey.

Alcohol and Anxiety − Final Considerations

Healthcare professionals must carefully treat individuals with mental health disorders and AUDs, recognizing the entwined nature of both conditions.

Neglecting one for the other can worsen symptoms, complicating the prognosis. The best option for addressing both alcohol withdrawal and anxiety symptoms is integrated treatment plans. If, after reading this article, you realize you may need treatment for alcohol abuse or anxiety disorder, seek professional help as soon as possible.

People Also Ask

How does alcohol affect anxiety?

Alcohol can initially ease anxiety by reducing inhibitions, but it often worsens symptoms long-term, disrupting neurotransmitters and sleep patterns and leading to increased anxiety.

Can alcohol cause mood disorders?

Yes, alcohol can contribute to mood disorders like depression and bipolar disorder by disrupting neurotransmitter balance and exacerbating symptoms over time.

How do you calm down with anxiety?

Practice deep breathing, mindfulness, and progressive muscle relaxation. Engage in physical activity and hobbies. Seek therapy for coping strategies. When prescribed by a doctor, medication can also help manage symptoms effectively.

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Retrieved on April 17, 2024.

Published on: March 9th, 2018

Updated on: April 17th, 2024

María José Petit-Rodríguez

About Author

María José Petit-Rodríguez

Medically Reviewed by

Dr. Ash Bhatt

Throughout his professional life, Dr. Bhatt has been conferred with diplomate status by the American Board of Psychiatry and Neurology, certifying him in both adult and child/adolescent psychiatry. His experiences in emergency rooms, frequently encountering patients with simultaneous health and addiction issues, directed his attention to these specific fields.

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