Does Alcohol Cause Anxiety?

When you first consider the question “does alcohol cause anxiety,” the most obvious answer might be no. Many people rely on alcohol to cope with anxiety because of its relaxing effects.

There’s more to it than that, however. Alcohol and anxiety have complex relationships, and alcohol-induced anxiety is a real problem for many people. Someone with a history of substance abuse may be more susceptible to developing any mental disorder. 

The Effects of Anxiety

Anxiety is something that people often talk about in terms of diagnosing themselves when they’re experiencing something distressing for them. Along with being a term often casually thrown around, it’s also a very real and potentially debilitating disorder. Anxiety has diagnostic criteria like other medical conditions and mental health conditions. 

An anxiety disorder isn’t the same as occasionally experiencing normal feelings of anxiety in stressful situations. People with anxiety disorders affect their life in major ways and impair their functionality.

Types of anxiety disorders include:

• Generalized anxiety disorder: When someone struggles with a generalized anxiety disorder (GAD), they have a constant, ongoing level of stress about various things in their life that’s out of proportion to the actual situation. Worries and anxiety symptoms may be broad and include money, health, relationships, and other things.
• Social anxiety disorder: Also known as social phobia, it’s more than being shy when dealing with social anxiety disorder. You might have physical symptoms or avoid normal daily activities because of your fear of being around others with diagnosable social anxiety disorder. 
• Panic disorder: This mental disorder leads to significant, sudden, and unexpected physical symptoms like a pounding heart, sweating, choking, shortness of breath, and an impending sense of doom. For some people, severe panic attacks can feel like a heart attack.

Other anxiety disorders include obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

Using Alcohol to Cope with Anxiety

One relatively common thing is turning to substances to cope with the symptoms of a mental disorder like anxiety. People use alcohol to reduce stress and unwind. In the short term, alcohol is a depressant and sedative that slows your central nervous system.

Initially, drinking it can help reduce your anxiety, help you feel generally relaxed, and even give you a mood boost. Some of the effects of alcohol can be similar to certain anti-anxiety medications.

The relaxation you feel when you first drink may be due to your blood alcohol content rising. At first, you feel good as your BAC levels go up. Then, as those levels fall, you can feel depressed or more anxious than before. This can quickly lead to a vicious cycle culminating in potential alcohol addiction. 

Does Alcohol Cause Anxiety?

When you drink, it changes your brain neurotransmitters, including your levels of serotonin. According to the National Institute of Mental Health, those effects can worsen symptoms in people with anxiety disorders or lead to alcohol-induced anxiety when maybe you didn’t have it before. 

Long-term consequences of heavy drinking and alcohol abuse can include new or worsening mental health problems, including alcohol-induced or more intense anxiety. 

People with an alcohol use disorder, according to research, have difficulties recovering from traumatic events. This difficulty likely stems from the changes in brain activity that occur because of the alcohol itself.

Long-term alcohol abuse can put you at greater risk of anxiety disorders in some cases, among other negative consequences. 

There’s another potential relationship between excessive drinking and anxiety to be aware of too.

High anxiety levels are a symptom of alcohol withdrawal related to long-term excessive alcohol consumption. If you’ve been regularly consuming large amounts of alcohol and suddenly stop, you may have alcohol withdrawal-induced anxiety. Other withdrawal symptoms can include hallucinations, sweating, vomiting, seizures, and increased anxiety levels.

Hangover Anxiety

Even if you aren’t necessarily a regular or heavy drinker, alcohol-induced anxiety can occur in other ways. Namely, there’s the concept of so-called “hangxiety.”

When you have the symptoms of a hangover, you might have physical and psychological symptoms similar to mental health conditions, including anxiety.

There are likely multiple reasons for increased anxiety-like behaviors and feelings when you have a hangover.

One could be a social phobia. When you drink, it can help you feel more socially relaxed. Then, your social phobia symptoms can return once those effects wear off. You can feel worse when your physical hangover symptoms are paired with worsening social anxiety.

You might also feel more intense social phobia because you did things when drinking that embarrass you or you wouldn’t normally do. 

Another reason is that your body attempts to detox. If you drink heavily the night before, your body has to process that alcohol to remove it from your body. The detox period is like mild withdrawal and can include anxiety, nervousness, and restlessness.

Other reasons that anxiety can feel worse during a hangover include:

• Emotional withdrawal can occur when your endorphins, natural feel-good hormones, are coming down after drinking. Drinking can make them rise at first, but then they naturally decrease, leading to a potentially low mood, emotional disturbances, and anxiety. Some of the symptoms can be similar to depressive disorders. 
• Dehydration makes you urinate more than usual, and you’re probably not focusing as much on staying hydrated as you should. This can cause anxiety along with other mood changes.
• Folic acid deficiency can occur because of drinking, and low levels of the nutrient are associated with anxiety and depression.
• Certain medicines can interact negatively with alcohol increasing feelings of anxiety.
• When you drink, you may not get enough sleep or have poor sleep quality, which can cause anxiety and other mood changes.

Substance Abuse and Anxiety: Co-Occurring Disorders

Not everyone who drinks and experiences alcohol-induced anxiety has a co-occurring mental disorder, but some people do.

There are bidirectional relationships between substances and a mental disorder. 

• As discussed above, someone might try to self-medicate their anxiety symptoms with problematic drinking. 
• That can worsen their anxiety disorder and contribute to an alcohol use disorder or addictive behaviors. 
• There’s also evidence that alcohol abuse can contribute to developing a mental health disorder.
• The same brain areas tend to be affected by both substance use disorders and mental health disorders.
• When someone has a mental health disorder and a substance use disorder, it’s a co-occurring disorder.
• Co-occurring disorders need unique treatment. You can treat one without the other because the outcomes aren’t likely favorable. For example, if you treat someone’s alcoholism and not their anxiety disorder, they’re more likely to relapse than someone without comorbid anxiety. 

Co-occurring disorder treatment is specialized and holistic so that both problems are dealt with individually and in the context of one another. If someone receives proper treatment for an anxiety disorder, they’re less likely to return to the use of alcohol to self-medicate.

Substance Abuse Treatment in the SF Bay Area

Effective treatments for co-occurring anxiety in alcohol-dependent patients usually include behavioral therapy, medication, and ongoing participation in something like a 12-step therapy such as Alcoholics Anonymous. According to research in the American Journal of Psychiatry, treatment of anxiety disorders might occur in a group or individual setting. 

If you’d like to learn about treatment for substance use disorder, reach out to Silicon Valley Recovery today at 408-547-4089. Our team can provide compassionate but informative answers about treating alcoholism and drug abuse.