The Connection Between Alcohol and Anxiety

By Geoffrey A. Booth, M.D., Medical Director, Rehabs Malibu

Everyone feels stressed out on occasion. Stress, worry, and fear are powerful yet common emotions that color each of our daily lives to some extent. We worry about relationships, about our finances, about catching Covid, and about our careers. It seems there is always plenty to fret about.

When we are plagued with anxiety on a consistent basis, we are probably dealing with an anxiety disorder. Anxiety disorders tend to feature feelings of irrational fear that can interfere with our quality of life. People struggling with daily anxiety may seek out unhealthy coping methods to help manage the stressful emotions. One of these self-medicating methods is using alcohol in the hope of calming nerves.

Alcohol has relaxing properties, and acts as a depressant on the central nervous system. When we ingest alcohol, it interacts with brain receptors and suppresses nerve pathway activity. Someone who struggles with stress or insomnia may drink alcohol to try to induce sleep, although alcohol ultimately interferes with the circadian cycle.

Alcohol is widely misused as a way to self-medicate feelings of anxiety. People facing an upcoming situation that is causing anxiety will have a few drinks before the event. This because problematic when stress is a daily reality and alcohol becomes the go-to remedy.

Too often, when alcohol is used to self-medicate mental health disorders like anxiety, a secondary disorder can later develop. Hence, someone who initially had anxiety disorder ends up with both anxiety disorder and co-occurring alcohol use disorder. However, it is also true that drinking alcohol can induce feelings of anxiety.

Learning healthy coping skills to help manage stress and anxiety is the answer. There are several techniques that can be utilized to help mitigate the effects of stress, without the need for alcohol.

Anxiety and Co-Occurring Alcohol Abuse

The symptoms of anxiety, such as the rush of fear, sweaty palms, shallow breathing, and pounding heart, are nature’s way of communicating to us that something dangerous or threatening is present. This “fight or flight” response is part of our hardwiring, prompting humans to confront the threat or to get away quickly.

Anxiety is also a mainstay of our busy, stressful culture. Learning healthy ways to process stressful situations is essential. Some people, though, may access certain coping skills that are not only ineffective but can also be harmful. Alcohol use is one of these.

Because alcohol is readily available and inexpensive, it is often accessed as a means to quiet down feelings of stress and anxiety. While it may seem harmless to have a couple of drinks after a stressful day at work, for some people this seemingly innocuous habit can trigger an alcohol use disorder.

Interestingly, data show that more women than men turn to alcohol to self-medicate an anxiety disorder with alcohol. According to a analysis published in Alcohol Research Current Reviews, not only are the comorbid disorders very prevalent in women, but evidence points to more women using alcohol to self-medicate anxiety symptoms than men.

The irony is that alcohol actually makes anxiety worse. Although there may be a temporary sense of relaxation caused by the alcohol, the alcohol ends up creating a boomerang effect as it is metabolized. The person ends up experiencing even more anxiety.

Types of Anxiety

There are certain types of anxiety of which the sufferers tend to gravitate toward alcohol abuse. These include:

Social anxiety: Someone with social anxiety disorder has an intense fear of social interactions. This can include fearing simple activities like eating a meal in public, or a social situation where there is extreme fear of being judged, such as public speaking. Symptoms include nausea, shaking, and racing heart.

According to an article by Book and Randall, “Social Anxiety Disorder and Alcohol Use,” the authors found that 20% of those who suffer from social anxiety disorder also have a co-occurring alcohol use disorder. For those who dread the prospect of being scrutinized or criticized publically, turning to alcohol becomes a coping tool, unless they avoid the situation altogether.

Panic disorder: When someone initially experiences a panic attack, they may seek medical attention thinking they might be having a heart attack. Symptoms include chest tightness or pain, shaking, palpitations, dizziness, abdominal distress, and sweating. When the symptoms of panic emerge, the person may immediately seek out alcohol as a means of quieting down the stress response.

Generalized anxiety disorder. Someone with GED experiences a heightened sense of anxiety throughout the day. Small triggers can cause a flood of adrenaline and cortisol. Symptoms of GED include irrational worrying and fear, irritability, insomnia, moodiness, stomach distress, nausea, trembling, trouble concentrating. People with GED that lean on alcohol to help control the stress symptoms have a heightened risk of developing an alcohol use disorder, because the anxiety symptoms are more pervasive in general.

Does Alcohol Cause Anxiety?

It is ironic that people try to reduce anxiety with alcohol, yet end up feeling more anxious. The University of North Carolina School of Medicine found that chronic high alcohol consumption alters brain pathways. The study demonstrates that heavy drinking opens someone up to anxiety due to a molecular connection between anxiety and alcoholism. This can impact how someone with a history of alcoholism recovers from a traumatic event, potentially impairing the critical mechanism relied on to overcome the trauma.

It’s true that heavy drinking can trigger symptoms of anxiety. There are many ways the effects of alcohol can make you feel anxious. These include:

• Drinking can cause your heart rate to increase, and that can make you feel like you are having a heart issue.
• Drinking can make you dehydrated, which causes nausea, weakness, and feeling lightheaded.
• Drinking can cause you to feel hyper or manic, making you feel shaky and then causing sleep problems.
• Drinking causes low blood sugar, leaving you feeling dizzy, weak, confused, and anxious.

If an alcohol use disorder has developed alongside the anxiety disorder, it is essential for the person to pursue addiction recovery. A dual diagnosis treatment program will provide on-site detox and withdrawal and a comprehensive addiction recovery program.

Relaxation Techniques to Help Anxiety

Stress is a significant trigger for alcohol abuse. To reduce that risk, it is essential that individuals learn to practice activities that can quickly help reduce feelings of anxiety or stress. Holistic therapies can help manage anxiety throughout the day. There are a wide variety of relaxation-inducing activities that can be easily accessed. These might include:

• Yoga classes
• Deep breathing techniques
• Massage therapy
• Aromatherapy
• Acupuncture
• Mindfulness
• Equine therapy
• Gardening
• Art therapy
• Journaling
• Meditation

In addition to engaging in these stress-reducing activities, it is also important to establish healthy lifestyle habits. Getting adequate sleep, eating a nutritious diet, and making sure to incorporate regular exercise into your routine will all help to reduce anxiety symptoms.

About the Author

Geoffrey A. Booth, M.D. is the Medical Director of Rehabs Malibu, an exclusive rehabilitation program located in the heart of Malibu. Dr. Booth has treated thousands of addicts over the years and now has dedicated most of his clinical time to providing medical care and detoxification to clients who suffer from substance abuse. He is committed to helping them establish the foundations for long-term sobriety. While not working, Dr. Booth has a rich personal life filled with activities surrounded by friends and family.