Anxiety is one of the most common mental health conditions worldwide. At the same time, alcohol remains one of the most widely used (and often misused) substances. Many people turn to alcohol to ease anxiety symptoms, using it as a quick fix to calm nerves or cope with stressful situations.
However, the relationship between alcohol and anxiety is far from simple. While alcohol might offer temporary relief, it often worsens anxiety in the long run and can even trigger it. Understanding the complex relationship between alcohol use disorder and anxiety disorders is essential for anyone struggling with either (or both) types of conditions.
Alcohol and anxiety have a bidirectional relationship. One can influence or worsen the other. For some, anxiety can drive increased alcohol use. For others, chronic alcohol use can lead to anxiety symptoms.
It’s not uncommon for people with anxiety disorders to use alcohol as a form of self-medication. This approach might offer short-term relief. But over time, this can lead to increased tolerance, dependence, and worsening anxiety. In fact, studies show that people with anxiety disorders are more likely to develop alcohol use disorder (AUD), and vice versa. What begins as a casual drink to relax can gradually turn into a dependency that fuels worsening mental health.
How Alcohol Affects the Brain and Nervous System?
Alcohol is a central nervous system (CNS) depressant. This means it slows down brain activity and impairs various functions in the brain and body. This makes it a popular choice for self-medication, as people experience a temporary easing of anxiety and may feel more sociable.
When someone drinks, alcohol affects the neurotransmitters in their brain. These are chemical messengers that help regulate mood, stress, and emotion. Alcohol temporarily enhances the effect of gamma-aminobutyric acid (GABA), a neurotransmitter responsible for producing calming effects. This is why people often feel more relaxed, less inhibited, and temporarily less anxious after a few drinks.
However, alcohol also reduces the activity of glutamate, a neurotransmitter involved in alertness, memory, and brain function. This can lead to poor cognitive performance and increased sedation. People may also experience lapses in memory during periods of drinking.
Over time, the brain adapts to these chemical changes by reducing its own production of GABA and increasing glutamate activity. This imbalance becomes problematic when the person stops drinking, as the brain struggles to regain balance without the presence of alcohol. This may result in increased anxiety, agitation, and other undesirable mental health outcomes.
Can Alcohol Cause Anxiety?
Yes. Alcohol can cause anxiety, both directly and indirectly. While moderate alcohol use may not affect everyone the same way, excessive or chronic alcohol consumption often contributes to anxiety disorders.
Here are a few ways alcohol can lead to anxiety:
- Neurochemical changes: As mentioned, alcohol disrupts the brain’s balance of neurotransmitters. When alcohol leaves the system, people may experience increased anxiety.
- Sleep disruption: Alcohol interferes with sleep cycles and REM sleep, which are critical for mental health. Poor sleep is strongly linked to increased anxiety levels.
- Withdrawal symptoms: Anxiety is a hallmark symptom of alcohol withdrawal, even after short-term use.
- Hangovers: The physical and psychological effects of a hangover (such as dehydration, fatigue, and low blood sugar) can mimic or intensify anxiety symptoms.
- Increased stress sensitivity: Long-term alcohol use can make individuals more sensitive to stress, creating a cycle of worsening anxiety.
Using Alcohol to Cope with Anxiety: A Vicious Cycle
One of the most concerning aspects of the relationship between alcohol and anxiety is the vicious cycle they can create. Here’s how the cycle may play out for someone with anxiety:
- Anxiety or stress triggers drinking: Someone may drink to “take the edge off” or temporarily feel more comfortable in social situations.
- Temporary relief is followed by a rebound effect: Once the alcohol wears off, anxiety returns—often more intensely.
- Increased anxiety leads to more drinking: To cope with the rebound effect or withdrawal, the person drinks again.
- Tolerance builds: Over time, more alcohol is needed to achieve the desired calming effect.
- Dependence and worsening anxiety develop: The person may become both physically and emotionally reliant on alcohol. Their anxiety may become more severe, as they’re now reliant on an addictive substance that may not always be available or offer inconsistent levels of effectiveness.
The cycle of addiction is particularly dangerous to people with anxiety, because it masks the underlying anxiety while feeding the development of substance use disorder.
Co-Occurring Disorders: When Anxiety and Alcohol Use Disorder Coexist
When someone has both an anxiety disorder and alcohol use disorder, they are said to have co-occurring disorders. Individuals dealing with addiction and mental illness often face greater challenges in recovery, as each condition can worsen the other.
Common co-occurring disorders that coincide with alcohol use disorder include:
- Generalized Anxiety Disorder (GAD)
- Social Anxiety Disorder
- Panic Disorder
- Post-Traumatic Stress Disorder (PTSD)
Dual diagnosis treatment addresses both the anxiety disorder and the substance use disorder at the same time. Ignoring one condition can lead to relapse or ongoing mental health struggles.
The Role of Withdrawal and Hangovers in Anxiety
Even occasional drinkers can experience heightened anxiety during hangovers. Known as “hangxiety,” this condition refers to the anxious feelings that follow a night of drinking. Symptoms include racing thoughts, panic, guilt, and irritability that often last into the next day.
For those with alcohol dependence, withdrawal symptoms can be far more intense. Withdrawal-related anxiety can begin as soon as a few hours after the last drink, and may include:
- Restlessness
- Increased heart rate
- Tremors
- Panic attacks
- Insomnia
In severe cases, withdrawal can lead to delirium tremens (DTs). This is a potentially life-threatening condition marked by extreme confusion, hallucinations, and agitation in addition to potentially dangerous physical effects.
Risk Factors for Developing Both Anxiety and Alcohol Issues
Not everyone who experiences anxiety or drinks alcohol will develop a problem with co-occurring disorders. However, certain factors increase the risk of co-occurring anxiety and alcohol use disorders:
- Genetics: A family history of either condition increases the likelihood of developing both.
- Trauma: Childhood trauma, abuse, or PTSD can lead to anxiety and alcohol use as a coping mechanism.
- Environment: Stressful home, work, or social environments can contribute to mental health challenges and risky drinking behaviors.
- Personality traits: Individuals who are highly sensitive, perfectionistic, or socially inhibited may be more prone to anxiety and alcohol misuse.
- Gender: Women are more likely to experience anxiety disorders, while men are more likely to use alcohol to cope (although both genders are at risk).
Treatment Options for Co-Occurring Anxiety and Alcohol Use
Effective treatment for co-occurring anxiety and alcohol use disorder requires a comprehensive, integrated approach. Some of the most common treatment options include:
- Medical Detox: For individuals with physical dependence on alcohol, medically supervised detox is often the first step to safely manage withdrawal symptoms.
- Dual Diagnosis Rehab Programs: These treatment programs treat both anxiety and addiction simultaneously using evidence-based therapies.
- Cognitive Behavioral Therapy (CBT): CBT is one of the most effective therapies for both anxiety and substance use. It helps individuals identify negative thought patterns and develop healthier coping strategies.
- Medication: In some cases, non-addictive medications such as SSRIs or SNRIs may be prescribed to treat anxiety.
- Support Groups: Peer support groups like Alcoholics Anonymous (AA) or SMART Recovery can provide ongoing encouragement and community.
- Mindfulness and Holistic Therapies: Yoga, meditation, breathwork, and other mindfulness techniques can help reduce anxiety and promote sobriety.
Strategies for Managing Anxiety Without Alcohol
Learning to manage anxiety without turning to alcohol is essential for long-term health and recovery. Healthy coping strategies include:
- Regular exercise: Physical activity is proven to reduce anxiety and boost mood.
- Sleep hygiene: Establish a consistent sleep schedule and avoid alcohol or caffeine before bed.
- Therapy: Work with a mental health professional to explore the root causes of anxiety and learn effective coping skills.
- Mindfulness: Practicing mindfulness techniques can reduce anxious thoughts and increase emotional regulation.
- Breathing techniques: Deep breathing exercises help calm the nervous system during moments of anxiety.
- Limit caffeine and sugar: These substances can worsen anxiety symptoms in some individuals.
- Stay connected: Talking with trusted friends or joining support groups can reduce feelings of isolation and anxiety.
Receive Help for Anxiety and Alcohol Addiction at Agape Treatment
At Agape Treatment Center, we understand the unique challenges of living with both anxiety and alcohol use disorder. Our compassionate, integrated approach ensures that both conditions are treated simultaneously, helping clients sustain their recovery.
Our programs include:
- Dual diagnosis treatment
- Individual and group therapy
- Medication management
- Holistic and evidence-based therapies
- Aftercare planning and relapse prevention
Whether you’re struggling with social anxiety and binge drinking, panic attacks and alcohol withdrawal, or anything in between, you’re not alone. At Agape Treatment, healing begins with connection, compassion, and the right clinical support. Contact Agape Treatment Center today to learn more.
Stephanie Robilio is an accomplished Clinical Director at Agape Behavioral Healthcare. With a Master of Social Work degree, LCSW license, and extensive training in Rapid Resolution Therapy under her belt, she brings a wealth of expertise to her role. Her unique combination of education and experience allows her to provide exceptional care to clients and lead her team with confidence. Stephanie’s joy comes from witnessing the moments when her patients creatively connect the dots and bravely move toward reclaiming their power. Her purpose is to help individuals understand their past so they can create a future full of hope, growth, and success. Stephanie attributes a large portion of her success to the supportive culture and strong sense of community fostered by the Agape team.
