Alcohol and Anxiety
What is Anxiety?
Anxiety is an emotion everyone experiences at one point or another. For example, you may feel nervous before speaking in front of a crowd, starting a new job, or find yourself worrying while stuck in traffic. In certain situations, these anxious feelings can be helpful, such as motivating you to be prepared or alerting you to be extra cautious. However, when fear and distress become overwhelming and those feelings alter from helpful to harmful, an anxiety disorder may be the cause. 3
More than 40 million adults have an anxiety disorder, making it the most common health concern in the United States. 3 There are many types of anxiety disorders, with varying symptoms. All are characterized by having persistent, excessive fear or worry in situations that are not threatening.3
The most common types of anxiety disorders include:
Generalized Anxiety Disorder (GAD)
Someone diagnosed with GAD may experience long periods of ongoing anxiety. The constant worry impacts their daily life and interferes with their ability to function.4
A panic attack is a sudden onset of intense anxiety. Panic disorder occurs by having reoccurring panic attacks that often happen without warning. People fear they may be having a heart attack when they experience a panic attack. They struggle to breathe, their heartbeats fast, they may feel light-headed or dizzy.5
Social Anxiety Disorder
Social anxiety disorder is more than just being shy. 6 People with this disorder often have looming fears of being judged, humiliated, or rejected. Those struggling with social anxiety disorder find social interactions such as going to school, working, and dating difficult.6
It’s not uncommon to avoid something that scares you. But for someone with a phobia, certain places, events, or objects can create intense feelings of irrational fear. People with specific phobias work hard to avoid any triggers and this attempt to control fear can consume their everyday life. 3
Causes of Anxiety Disorders
Research indicates a combination of factors may play a role in causing anxiety disorder. These risk factors may include3:
- Genetics. Anxiety can “run in the family.” Some families may have a higher-than-average amount of anxiety disorders among relatives.
- Environmental. This may include a traumatic or stressful event, death of a loved one, or a diagnosis of a serious illness.
- Medication. Anxiety may be a side effect of certain medications.
- Drugs and alcohol. Drug and alcohol misuse or withdrawal may worsen or cause anxiety.
Can Alcohol Cause Anxiety?
Anxiety disorders commonly co-occur with alcohol use disorder. 1 People who misuse alcohol to the extent that they cannot control their alcohol consumption, despite the negative consequences may be diagnosed with an Alcohol Use Disorder (AUD). 9
But determining which came first is a bit more difficult. Some studies indicate individuals who have a co-occurring anxiety disorder and alcohol use disorder report they had issues with alcohol misuse prior to developing issues with anxiety.1
Conversely, studies have also shown that many people use alcohol to cope with anxiety disorders or relieve symptoms of anxiety.12 Over time, this may develop into an alcohol use disorder.
That each disorder can influence the other suggests the relationship between anxiety and substance use disorders is more complex, and the two disorders are interrelated.1 According to this model, individuals who develop an anxiety disorder are at an increased risk of developing an alcohol use disorder and vice versa. 1 Regardless of which disorder came first, research suggests these disorders can fuel each other and progress to dangerous levels if either of them is left untreated.
Treating Co-occurring Alcoholism and Anxiety
When someone has more than one mental health disorder, such as an anxiety disorder and an alcohol use disorder it is referred to as a dual diagnosis or co-occurring disorders.1
Because each condition influences the other, studies point toward the effectiveness of integrating care.11 The goal of integrated co-occurring disorder alongside alcohol rehab treatment is to help people learn how to maintain sobriety and manage the symptoms of their anxiety at the same time. Research has shown that people who participate in integrated treatment are more likely to stay sober, see a significant reduction of their symptoms, visit the hospital less often, live independently, maintain steady employment, and report feeling happier with their lives.11
Treatment for alcohol use disorder and co-occurring anxiety disorders will be uniquely tailored to an individual’s specific needs. Common types of treatment that can be directed toward treating either or both disorders include:7,8,11
- Psychotherapy or “talk therapy,” including cognitive behavioral therapy.
- Medications such as anti-anxiety medications and antidepressants.
- Complementary health approaches, including stress relief, exercise, meditation, and relaxation techniques.
If you are suffering from an alcohol use disorder and anxiety disorder, treating both disorders simultaneously at a qualified rehab facility can offer the necessary treatment toward a healthy recovery.
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- Smith, J.P., & Randall, C.L. (2012). Anxiety and alcohol use disorders: comorbidity and treatment considerations. Alcohol research: current reviews, 34(4), 414–431.
- Price J.S. (2003). Evolutionary aspects of anxiety disorders. Dialogues in clinical neuroscience, 5(3), 223–236.
- National Alliance on Mental Illness. (2017, December). Anxiety Disorders.
- National Institute of Mental Health. (2016). Generalized Anxiety Disorder: When worry gets out of control.
- National Institute of Mental Health. (2016). Panic Disorder: When fear overwhelms.
- National Institute of Mental Health. (n.d.). Social Anxiety Disorder: More than just shyness.
- National Institute of Mental Health. (n.d.).
- National Institute of Mental Health. (n.d.). Complementary Health Approaches.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5, Washington, D.C.: American Psychiatric Association.
- National Institute of Mental Health. (2020, May). Substance Use Disorder.
- Flynn, P.M., & Brown, B.S. (2008).Co-occurring disorders in substance abuse treatment: Issues and prospects. Journal of Substance Abuse Treatment, 34(1), 36-47.
- Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and anxiety, 35(9), 851–860.