The Relationship Between Alcohol Use and Anxiety

Anxiety disorders are the most common mental illnesses in the United States, according to the Anxiety and Depression Association of America (ADAA). An estimated 40 million adults age 18 and older are struggling with some form of anxiety disorder, which equates to about 18 percent of the country.

Unfortunately, less than 40 percent of those with anxiety receive treatment for it. There are several reasons for this, including a lack of accessibility to professional mental health services. There’s a sense of shame or embarrassment because of the negative stigma that surrounds many mental health issues. Some people are unaware they are struggling with anxiety, especially if it co-occurs with another disorder, as it often does, including addiction.

In fact, the ADAA also reports that about 20 percent of people dealing with anxiety are also struggling with alcohol abuse or alcohol use disorder (AUD).

So do people with anxiety develop AUD by attempting to self-medicate? Or, can excessive alcohol use cause anxiety symptoms to manifest, even if someone did not have the disorder before abusing alcohol?

The Dangers of Self-Medicating

It is important to be aware that there are different types of anxiety. One is generalized anxiety disorder (GAD). This is a long-term condition in which a person will feel anxious as a response to a wide range of situations and will quickly replace one reason to feel worried with another.

Social anxiety is a more specific but also widespread form of anxiety. Rather than just being “shy,” social anxiety denotes an extreme phobia to the point where the idea of a social situation like a party is enough to send someone into a panic.

Many people will instead self-medicate their anxiety through substance use. Alcohol is a popular choice, in part, because it is a sedative. It depresses the central nervous system and negates some of the effects of anxiety. In fact, the ADAA also reports that roughly 20 percent of people with a social anxiety disorder are also dependent on alcohol.

For someone with anxiety, alcohol can make them feel as though they are more at ease as the sedative effects work against the feelings of anxiety. At first, alcohol can seem like a solution to the problem. It works similarly to the way an anti-anxiety medication would, making someone feel less shy. It also gives them a boost in mood and makes them feel more self-confident.

However, these supposed benefits are extremely short-lived. As these feelings fade, someone with anxiety may find themselves growing psychologically reliant on alcohol to feel at ease. They may drink more, becoming tolerant to alcohol’s effects and needing more of it to feel relaxed. Eventually, misuse and abuse can progress to a full-blown alcohol use disorder.

Anxiety and Drinking: a Vicious Cycle

Using alcohol to cope with the symptoms of anxiety can not only result in developing a substance use disorder but also will eventually only serve to worsen someone’s anxiety disorder. In fact, there is even such a thing as alcohol-induced anxiety, which can affect those who do not have an anxiety disorder.

Chronic alcohol use as a form of self-medication to cope with anxiety can worsen one’s anxiety disorder. It does this through cyclical behavior that encourages the individual to become more and more dependent on alcohol use to function. At the same, it makes it harder for the person to function. The process generally looks something like this:

  • A person drinks alcohol to relieve their anxiety.
  • They experience the initial calming effects it has on the brain.
  • As their body begins to process the alcohol, the anxiety rebounds as a symptom of withdrawal.
  • They drink again to relieve the rebound anxiety.
  • The cycle starts all over again.

It doesn’t help that rebound anxiety is generally even harder to deal with after alcohol use than the anxiety the alcohol was attempting to medicate in the first place.

In some cases, alcohol can even cause symptoms of anxiety to manifest in those without an anxiety disorder. This is, in part, because drinking in excess can induce feelings of anxiety on its own, to the point of even triggering a panic attack. Alcohol can significantly alter the levels of serotonin and other transmitters in the brain that directly affect mood, including symptoms that mirror those of an anxiety disorder.

Using alcohol to cope with anxiety may seem like it helps at first. However, it will quickly become more of a problem, and that’s without acknowledging all of the serious health consequences of chronic alcohol use.

Once someone has become dependent on alcohol and is also struggling with anxiety, the person will need to have both disorders treated concurrently so that they can successfully recover from either.

This is called dual diagnosis treatment, which gives the person the best chance to recover from either disorder. If someone instead gets treatment only for substance addiction or anxiety, neither treatment will stick. The individual will most likely relapse and go back to using alcohol to drown out feelings of anxiety.

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