AnxietyAlcohol and Anxiety: Understanding the Complex Relationship

Alcohol and Anxiety: Understanding the Complex Relationship

Alcohol use and anxiety have a complex relationship that has significant implications for mental health. Anxiety disorders are among the most common mental health problems, affecting large numbers of people worldwide. Alcohol is often used as a coping mechanism to reduce feelings of stress and anxiety. However, the relationship between alcohol use and anxiety is not straightforward; it is bidirectional, meaning that alcohol can both reduce and increase anxiety.

Understanding the relationship between alcohol and anxiety is crucial for effective management and treatment of both conditions. Regular use of alcohol can lead to changes in the brain that can worsen anxiety symptoms over time. Conversely, some people may begin to rely on alcohol to self-medicate the symptoms of an anxiety disorder, leading to a cycle of dependence and potentially worsening mental health outcomes. So while alcohol may provide temporary relief from anxiety, it can contribute to long-term anxiety disorders, creating a difficult cycle to break.

Key Takeaways

  • Alcohol can temporarily reduce anxiety, but can make it worse over time.
  • Using alcohol to self-medicate can lead to a cycle of dependence.
  • Effective management of both conditions is necessary for mental health.

Anxiety And Alcohol Overview

The interaction between anxiety and alcohol use is complex, often involving a vicious cycle where each can exacerbate the negative effects of the other. From the physical effects on the body to the psychological consequences, understanding this dynamic is crucial to managing both conditions.

Mild Detoxification

Detoxification from alcohol, even at low levels, can cause noticeable withdrawal symptoms. These symptoms may include anxiety, which is particularly pronounced in people with alcohol dependence. This form of anxiety can manifest itself as nervousness or restlessness as the body adjusts to the absence of alcohol, a known depressant.

Sleep Disruption

Regular alcohol consumption can disrupt normal sleep patterns and lead to sleep disorders. Although alcohol may initially cause drowsiness, it ultimately reduces sleep quality and can worsen conditions such as social anxiety disorder by increasing fatigue and stress.

Mineral Depletion

Alcohol use can lead to mineral depletion in the body, especially minerals that are essential for maintaining mental health and well-being. This depletion can contribute to anxiety symptoms and increase feelings of distress or inadequacy.

Poor Food Choices

Frequent alcohol consumption is often associated with poor dietary choices. The lack of nutrients and an unbalanced diet can further contribute to anxiety levels, creating a negative feedback loop that increases the risk of continued alcohol use and anxiety.


Alcohol is a diuretic and causes dehydration. Dehydration can worsen anxiety symptoms because it affects the body’s overall functioning and can increase feelings of unease or panic.

Social Embarrassment

Alcohol consumption can lead to behaviours that cause social embarrassment, which in turn can trigger or worsen anxiety, particularly in people with social anxiety disorder. Fear of further embarrassment can lead to a reluctance to engage in social situations, often isolating the individual.

Alcohol Allergy

In rare cases, individuals may experience an alcohol allergy with immediate physical symptoms that can cause anxiety. The potential for such reactions may cause a fear of alcohol consumption due to the unpredictability of these allergic reactions.

How Alcohol Impacts Anxiety

Alcohol consumption can have a significant impact on anxiety levels. While it may seem to relieve stress at first, regular or heavy drinking can worsen anxiety disorders over time by affecting neurotransmitter balance and brain health.

Be Aware Of Mixing Anxiety Medications And Alcohol

People with anxiety disorders often need medication to manage their symptoms. Mixing alcohol with anxiety medications can be counterproductive because alcohol alters the function of neurotransmitters, potentially reducing the effectiveness of the medication. For example, serotonin, a key neurotransmitter targeted by many anxiety medications, can be disrupted by alcohol use. It is important to understand that substances such as alcohol can affect the brain’s chemical balance, making it more difficult to treat and manage an anxiety disorder.

Some studies, such as the one observing mGlu5-dependent modulation of anxiety, highlight the negative impact of binge drinking on mood and anxiety levels, exacerbating symptoms of anxiety disorders during early withdrawal from excessive drinking. This research underlines the delicate balance required in managing both alcohol consumption and anxiety, particularly when stopping drinking can lead to increased anxiety.

Consequently, people experiencing withdrawal symptoms, such as delirium tremens, require careful management, which is further complicated by the complex relationship between alcohol and anxiety. Understanding how alcohol interacts with anxiety medications and neurotransmitter regulation can lead to better decisions for those seeking relief from anxiety disorders, ensuring that treatment strategies focus on safety and efficacy.

How Alcohol Can Cause Anxiety And Why You Shouldn’t Treat Anxiety With Alcohol

Alcohol can cause anxiety

Alcohol is often consumed for its initial calming effect on the central nervous system, but this can lead to tolerance and alcohol use disorder (AUD). Chronic alcohol use can cause physiological changes in the brain, such as altering neurotransmitter levels, which can increase susceptibility to anxiety. Drinking to relieve anxiety can backfire because alcohol changes the levels of serotonin and other neurotransmitters in the brain, which can make anxiety worse. When the alcohol wears off, you may experience heightened levels of anxiety and fear, often referred to as ‘hangxiety’, which can be quite distressing.

In addition, alcohol withdrawal can cause anxiety symptoms that may be mistaken for generalised anxiety disorder but are actually a consequence of dependence. These symptoms can include hallucinations and extreme anxiety during withdrawal. The discomfort of these symptoms often leads to a cycle of drinking to relieve the discomfort, which reinforces the dependence.

People who want to manage their anxiety should seek professional treatment, including therapies such as cognitive behavioural therapy (CBT) or medication, rather than self-medicating with alcohol. Therapy provides a safe environment to explore the roots of anxiety and develop healthier coping mechanisms. In summary, far from being a helpful solution, alcohol can often contribute to and exacerbate anxiety. Professional treatment is recommended to effectively address the dual challenges of anxiety and AUD.

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Managing Anxiety And Alcohol

A multifaceted approach is essential when addressing the co-occurrence of anxiety and alcohol use disorders. It is crucial to address both conditions simultaneously to ensure a comprehensive treatment plan.

For anxiety, methods such as cognitive behavioural therapy (CBT) have been shown to be effective. CBT helps people understand the relationship between thoughts, feelings and behaviours, and provides strategies for managing anxiety symptoms. These interventions focus on identifying triggers and developing coping mechanisms that do not involve alcohol use.

For alcohol use disorders, which may overlap with wider substance use disorders, medical and psychological interventions are often recommended. Seeking help from a doctor or mental health professional is important. They may suggest a combination of medication-assisted therapy, counselling and support groups to help with recovery.

In some cases, people may use alcohol to cope with anxiety, which can lead to a cycle of dependence. That’s why it’s important to seek therapy that addresses the underlying issues of anxiety, while also focusing on reducing alcohol use.

Finally, it is important to build a supportive network and make lifestyle changes that promote mental wellbeing. Practices such as regular exercise and mindfulness can enhance the effectiveness of treatment and help to manage both anxiety and alcohol problems.

Why People Use Alcohol For Anxiety

People often turn to alcohol as a means of coping with anxiety. Alcohol is a central nervous system depressant that can temporarily reduce the stress and physical symptoms of anxiety, providing an alluring sense of relief. Alcohol can trigger the release of neurotransmitters that produce a relaxing effect, attracting people who are seeking an escape from persistent anxious feelings.

However, this self-medication can lead to alcohol abuse, especially if you rely on it frequently to relax. The cycle often escalates to heavy drinking as tolerance builds and more alcohol is needed to achieve the same calming effect. This increased use can lead to a substance use disorder, in which individuals find themselves in a problematic pattern of alcohol use that becomes difficult to control.

It is important to recognise that while alcohol can provide a temporary respite, it often exacerbates anxiety over time. By drinking to cope, a short-term solution paves the way for long-term challenges, including an increase in anxiety symptoms once the alcohol wears off.

It’s important to consider healthier relaxation techniques, such as mindfulness or exercise, which can reduce anxiety without the risks associated with alcohol. Detailed insights into how different neurotransmitters affected by alcohol may contribute to addiction and its relationship with anxiety can be found in neurobiological and genetic studies.

Anxiety can also significantly impair social interactions, and for some, alcohol may temporarily facilitate these interactions. This coping mechanism is often seen in people with social anxiety disorder, where alcohol acts as a social lubricant, albeit a risky and potentially harmful one.

The relationship between alcohol and anxiety is complex and multifaceted, with the initial relief provided by alcohol masking the underlying risks and potential for addiction.

Frequently Asked Questions

This section aims to answer common questions about the complex relationship between alcohol and anxiety, providing evidence-based answers to deepen understanding.

Can drinking alcohol make anxiety symptoms worse?

Yes, drinking alcohol can certainly make anxiety symptoms worse. Although some people may experience temporary relief from anxiety when they drink alcohol, this is often followed by an increase in anxiety as the effects of alcohol wear off – a phenomenon supported by psychological and neurobiological perspectives.

What is the link between drinking and panic attacks?

The relationship between drinking and panic attacks is complex. For some people, alcohol can trigger the onset of a panic attack, particularly those with panic disorder. The sedative effects of alcohol can sometimes mask anxiety symptoms, but as alcohol is metabolised it can lead to increased panic and anxiety symptoms in susceptible individuals.

Are there long-term effects of alcohol on anxiety?

Long-term alcohol use can have a profound effect on anxiety levels. Chronic alcohol use is associated with an increased risk of developing persistent anxiety symptoms and can also alter brain chemistry and neurobiology, making a person more susceptible to anxiety disorders over time.

How does alcohol withdrawal affect anxiety disorders?

Alcohol withdrawal can have a significant impact on anxiety disorders by increasing anxiety symptoms. Withdrawal from alcohol can lead to acute anxiety, which is often a component of alcohol withdrawal syndrome. This can be particularly challenging for people with pre-existing anxiety disorders.

Can alcohol use lead to the development of an anxiety disorder?

There is some evidence that prolonged alcohol use may contribute to the development of an anxiety disorder. Alcohol can alter the balance of neurotransmitters in the brain, which can lead to changes in mood and behaviour and possibly trigger the onset of an anxiety disorder, especially in those with a predisposition.

Is there a difference in how alcohol affects anxiety between men and women?

Research suggests that there may be gender differences in how alcohol affects anxiety. Hormonal variations, differences in body composition and social factors may influence the susceptibility and response to anxiety and alcohol use in men and women. However, the relationship is complex and individual experiences can vary widely.


Research shows that alcohol use disorders (AUDs) and anxiety disorders often co-occur, with each exacerbating the other. People may use alcohol to cope with anxiety, leading to AUDs, while alcohol misuse may increase anxiety, creating a harmful cycle. Effective treatments address both AUDs and anxiety together, focusing on how they interact. Strategies that target neurotransmitter systems are promising and offer combined benefits.

For patients with both anxiety and alcohol dependence, a thorough assessment is key. Treatment should be multifaceted, including medications that address the underlying biology and reduce symptoms of both conditions. Successful treatment requires a holistic approach, combining psychological, behavioural and pharmacological methods. A well-rounded treatment plan is more likely to reduce the effects of AUDs and alleviate anxiety disorders.


  1. Mayo Clinic. “Social Anxiety Disorder: Symptoms and Causes.” Mayo Clinic. Link.
  2. National Center for Biotechnology Information. “Internet-Based Cognitive Behavioral Therapy for Social Anxiety Disorder: A Systematic Review and Meta-analysis.” PubMed Central, PMC6371787. Link.
  3. Anxiety and Depression Association of America. “Tips to Manage Anxiety and Stress.” ADAA. Link.
  4. National Center for Biotechnology Information. “Social Anxiety Disorder and Alcohol Use.” PubMed Central, PMC4065474. Link.
  5. Anxiety and Depression Association of America. “Social Anxiety Disorder and Alcohol Abuse.” ADAA. Link.
  6. National Center for Biotechnology Information. “The Relationship Between Social Anxiety Disorder and Alcohol Use Disorders: A Critical Review.” PubMed Central, PMC6927748. Link.

Mark Willson, holding a Ph.D., functions as a psychotherapist in Washington, D.C. His specialized fields encompass addiction, anxiety, depression, as well as sexuality and interpersonal connections. Dr. Willson holds the distinction of being a diplomat for the American Board of Addiction and Anxiety, further serving as a certified counselor and addiction specialist.

Aside from his personal professional endeavors, Dr. Wilson has engaged in roles as an author, journalist, and creator within substantial medical documentary projects.

Isabella Clark, Ph.D., held the position of a professor within Emory University’s School of Medicine, working in the Department of Mental Health and Nutrition Science. Alongside this role, she served as a research associate affiliated with the National Research Center. Dr. Clark’s primary area of research centers on comprehending the mechanisms through which adverse social encounters, encompassing prolonged stress and traumatic exposure, contribute to a spectrum of detrimental mental health consequences and coexisting physical ailments like obesity. Her specific focus lies in unraveling the reasons behind the varying elevated susceptibility to stress-linked disorders between different genders.


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