The Relationship Between Anxiety and Alcohol Use

It’s really important to be aware of the connection between alcohol use and anxiety. It’s an issue affecting many people and understanding how the two are linked supports people to look after themselves as well as those close to them.

In the UK, there are over 8 million people living with anxiety.[1] The fact that comorbid anxiety disorder and alcoholism is common means that it’s a real risk in relation to future health and well-being outcomes.

Treatment options are available and are especially effective when received at a private rehab clinic.

The link between alcohol and anxiety

There’s a huge amount of research that demonstrates the link between alcohol use and co-occurring anxiety. As with many dual diagnoses, mental health conditions can both lead to, and also be caused by substance use.

What exactly is anxiety?

It’s unhelpful that so many people throw around the term “anxiety” without much understanding of what it actually is. Doing so creates a space of misunderstanding in the wider society.

There’s also the point that in some instances, a feeling of anxiety can be quite healthy (i.e. for a student sitting an exam).

As a true medical condition, the symptoms of anxiety can be debilitating and have a seriously negative impact on a person’s life. There are various forms of anxiety and it’s useful to know what they are whether for you or someone you care about.

• Generalised anxiety disorder: this is characterised by a constant feeling of stress, worry, and feelings of overwhelm. For some it presents as a sense of doom looming over everything. It can stop people from taking part in particular activities. Some people experience high functioning anxiety, where on the face of things they’re coping well but underneath they’re living with serious anxiety which might, for instance, look “organised” but it’s actually a form of hypervigilance.
• Panic disorder: people who suffer with this will experience regular panic attacks, which can be severe and extremely distressing. There are very physical symptoms during an episode including a racing heart, heart palpitations, shortness of breath, sweating, and tingling fingers. In fact, symptoms can be so pronounced that panic attacks can be mistaken for heart attacks.
• Social anxiety disorder: this is where a person develops severe anxiety around social situations. They might feel nervous, experience feelings of doom, and nausea, and might have panic attacks. Actually, the condition can even lead to the development of a social phobia such as agoraphobia.

Tips for managing anxiety

While it’s advisable to see a healthcare professional if you’re living with a mental health condition, there are various things you can do to help manage symptoms of anxiety.

• Eat a balanced diet ensuring you get your vitamins and minerals.
• Cut down on processed foods and sugary drinks.
• Reduce alcohol and substance use.
• Cut out caffeine (which can lead to heart palpitations and feelings similar to anxiety).
• Create a bedtime routine that supports relaxation so you can fall asleep easier.
• Exercise; walking, running, swimming, and cycling are great options.
• Connect to nature; the woods and the ocean are particularly relaxing.
• Practise relaxing activities such as yoga, tai chi, guided meditations, or treat yourself to a massage.

What is Alcohol Use Disorder?

Alcohol use disorder (AUD) is where a person has developed problematic drinking or heavy drinking to the point where they’re unable to regain control of their habit. This is despite the negative consequences rippling through their life.

In the most severe cases, the person can develop alcohol dependence where they need alcohol, and removing it is dangerous unless supported through a medically-assisted detox.

This is because the effects of alcohol change the balance of GABA amino acid in the brain and as alcohol starts to deplete, seizures can occur.

Alcohol as a self-medication tool for anxiety

Anxiety puts an enormous strain on your central nervous system (CNS) causing your brain to release stress hormones. Living with anxiety long-term can be especially exhausting as it keeps you in a heightened state of arousal where you feel stressed, scared, and worried.

In the medical field, doctors prescribe selective serotonin reuptake inhibitors (SSRIs) which are used in antidepressant therapy, and benzodiazepines (i.e. diazepam) to treat anxiety. These have the effect of calming the CNS so that the patient can relax.

Now, if a person is suffering from anxiety but doesn’t go to the doctor, which can be quite common, they might discover that alcohol relaxes them. It’s a depressant after all.

Some of the side effects of alcohol can actually be quite similar to benzodiazepines. If a person drinks and feels this helps to reduce feelings of anxiety they can be more likely to return to drink and use alcohol again as a self-medication tool.

The problem with alcohol, however, is that it comes with a host of effects that can increase levels of anxiety and actually cause it. One prime example is known as the rebound effect.

This is where feelings of depression and anxiety bounce back worse after drinking. What happens then? People repeat the action; returning to alcohol to try and reduce anxiety, and so a cycle begins, which for some can lead to addiction and/or alcohol dependency.

What the statistics say about alcohol use disorder and anxiety

In 2020, the Guardian reported an “explosion” of anxiety in the UK.[2]  At the time it cited various reasons linked to Brexit and financial austerity, and we know that the worldwide pandemic will have an impact. Now, we have the cost of living crisis, so it seems inevitable that anxiety conditions are here to stay.

Every week in the UK, Mind (the mental health charity) reports that 6 in 100 people are diagnosed with generalised anxiety and 2 in 100 with phobias.[3]. As mentioned earlier, over 8 million people have anxiety in the UK.

Research shows that “20 percent of people with a social anxiety disorder also suffer from alcohol abuse or dependence”.[4]

It’s also been reported that anxiety and AUD “co-occurred about two to three times as often as would be expected by chance alone”. This same study revealed that 21.9% of people reported self-medicating with alcohol and other substances to manage anxiety.[5]

Of course, when people use substances to manage anxiety, this can lead to addictive disorders

Alcoholism and anxiety as a co-morbid condition

Many people on entering rehabilitation will discover (or might already suspect and have it confirmed) that they have a comorbid condition or dual diagnosis.

In this case, it would mean they are living with alcohol addiction and anxiety. It’s common that people in this situation won’t be able to identify what came first.

Sometimes it’s clear that a person first had anxiety and started using alcohol to manage symptoms. Doing so regularly then led on to the development of an alcohol use disorder.

The risk factors associated with using alcohol to manage anxiety can be increased if a person is reserved about contacting healthcare professionals in relation to their mental health (i.e. anxiety). Sadly, developing an addiction introduces the need for more healthcare professionals than originally necessary.

In other cases, a person might have started using alcohol which led on to the development of anxiety. One way alcohol use can lead to anxiety is shown through the state regularly referred to by drinkers as “Hangxiety”.

This is when after drinking, you feel unsettled or anxious. This is linked to a depletion in the brain chemicals, dopamine (the “pleasure” chemical) and GABA amino acid (which helps you feel relaxed).

In private rehab clinics, whether anxiety or addiction developed first, you’ll be treated in light of both but with a focus on addiction.

Does alcohol cause or exacerbate pre-existing anxiety?

Alcohol can both cause anxiety and increase your pre-existing anxiety level. While many people use alcohol to manage stressful emotions, events, or triggers and might think it can help initially, it’s usually not long before the truth of the matter sets in.

Sadly for some, this might turn to excessive drinking in a bid to manage anxious symptoms but of course this worsens the situation as it makes anxiety more severe and also leads to addictive behaviours.

Ultimately, the best way to treat anxiety is by looking after your physical, emotional, and mental health through exercise, healthy eating, and positive activities. If you’re struggling at this point, it’s advisable to see your GP who can prescribe medication and make other recommendations.

How alcohol use is linked to panic attacks

Alcohol is a psychoactive substance. What this means is that is directly impacts various parts of your brain and how it functions. One of the most significant ways you’re affected is in how alcohol intake affects the release, balance, and growth of brain chemicals and also hormones.

As well as altering your balance of dopamine, serotonin, and GABA, which are brain chemicals that all regulate your mood, alcohol abuse also alters the hormones released from your thyroid that help regulates emotions.

With all of these imbalances, your risk of alcohol-related problems linked to mental and emotional health is vastly increased. This is especially seen in the case of anxiety and the development of panic attacks.

Treating alcohol use disorder and anxiety

If you’re living with an alcohol use disorder and anxiety, there is support and treatment available. In fact, it’s important you get help for both conditions as managing both greatly improve your future prospects in relation to your physical and mental health, both of which are important.

There are various places you can go for support in the community ranging from Alcoholics Anonymous groups, SMART recovery groups, to accessing the drug and alcohol services provided through the NHS.

However, the most effective alcoholism treatments and programmes are offered at private rehab clinics. There you get a tailored treatment package so your specific needs are met.

Rehab clinics offer a range of approaches including psychotherapies, holistic therapies, relapse prevention therapy, and 12 Step therapy groups. Many clinics offer specialist support for concurrent alcoholism with other mental health conditions so you’ll get the care you need.

Medications used in alcohol addiction and anxiety treatment

In the UK, there are various medications used in the treatment of alcohol addiction and to reduce feelings of anxiety. Some of these can overlap and be used to treat both.

Whether at a private rehab or through the NHS, you might be prescribed the following:

• Selective serotonin reuptake inhibitors (SSRIs) are antidepressants for mood disorders and prescribed for both depression and anxiety.
• Benzodiazepines. The most commonly prescribed in the UK is diazepam (also known as Valium) used in the treatment of anxiety disorders.
• Librium is used to treat alcohol dependency. It manages withdrawal symptoms so that you don’t experience seizures (which can be fatal). A Librium-based detox lasts between seven to ten days at a rehab clinic after which you’ll be alcohol-free.

Psychotherapies for alcohol use disorder and anxiety

At rehab clinics, there are various psychological interventions used to treat residents.

The main therapy used is cognitive behavioural therapy (CBT), which is an evidence-based approach meaning that it’s proven to be successful at treating addiction and anxiety. It’s widely used throughout the NHS, private clinics, and actually beyond the UK is used throughout the world.

In private rehabilitation clinics, other psychotherapies that are used include motivational enhancement therapy, which has a focus on exploring your ambivalence around alcohol use and recovery. From this point, you develop self-awareness around your alcohol use and find your fuel for change.

Another therapy used at rehab clinics is Dialectical behavioural therapy. This is offered to people who find it especially difficult to manage their emotions. It can sometimes be useful where anxious symptoms are present. The on-site psychologist would assess you to see if this is appropriate for your needs.

To find out more about what rehab clinics are available near you, contact the Rehab 4 Alcoholism team today.

FAQs

How do you stop anxiety after drinking alcohol?

Alcohol-induced anxiety is caused by the imbalance of brain chemicals and hormones that has occurred.

The best way to stop anxiety is to practise grounding techniques, and breathing exercises, and take part in relaxing activities.

You’ll also need to replenish vitamins and minerals by eating nutritious food and drinking water. Avoiding alcohol is advisable.

Can drinking alcohol every night cause anxiety?

Drinking alcohol every night can lead to anxiety. Alcohol upsets the balance of GABA (an amino acid), dopamine, and serotonin in your brain; these are the chemicals that help you feel relaxed and happy.

Does alcohol cause anxiety and depression?

Alcohol can cause anxiety and depression because of how it affects your brain chemicals and the hormones in your body that regulate feelings and emotions.

References

[1] https://mentalhealth-uk.org/help-and-information/conditions/anxiety-disorders/what-is-anxiety/ 

[2] https://www.theguardian.com/society/2020/sep/14/uk-has-experienced-explosion-in-anxiety-since-2008-study-finds

[3] https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/#:~:text=In%20any%20given%20week%20in%20England%20%5B2%5D%3A,PTSD)%3A%204%20in%20100%20people

[4] https://adaa.org/understanding-anxiety/social-anxiety-disorder/social-anxiety-and-alcohol-abuse#:~:text=About%2020%20percent%20of%20people,a%20stronger%20connection%20among%20women.

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860396/

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