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Alcohol And Anxiety Co-Occurring Mental Health Disorder

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Seeking Dual Diagnosis Treatment Centers NJ? Get real facts about how treating alcohol abuse and anxiety disorder at the same time, in your local Dual Diagnosis Center in New Jersey

By We Level Up NJ Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: November 3, 2022

The Link Between Anxiety And Alcohol

What Is Anxiety?

Anxiety is a feeling of dread, fear, and uneasiness. It is the feeling of worry about what’s going to happen. It might cause some physical symptoms like sweating, feeling restless and tense, and a rapid heartbeat. According to the National Institute of Health (NIH) [1], anxiety can be a normal stress reaction. For instance, you might feel anxious when faced with a difficult problem at work, before taking an exam, or before making an important decision. Occasional anxiety can be useful. It can help you to cope. Anxiety may help you focus or give you a boost of energy. But for individuals with anxiety disorders, the fear is not temporary and can be overwhelming.

What Is Anxiety Disorder?

Anxiety disorders are conditions in which a person has anxiety that does not go away and can get worse over a period of time. The symptoms can interfere with day-to-day activities such as schoolwork, job performance, and relationships. The cause of anxiety is unknown. Factors such as brain biology, genetics, chemistry, stress, and your environment may play a role. [2]

Anxiety Disorders And Alcohol Abuse

Alcohol consumption and anxiety problems frequently coexist in the same person. Dual diagnosis refers to this co-occurrence.

Many people may turn to binge drinking large amounts of alcohol due to anxiety. Additionally, drinking alcohol can cause people to feel more anxious both during and afterward.

In comparison to the general population, people with anxiety disorders are two to three times more likely to develop an alcohol or other drug misuse disorder at some point in their lives.

Alcohol Abuse Spectrum

Most people don’t usually worry about moderate alcohol usage. It is acceptable to have a glass of wine with dinner or a few drinks while out with friends. Alcohol and other drugs, on the other hand, can exacerbate the feelings of anxiety in those with anxiety disorders.

A medical diagnosis of “alcohol use disorder,” or AUD, is made when a person’s drinking problem is serious enough. Individuals must satisfy the following requirements in order to receive an AUD diagnosis:

  • Have moments when they drank more or for longer than they wanted to
  • More than four drinks every week
  • Consumption of five or more alcoholic beverages each day
  • Attempts to reduce or quit drinking are unsuccessful
  • Then spend a lot of time drinking or becoming sick
  • Drink on despite the problems it is inflicting on family or friends
  • Encounter significant needs or a strong need to consume
  • After drinking, experience feelings of regret or shame

Alcohol And Anxiety Statistics

You’re definitely familiar with the awful sensation that follows a night of binge drinking if you drink for long enough or hard enough. You might try to mentally relive the talks from the evening or go through your text messages to make sure you didn’t send anything you later regretted. Or perhaps you start mass-apologizing to friends and family right away.

While this can be a typical side effect of binge drinking, it could also indicate a more serious problem termed “hangxiety.”


21.9%

In the community, 21.9 percent of people with anxiety disorders supported using alcohol or drugs or both as self-medication.

Source: SAMHSA

6 million

6.8 million adult Americans, or 3.1% of the population, suffer from a generalized anxiety disorder, although only 43.2% get treatment.

Source: SAMHSA

15 million

15 million adult Americans, or 7.1% of the population, suffer from Social Anxiety Disorder.

Source: SAMHSA


8 Most Common Alcohol And Anxiety FAQs

  1. What Is The Connection Between Alcoholism And Anxiety?

    Anxiety and alcoholism. Serotonin and other neurotransmitter levels in the brain are altered by alcohol, which can exacerbate anxiety. In fact, once the alcohol wears off, you can feel even more worried. Anxiety brought on by alcohol might persist for several hours or even the entire day after drinking.

  2. Is It Dangerous To Mix Anxiety Meds And Alcohol?

    Alcohol and anxiety meds. It is advised to avoid consuming alcohol while taking an antidepressant. It can be harmful and it might make your symptoms worse. You can have increased anxiety or depression if you combine medications with alcohol.

  3. How Dangerous Is The Anxiety And Alcoholism Cycle?

    A person who is suffering from anxiety might think that a couple of drinks will help them relax.

    In fact, drinking alcohol can make an anxious person feel worse. Here’s an illustration of a typical cycle which includes a person drinks alcohol, initially feels calm as the alcohol affects the brain, then feel anxiety as a symptom of alcohol withdrawal as the body processes the alcohol, they may want to drink again to try to relieve their anxiety, but this only starts the process from the origin. As the initial calming effect disappears, the person can feel anxiety after quitting drinking alcohol build again as the effects wear off.

    Remember, the more alcohol consumed, the greater the tolerance will be. Over time there is a need to drink more alcohol to feel the same effects. Over time this may negatively affect mental health, resulting in a higher level of anxiety and depression after drinking. Anxiety disorder makes an individual start drinking alcohol, which worsens their anxiety, which leads them to drink more and worsens their anxiety further. It’s a never-ending vicious cycle of alcohol and anxiety.

  4. What Are Effective Ways To Provide Alcohol And Anxiety Relief?

    Some effective ways to provide alcohol and anxiety relief include don’t consume alcohol on an empty stomach, drinking water whenever you drink alcohol, slowing down during drinking, and putting a cap on it.

  5. Does Alcohol Cause Anxiety And Depression?

    Alcohol depression and anxiety. Alcohol is a depressant that alters the serotonin and dopamine levels in your brain which are naturally associated with happiness. This means that even while you’ll have an initial “boost” the night before, you’ll lack these same chemicals the next day, which could make you feel worried, sad, or depressed.

  6. How Does Alcohol Cause Depression And Anxiety?

    Alcohol is a depressant that alters the serotonin and dopamine levels in your brain which are naturally associated with happiness. This means that even while you’ll have an initial “boost” the night before, you’ll lack these same chemicals the next day, which could make you feel worried, sad, or depressed.

  7. Is Hydroxyzine For Anxiety And Alcohol Effective?

    Alcohol and hydroxyzine together increase the chance of adverse effects like sleepiness, making the combination potentially dangerous. In general, it’s advised to abstain from drinking when taking hydroxyzine.

  8. What Is An Effective Medication For Anxiety And Alcohol Withdrawal?

    By mimicking the effects of alcohol on the brain, benzos are used to alleviate the symptoms of alcohol withdrawal. The anti-anxiety effects of alcohol and benzodiazepines are comparable in their effects on the brain.

    As a result, benzodiazepines can essentially take the place of alcohol’s effects in the brain and lessen the likelihood of withdrawal symptoms. Your dose of a benzodiazepine may be gradually decreased over time after you start taking one for AWS in order to gradually wean off the drug while still preventing withdrawal symptoms.

    Because they start working rapidly and last a long time, benzodiazepines, particularly long-acting benzodiazepines, are the first-choice drugs to use for AWS. In terms of how they function in your body, they are also more predictable than other alternative AWS treatments. They are suggested as secure and reliable treatments for AWS.

What Are Anxiety And Depression?

Depression is different from anxiety. The World Health Organization (WHO) [2] describes depression as a low mood that lasts for most of the day, nearly every day, for at least two weeks. It can range from low spirits to feeling suicidal.

But depression and anxiety often go together. Feeling anxious and worrying constantly can make you feel low, and about half of people who suffer from depression also get attacks of anxiety.

Alcohol and Anxiety
Alcohol and anxiety can become a dangerous, self-perpetuating cycle.
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What Are The Types Of Anxiety Disorders?

Generalized Anxiety Disorder (GAD)

  • Individuals with GAD worry about common issues such as money, health, work, and family. But their worries are extreme and excessive, and they have them almost every day for at least 6 months.

Panic Disorder

  • Individuals with panic disorder have panic attacks. These are sudden, recurrent periods of intense fear when there is no danger. The attacks come on quickly and can last several minutes or more.
  • Some individuals feel like they are having a heart attack. Symptoms can include difficulty breathing, chest pain, heart palpitations, feelings of impending doom, and feeling like you’re out of control.

Social Anxiety Disorder (SAD)

  • Social Anxiety Disorder was previously referred to as a social phobia. This involves intense fear of social or performance situations such as public speaking. For example, a person with a social anxiety disorder may worry that their behaviors and feelings will be judged negatively by others or have an intense fear.

Obsessive-Compulsive Disorder (OCD) 

  • OCD may occasionally be categorized as an anxiety disorder. Common compulsions or worries that people may experience are what define the obsessive-compulsive disorder. These compulsions can become out of control to the point where they significantly stress a person out and interfere with other facets of their lives, such as obligations or activities.

Post-Traumatic Stress Disorder (PTSD)

  • PTSD may occasionally be categorized as an anxiety disorder. People frequently experience powerlessness, suicidal thoughts, aggressiveness, self-harm, sadness, and anxiety after a stressful event. Hallucinations, nightmares, and flashbacks are common symptoms of PTSD.

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What Are The Symptoms Of Anxiety Disorders?

The different types of anxiety disorders can have different symptoms. But they all have a combination of:

  • Anxious beliefs or thoughts that are difficult to control. They make you feel tense and restless and interfere with your day-to-day life. They do not go away and can get worse over time.
  • Physical symptoms, such as a pounding or rapid heartbeat, unexplained pains and aches, shortness of breath, and dizziness,
  • Changes in behavior, such as avoiding everyday activities you used to do

Who Is At Risk For Anxiety Disorders?

The risk factors for the different types of anxiety disorders may vary. For instance, GAD and phobias are more common in women, but social anxiety disorders affect men and women equally. There are some general risk factors for all types of anxiety disorders, including:

  • Certain personality traits, such as being withdrawn or shy when you are meeting new people or in new situations
  • Family history of anxiety or other mental disorders
  • Traumatic events in early childhood or adulthood
  • Some physical health conditions, such as arrhythmia or thyroid problems

Effects Of Alcohol And Anxiety

Alcohol functions as a sedative, so it can help the person feel more at ease. Also, it may make the person feel more socially confident at a party or help them forget worries.

Alcohol and Anxiety
Anxiety makes a person start drinking, which worsens their anxiety, which leads them to drink more and worsens their anxiety further. It’s a never-ending vicious cycle of alcohol abuse and anxiety.

However, these are short-term benefits. When a person drinks alcohol, it disturbs the balance of chemicals and processes in the brain. The relaxed feeling a person may experience during the first drink is because of the chemical changes alcohol causes in the brain. Alcohol works by depressing the part of the brain that we associate with inhibition.

But these effects wear off fast, and the pleasant feelings fade. If people rely on a substance like alcohol to mask anxiety problems, they may become dependent on it to relax, which can lead to alcohol addiction.

A possible side-effect of this is that the more a person drinks, the greater the tolerance for alcohol will be. Over a period of time, the person may need to drink more alcohol to get the same feeling. Thus, in the long term, this pattern of alcohol abuse may affect mental health.

Self-Medicating Alcohol And Anxiety Disorders

Anxiety is a disorder that attacks the central nervous system or CNS. It can increase blood flow, accelerate the heart rate, and push the brain into overdrive. In situations like extreme anxiety that need to be medically treated, doctors will typically prescribe benzodiazepines or benzo’s, as they are CNS depressants. However, the effects that make benzodiazepines helpful in these diagnoses are the same effects many experiences with alcohol.

In cases where a person cannot gain a prescription for their Anxiety Disorder, perhaps the doctor does not think it warrants a prescription or wants the client to try other methods to get their anxiety under control, the person suffering may resort to alcohol. This is also very common among people struggling with an anxiety disorder who either cannot afford therapy or are too embarrassed to seek it. While this may seem like it works in the beginning, in truth, the slight help that alcohol gives is short and temporary, and it comes with a great cost. According to the National Institute of Biotechnology Information (NCBI) [3], alcohol and benzodiazepines generate anxiety, panic, and phobias.

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Anxiety And Alcohol Disorders: Which Comes First?

Alcohol abusers with anxiety disorders frequently become trapped in a self-destructive cycle, making it difficult to determine which condition developed first. The signs of one condition might exacerbate the signs of another.

People with anxiety disorders may use alcohol self-medication to try and reduce their symptoms. In general, alcohol misuse usually emerges following the onset of an anxiety illness. But frequently, drinking alcohol can make anxiety feel worse.

Driving while intoxicated, missing out on routine tasks, and developing an alcohol addiction are all effects of alcohol abuse combined with an anxiety problem.

Alcohol And Anxiety – The Vicious Cycle

A person who is suffering from anxiety might think that a couple of drinks will help them relax.

In fact, drinking alcohol can make an anxious person feel worse. Here’s an illustration of a typical cycle:

  • A person drinks alcohol
  • They initially feel calm as the alcohol affects the brain
  • They feel anxiety as a symptom of alcohol withdrawal as the body processes the alcohol
  • They may want to drink again to try to relieve their anxiety
  • But this only starts the process from the origin. As the initial calming effect disappears, the person can feel anxiety after quitting drinking alcohol build again as the effects wear off

Remember, the more alcohol consumed, the greater the tolerance will be. Over time there is a need to drink more alcohol to feel the same effects. Over time this may negatively affect mental health, resulting in a higher level of anxiety and depression after drinking. Anxiety disorder makes an individual start drinking alcohol, which worsens their anxiety, which leads them to drink more and worsens their anxiety further. It’s a never-ending vicious cycle of alcohol and anxiety.

The Reality Of Alcohol And Anxiety

Alcohol can lower the levels of serotonin, or what’s generally known as the happiness hormone. As a result, reduced levels are associated with increased anxiety. Moreover, the body will ultimately build up a tolerance to alcohol, making it less efficient for producing relaxing and calming effects. Additionally, ongoing alcohol use can result in a different set of health issues and complications.

According to the National Center for Biotechnology Information (NCBI) [4], the co-occurrence of alcohol and anxiety disorders is relatively common. The research found that 20% of those with social anxiety have an alcohol misuse problem.

Experts suggest finding alternative ways to relax and socialize away from alcohol. Examples are: heading out for brunch instead of dinner, an exercise class, or more time spent outside. These types of activities can significantly lower symptoms and increase happy hormones in the body that may help someone win the battle against alcohol and anxiety disorders.

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“Hangxiety” has become a buzzword that defines the uncomfortable feeling that often characterizes heavy alcohol use, but what does it mean? It is the feeling of being “on edge” after a night of drinking. It is also the feeling that “something’s not right” and being paranoid or flat-out scared, and can’t explain why. This phenomenon is an example of an anxiety hangover, more commonly known as “hangxiety”.

Although even a heavy night of drinking may trigger anxiety, major withdrawal symptoms and bad hangovers make alcohol panic attacks even more likely. Hangovers can also add to stress if a person can’t function or has to miss school or work.

If it’s a severe hangover, a person can experience:

  • Sweating
  • Nausea
  • Paranoia
  • Psychosis
  • Trembling
  • Elevated heart rate

Finding Integrated Treatment For Co-Occurring Disorders 

Comorbidity is the term used to describe when a person battles both an alcohol disorder and an anxiety disorder simultaneously. The largest advantage of integrated treatment, which enables patients to address the symptoms of both diseases simultaneously, comes to those who have been diagnosed with comorbid ailments.

This kind of therapy is crucial since the likelihood of both disorders returning increases if one disorder is not totally treated. However, people can regain control of their lives once both requirements have been appropriately addressed.

Finding The Next Level Of Treatment For Alcohol And Anxiety Disorders

If you or your loved one are using alcohol as a self-medicating measure, you might feel that it “works” to help you cope with your alcohol and anxiety disorders symptoms. However, while you might feel that it works in the short term, it’s more likely to cause you problems in the long run. If you have an anxiety disorder, alcohol misuse and withdrawal can make your symptoms worse.

If you or your loved one have anxiety and are using alcohol to cope, it’s important that you seek support from your doctor or mental health professional. It’s never too late to reach out for help if you are trying to cope with co-occurring mental health conditions and substance use disorders.

There are many effective treatments for anxiety and alcohol use disorders, including ongoing individual therapy, group therapy, prescribed medications, or a combination of these methods [5].

If you or someone you love is struggling with alcohol and anxiety disorder, get them the safest help they need and deserve. Our team at We Level Up NJ specializes in creating an ideal environment and providing effective therapies 

Both long-term alcohol misuse and alcohol withdrawal can significantly increase anxiety levels
Both long-term alcohol misuse and alcohol withdrawal can significantly increase anxiety levels.

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Sources

[1] NIH – https://medlineplus.gov/anxiety.html

[2] WHO – https://www.who.int/news-room/fact-sheets/detail/depression

[3] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1295099/

[4] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860396/

[5] we level up5 Ways to Manage Anxiety

Alcohol Research—Anxiety and Alcohol Use Disorders Comorbidity and Treatment Considerations

Anxiety And Depression Associates Of America—Substance Use Disorders

National Institute on Alcohol Abuse and Alcoholism—Alcohol Use Disorder

Kushner MG, Abrams K, Thuras P, et al. Follow-up study of anxiety disorder and alcohol dependence in comorbid alcoholism treatment patients. Alcohol Clin Exp Res. 2005;29(8):1432-1443. PMID: 16131851.

Chan YF, Dennis ML, Funk RR. Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment. J Subst Abuse Treat. 2008;34(1):14-24. PMID: 17574804.