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Alcohol and Anxiety

Effects, Cycle, & Treatment of Alcohol and Anxiety

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 rapid heartbeat. Anxiety can be a normal stress reaction. For example, 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 people with anxiety disorders, the fear is not temporary and can be overwhelming.

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 anxiety disorder symptoms can interfere with day-to-day activities such as schoolwork, job performance, and relationships. The cause of anxiety is still unknown. Factors such as brain biology, genetics, chemistry, stress, and your environment may play a role. Depression is different from anxiety. Depression is described 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.

Alcohol and Anxiety
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.

Alcohol and Anxiety Attacks

Alcohol and anxiety problems are common co-occurring disorders that can cause severe distress and impair your daily life. Anxiety and alcohol abuse often make each other significantly worse. Alcoholism can exacerbate an existing anxiety disorder or may lead to new anxiety symptoms and vice versa. This means that a pre-existing anxiety disorder can contribute to alcoholism (as many people use alcohol as an unhealthy coping mechanism).

Alcohol changes levels of serotonin and other neurotransmitters in the brain, which can worsen anxiety. In fact, you may feel more anxious after the alcohol wears off. Alcohol-induced anxiety can last for several hours, or even for an entire day after drinking. Using alcohol to cope with social anxiety disorder can be dangerous. With social anxiety, you may find social situations unbearable. It’s common for people with a social anxiety disorder to drink alcohol to cope with social interactions. Doing this can lead to a dependence on alcohol during socializing, which can make anxiety symptoms worse.

Can Alcohol Cause Anxiety?

The long-term consequences of alcohol abuse can be a variety of health problems, including mental health disorders. Research shows that people with alcoholism find it difficult to recover from traumatic events. This is possible because of the effects of alcohol abuse, which can actually change brain activity.

Long-term heavy drinkers may be predisposed to developing an anxiety disorder. However, there is no evidence that moderate drinking will cause anxiety. Alcohol withdrawal and anxiety are deeply linked. Increased anxiety is also a symptom of alcohol withdrawal. If you’ve consumed alcohol in large amounts for a long period of time and suddenly stop drinking, your anxiety can be aggravated by the side effects of alcohol withdrawal.

How Does Alcohol Worsen Anxiety?

Alcohol shifts the serotonin levels and other neurotransmitters in the brain, which can worsen anxiety. In fact, you may feel more anxious after the alcohol wears off. If you drink excessively for long enough, alcohol will begin to alter your brain chemistry. Otherwise healthy people can begin to develop anxiety disorders after long-term use. You may start to experience alcohol-induced anxiety which can last for hours or even an entire day after drinking. It’s that next day jittery feeling and a racing heart that you just can’t shake.

Anxiety and Alcohol Abuse

A substantial number of people who have problems with alcohol also experience strong anxiety and mood problems. From the psychological perspective, behavioral research demonstrates that drinking to cope with negative affect is a potent indicator for current and future problems with alcohol. Neuroscientific research implicates overlapping neurobiological systems and psychological processes in promoting the rise of negative affect and alcohol misuse.

Research has shown that up to 50% of individuals receiving treatment for problematic alcohol use also met diagnostic criteria for one or more anxiety disorders. This percentage can be compared with the prevalence of current (within the past 12 months) anxiety disorders in the U.S. community, which is estimated to be 11%. Regardless of which came first, having a diagnosis of an anxiety disorder or an alcohol use disorder could cause the other disorder to occur.

Alcohol and Anxiety
Alcohol and anxiety can become a dangerous, self-perpetuating cycle.

How Does Drinking Alcohol Affect Anxiety? 

Anxiety is a disorder that attacks the central nervous system (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.

Does alcohol help anxiety? 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), alcohol and benzodiazepines generate anxiety, panic, and phobias.

The Vicious Cycle of Alcohol and Anxiety

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 the 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.

Alcohol’s Anxiety Hangover 

A combination of the terms “hangover” and “anxiety,” “hangxiety” refers to the experience of feeling the physical effects of alcohol, related to a hangover (headache or stomach ache, tiredness, nausea, etc), compounded by psychological uneasiness. 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. 

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

Hangxiety is a phenomenon that can happen on an occasional or more regular basis, as it can be connected to several factors. The most common reason (and the most obvious) is linked to a generally reduced dopamine secretion. Known as the “happy hormone,” dopamine is produced by the brain and used to send messages among nerve cells, regulating our anxiety levels. And the greater the alcohol consumption, the greater the drop in dopamine, which can lead to feelings of anxiety.

Cortisol may also play a role in the emergence of feelings of “hangxiety.” Unlike dopamine, this hormone, which is linked with carbohydrate regulation, can increase stress if it is secreted in too large amounts. Excessive alcohol intake will lead to an overproduction of cortisol and may therefore lead to stress and anxiety.

Hangxiety Symptoms

Symptoms of hangxiety vary from person to person, like with all other illnesses and disorders. Some of the common signs and symptoms of hangxiety are as follows:

  • Fatigue
  • Weakness
  • Thirst
  • Headache
  • Muscle ache
  • Nausea
  • Stomach pain
  • Vertigo
  • Light and sound sensitivity
  • Irritability
  • Anxiety
  • Paranoia
  • Sweating
  • Increased blood pressure

Link Between Anxiety Meds and Alcohol 

Antidepressants are the most common anxiety medication prescribed by doctors. They are believed to work by increasing specific neurotransmitters like serotonin in the brain. Serotonin levels affect how a person feels. Alcohol and anxiety meds are especially dangerous when combined. Problem drinkers were 1.5 times more likely to drink and use anxiety meds. Interestingly, problem drinking among women is linked with anxiety meds use.

Antidepressants typically include SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors), and tricyclic antidepressants. Lexapro, Paxil, Zoloft, and Celexa are brand names of SSRIs prescribed in the treatment of chronic anxiety. Effexor and Cymbalta are SNRI brand names. SNRIs work to slow the breakdown of the brain chemicals serotonin and noradrenaline. In tricyclic antidepressants, the main working mechanism is a three-ring chemical structure.

After taking a prescription drug meant to address diagnosable anxiety, many individuals casually chase it with alcohol. They never think about the important question of “can you drink alcohol while on anxiety meds?” “Does alcohol help anxiety?” In the short term, alcohol may help dull anxious feelings and thoughts. That’s because alcohol is a depressant.

The use of alcohol may slow down racing thoughts and makes worries seem less urgent. It does nothing to eliminate the source of the anxiety, however, and once the effects of the alcohol dissipate, the anxiety returns with a more evident effect. Some individuals who repeatedly consume alcohol to help cope with anxiety experience more anxiety when they know that the effects of the alcohol are wearing off.

Alcohol and Xanax

Taking alcohol and anxiety meds such as Xanax together will intensify the effects of both substances. Researchers haven’t been able to understand why this happens. However, it’s likely due to chemical interactions between alcohol and anxiety meds like Xanax in our bodies. A study on animals released in 2018 suggested the presence of ethanol, which is the main ingredient in an alcoholic drink, might increase the maximum concentration of Xanax in the bloodstream. This can lead to an “enhanced” high, as well as enhanced side effects. It also pushes the liver to work harder and break down both Xanax and alcohol in the body.

Alcohol and Anxiety
The co-occurrence of alcohol and anxiety disorders is relatively common, 20% of those with social anxiety have an alcohol misuse problem.

Both alcohol and anxiety meds like Xanax have individual sets of side effects that impact an individual’s behavior and mental state. Because of this, the two should never be used together as they can cause life-threatening effects. When used with alcohol, the introduction of Xanax to one’s body can cause one’s heart to stop beating, hamper neural activity, or slow your breathing to the point of respiratory failure, permanent brain injury, coma, or death.

Combing alcohol and anxiety meds like Xanax also increases the likelihood of a Xanax overdose, which can lead to respiratory depression, seizures, and potentially even death. An abundance of alcohol and anxiety meds like Xanax can relax and slow body functions to the point that the user’s heart stops beating or they stop breathing, again resulting in a coma or death. Learn more about the dangers of mixing anxiety meds such as Trazodone and alcohol, and Valium and Alcohol,

Dual Diagnosis Treatment for Alcohol and Anxiety Problems

There is a strong link between mental health conditions, such as anxiety disorder and alcohol abuse. Individuals who struggle with mood disorders like anxiety are more susceptible to developing an addiction to drugs or alcohol, often to self-medicate symptoms of their underlying mental health condition. These co-occurring disorders can make each other worse without proper treatment.

To determine the most effective ways to treat alcohol and anxiety problems, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional.

Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated process of withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug abuse. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.

Psychotherapy for Depression and Anxiety

Several different modalities of psychotherapy have been used in the treatment of depression including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
  • Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Substance abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use disorders and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

Someone with a Xanax addiction may take up to 20 or 30 pills per day. If the user decides to stop the Xanax dosages, they may experience withdrawal effects such as anxiety, restlessness, insomnia, and tremors. The development of tolerance and withdrawal are indications of addiction. If you or a loved one are struggling with long-term alcohol and anxiety problems, contact one of our helpful treatment specialists today. We Level Up can provide information on dual diagnosis and detox programs that may fit your specific needs.

alcohol and anxiety
No matter what, when dealing with alcohol and anxiety problems, the care and supervision of a medical professional are necessary.
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/