Alcohol and anxiety: Panic Attacks After Drinking

The evidence of the medical practice shows a clear association between anxiety and alcohol use disorders (AUDs), to the point that up to 50% of individuals receiving treatment for problematic alcohol use also met diagnostic criteria for one or more anxiety disorders. While it might be tempting to turn to alcohol to manage feelings of anxiety, it can be a slippery slope that worsens anxiety problems and increases your risk of developing an alcohol use disorder. Instead of alcohol, consider talking to a mental health professional about effective anxiety management options, which may include psychotherapy and medication. Sometimes, people turn to alcohol or other substances to help them hide from their problems or cope with symptoms of mental illness. In some cases, people with certain mental health conditions, such as anxiety or panic disorder, might develop an unhealthy relationship with alcohol.

Understanding the immediate impact of alcohol on anxiety is crucial for individuals navigating their mental health and making informed choices about alcohol consumption. Alcohol consumption can have immediate effects on anxiety levels, sometimes leading to anxiety attacks or heightened anxiety shortly after drinking. While alcohol may initially induce a sense of relaxation or euphoria, especially in social settings, its impact on brain chemistry can quickly turn detrimental for individuals prone to anxiety.

Understanding the dynamics between alcohol consumption and anxiety requires a nuanced exploration of both psychological and physiological factors, which mental health professionals continue to investigate and address. Similarly, people with severe anxiety disorders may be more likely to develop AUD, particularly if they use alcohol as a coping mechanism. A 2018 narrative review suggests that 21.9% to 24.1% of people with an anxiety disorder or mood disorder use alcohol or drugs to relieve their symptoms. People with severe anxiety disorders may be especially at risk of developing AUD. It’s possible to have anxiety after drinking alcohol without having an anxiety disorder.

Treatment for Alcohol Use and Anxiety Disorders

It was furthermore noteworthy that scores on a measure of the participants’ overall anxiety levels (i.e., trait anxiety) also changed significantly at 3-month follow-up. This latter finding suggests that state anxiety that occurs during early abstinence can lead respondents to consider their increased anxiety levels as more chronic than they actually are. Therefore, retrospective self-reports collected at baseline should be interpreted with caution.

As a result, it’s possible that having a few drinks that make your BAC rise and then fall back to normal again can make you more anxious than you were before. We tend to pair up our vices, and not only drink alcohol but also eat highly dense, problematic foods. Your body can have an uncomfortable sensation the next day as a result, which can feel like a nervous energy or anxiety.

Not all people struggling with alcohol problems meet diagnostic criteria for anxiety disorders. This is good news, because most people with anxiety disorders do not report drinking to cope with their symptoms, but it also raises questions. For example, why do some people with anxiety problems drink to cope and others do Johns Hopkins Scientists Give Psychedelics the Serious Treatment not? Also, if this population has no increased risk for AUD, how is that consistent with the shared neurobiology thesis?

Treatment Considerations: Addressing Alcoholism and Depression Simultaneously

The historical roots of this treatment modality largely can be traced back to the development of Alcoholics Anonymous (AA) in Akron, Ohio, in the 1930s and 1940s. It has been estimated that nearly 1 in every 10 Americans has attended at least one AA meeting, and it is “the most frequently consulted source of help for drinking problems” (McCrady and Miller 1993, p. 3). Collectively, these independent findings are consistent with the mutual-maintenance model of comorbid anxiety and AUDs. Furthermore, to date no studies have empirically tested these dynamic and interactive factors in a longitudinal model. Thus, the status of the science underpinning the mutual maintenance hypothesis at this time only yields indirect agreement.

How Alcohol and Anxiety Are Linked?

According to the Anxiety and Depression Association of America (ADAA), it isn’t unusual for people with social anxiety disorder and other anxiety disorders to use alcohol to try to calm anxiousness and ease related symptoms. About 20 percent of people with social anxiety disorder also suffer from alcohol dependence. One limitations of this study is that the results may not reflect the general population because the study only sampled persons who visited a hospital; another limitation is that the number of female subjects with high alcohol consumption levels was low and thus yielded limited statistical significance. We believe that it would be meaningful to conduct further studies on female subjects to compare the sleep quality between hazardous drinkers or patients with alcohol use disorder and moderate drinkers or persons who do not drink at all. In addition, further studies are recommended focused on the correlation between alcohol consumption and sleep apnea or restless leg syndrome, both of which were found to be significant in the present study. In the present study, which focused on the effects of alcohol consumption on sleep quality among adults aged 20 years and older, we found that AUDIT-KR and PSQI-K scores were significantly correlated among male subjects.

1. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia.
2. In other words, it appears that men with more alcohol consumption suffer from overall poor sleep quality, experience difficulty in maintaining sleep rather than falling asleep, suffer from shorter overall sleep duration, and therefore have worse subjective sleep quality.
3. For those who have an alcohol use disorder, it’s a symptom of alcohol withdrawal syndrome.
4. Typologies are the oldest formal approach to categorizing alcohol misuse accompanied by strong negative affect.
5. In this study, we found that anxiety symptoms were more strongly correlated with PSQI-K values than depression symptoms and that women showed greater correlation between PSQI-K values and anxiety or depression symptoms as compared to men.

Paul ‘Gazza’ Gascoigne: Triumphs and Trials in the Fight Against Addiction

Taken together, the epidemiological and clinical literature describing the relationship between anxiety and AUDs shows that this comorbidity is both prevalent and clinically relevant. The following sections will review fundamental concepts related to how these disorders co-occur and describe approaches to diagnosing and treating comorbid anxiety and AUDs. However, restricting attention to a single diagnosis and its relationship to alcohol misuse does not align with more recent research.

Perhaps currently unknown factors—cultural, psychological, or biological—protect these biologically vulnerable individuals by discouraging drinking to cope. In the sequential approach to treating comorbid anxiety and AUDs one disorder is treated prior to addressing the other disorder. Advocates of this approach point out that it may be prudent to begin, for example, by treating a client’s alcohol problem and waiting to see whether abstinence leads to remission of the psychiatric problem (e.g., Allan et al. 2002; Schuckit and Monteiro 1988). This model also allows clinicians to engage clients who may be more ready to address one disorder than the other, and this may be a pragmatic early treatment strategy for comorbid clients who may only have interest in changing one of their problems (Stewart and Conrod 2008). The results of this study suggest that paroxetine may be useful in this subgroup of alcoholics by alleviating social anxiety as a reason for drinking, and that once social anxiety symptoms are reduced, the stage may be set for the introduction of an alcohol intervention. In addition to adjusting standard pharmacotherapy and psychotherapy protocols for anxiety and AUDs when treating comorbid clients, it also is crucial to apply these methods in a way that produces the best outcomes for both disorders.