Alcoholism and Anxiety: The Complicated Relationship

It’s not uncommon at all to hear that someone that suffers from an anxiety disorder may also struggle with alcohol dependence, as the two seem to go hand in hand much of the time. In fact, up to 45 percent of those who are diagnosed with alcohol dependence also meet the criteria for an anxiety disorder. You or someone you know may have used alcohol to calm your nerves once in a while, as it is quite common, but problems start when a dependence occurs and it’s difficult to stop.

Like depression and alcohol abuse, anxiety and alcoholism are undoubtedly linked. Studies have shown that one-third of the people who have anxiety disorders struggle with substance abuse, and that one-third of substance abusers also have an anxiety disorder.

The most common mental illness in the U.S., anxiety disorders afflict 40 million adults—twice as many women as men—and take a toll on the economy of more than $40 billion each year due to healthcare costs and lost productivity. A recent New York Times article reports that “the anti-anxiety drug alprazolam, — better known by its brand name, Xanax — was the top psychiatric drug on the list, clocking in at 46.3 million prescriptions in 2010.”

The tragic side of alprazolam and many other anti-anxiety drugs is that they are highly addicting and contribute to a large percentage of people recovering from substance use disorder who want to quit or relapse back to alcohol or drug use after many years of recovery. A relapse can be devastating to a person’s mental and physical health. Some people lose their families and their jobs. Some even lose their lives.

Anxiety is normal but Anxiety disorders are not normal. The challenge of diagnosing anxiety disorders is that everyone has some degree of anxiety. Anxiety becomes a disorder when it interferes with life or causes a lot of distress.

The Connection Between Alcohol Abuse and Anxiety

To understand this dilemma, there are three clear explanations for the connection.

  • First, someone who is experiencing a high amount of anxiety, especially in a social situation, may reach for alcohol to calm the nerves. Two or three drinks have the tendency to suppress the nervous system, making that person relax a bit more. In essence, they self-medicate themselves via alcohol.
  • Second, for the person that continues to rely on alcohol to calm the nerves, that person’s stress response system in the body becomes disrupted. The drinking calms the nerves, but then the stress system goes through withdrawal, and oftentimes more stress will be experienced as a result. The repetitive withdrawal cycle can cause them to keep reaching for more and more alcohol.
  • Thirdly, the link could be due to a more psychological issue like extreme sensitivity to anxiety and a predisposition to alcohol dependence.

It’s estimated that approximately 15 million adults in the United States are currently diagnosed with a social anxiety disorder. Unfortunately, many of these men and women self-medicate using alcohol.

According to Stein and Walker in the book Triumph Over Shyness: Conquering Social Anxiety Disorder, many times what occurs is that those who struggle with social anxiety have co-occurring emotional issues like depression, which can make trying to contend with anxiety much more difficult.

Stein and Walker also point out that self-medicating anxiety with alcohol can actually make anxiety worse, causing it to increase. It can also boost depression and irritability the day or two after drinking.

The Risks of Drinking to Cope With Anxiety

stress written on blackboardEveryone has a different threshold level or limit as to how much stress or stimulus coming to us from the world, that we can handle. As soon as that threshold is exceeded – we deal with that by engaging in a variety of coping mechanisms. Most ‘dysfunctional’ behavior stems from our ability to withstand this ‘stress.’

Anxiety sometimes drives people to do things to get rid of the discomfort. Many people who experience chronic feelings of anxiety about social situations, work, and relationships, or other aspects of everyday life often reach for a beer or a glass of wine to quell their unease.

Can Alcohol Make Anxiety Worse?

Alcohol may help anxious people cope in the short term, but over time this strategy can backfire. Self-medicating with alcohol or drugs can increase the risk of alcoholism and other substance abuse problems, without addressing the underlying anxiety. And anxiety becomes the trigger for continued alcohol use and dependence. People probably believe that self-medication works.

What people do not realize is that this quick-fix method actually makes things worse in the long term. On the flip side of the alcohol/anxiety relationship, alcohol consumption and hangovers can make many people anxious. It is a scientifically based understanding fact that alcohol can cause anxiety.
Scientists believe that alcohol causes or at least increases anxiety in 6 basic ways:

1.  Mood

  • Alcohol can affect our mood because it can affect the level of serotonin in the brain. Serotonin is a feel-good brain chemical that when in short supply can cause feelings of anxiety and depression.

2. Drop in Blood Sugar

  • A drop in blood sugar can cause dizziness, confusion, weakness, nervousness, shaking, and numbness. These symptoms can most certainly trigger a bout of anxiety.

3. Dehydration

  • This has been known to cause nausea, dizziness, fatigue, light-headedness, and muscle weakness. These symptoms wouldn’t cause anxiety per se but they add to a sense of illness that fosters anxiety.

4. Nervous System

  • The nervous system is affected because in order for the div to fight off the sedative effects of alcohol it puts the div into a state of hyperactivity in order to counteract this effect. This hyperactivity can lead to shaking, light/sound sensitivity, and sleep deprivation.

5. Heart Rate

  • Your heart rate can become elevated as a result of consuming alcohol which can cause a palpitation false alarm and put you into a state of anxious anticipation. Is it a heart attack or isn’t it, you might ask. This “what if” questioning can increase your general state of anxiety.

6. Concentration

  • A hard night of drinking can also make you hazy, bring on headaches, and create a sense of disorientation. Treatment for many anxiety disorders most often includes a combination of non-addicting medication and cognitive-behavioral therapy. Research suggests that a combination of cognitive-behavioral therapy and medication can help control symptoms and lead to complete remission in some people.

Do You Suffer From Alcohol Dependence?

Take a look at the following characteristics and see if any resonate with you:

  • Do you drink alcohol to calm your nerves?
  • Do you drink more than four times per week?
  • Have you tried to stop drinking before to no avail?
  • Do you drink in the mornings?
  • Do you lie about how much or how often you are drinking?
  • Have friends or family members talked to you about your drinking habits?
  • Do you feel bad about your alcohol consumption?

If you see yourself in more than one or two of these characteristics, you could very well have a problem with alcohol.

To help determine if you might have a problem with alcohol dependence you can also take our brief self-assessment quiz.

Treatment for Addiction and Anxiety Disorders

be strong message for recoveryWhether you’re dealing with social anxiety, alcohol dependence, or both, there is help available in the form of various treatments.

  • Alcohol Rehab. Rehab is a valuable tool to help those who are dependent upon alcohol to get free. There is inpatient rehab, in which you stay at the facility, and there is outpatient rehab, which includes Intensive Outpatient Programs (IOP), or Partial Hospitalization Programs (PHP) where you simply attend at designated times throughout the week ranging from 9-30 hours a week. Both options are a great way to get free from alcoholism and social anxiety.
  • 12 Step Meetings. Attending a 12 Step group like Alcoholics Anonymous is helpful to get free from alcoholism, as there is a lot of support and the opportunity to get yourself a sponsor and work through the 12 Steps. In doing so, you will have the opportunity to perhaps decrease or eliminate those symptoms of social anxiety as well.
  • Counseling. By seeing a therapist, you are able to receive the support and insight that you need in order to contend with alcohol dependence and anxiety. It’s a great idea to commit to counseling for a short (or long) period of time to develop new goals, learn to be mindful, and discover new ways of responding to the symptoms of both conditions.

Treatment for anxiety disorders treated by psychotherapists and psychologists most often includes cognitive-behavioral therapy known as CBT. Research suggests that a combination of cognitive-behavioral therapy and non-addicting medications can help control symptoms and lead to complete remission in some people.

Anxiety and alcohol dependence do go hand in hand sometimes, but there is treatment available for both. If you recognize yourself in either or both conditions, do not hesitate to step out and get yourself on the road to recovery. There is certainly freedom available for you; you simply have to take that first step.

For those people who have suffered an alcohol and drug relapse, or who have not been able to maintain sobriety due to anxiety, Lasting Recovery offers a cognitive behavioral program. We support people to people make changes in their thinking and in their lives and to understand the causes of anxiety and basic fears.

We offer the Fearless Change Process that helps you to see that a lot of anxiety comes from unmet needs or fear that one’s needs will not be met in the future.

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