Have you ever woken up after a night of drinking and felt like your heart was beating out of your chest? Maybe you awoke with a sense of panic and overwhelm.
Have you also noticed that after drinking heavily, you feel more anxious and on edge even a day or two later?
If you’re a heavy drinker, meaning you binge drink four or more times per month, you may have noticed an increase in anxiety symptoms in your daily life over the years.
Why does this happen? Does alcohol cause anxiety?
- Why Alcohol Makes Anxiety Worse
- The Relationship Between Alcohol and Anxiety Disorders
- Can alcohol cause anxiety?
- The Impact of Alcohol on Anxiety Medication
- The Anxiety and Alcoholism Cycle
- Alcohol and Anxiety Statistics
- “But alcohol is the only thing that helps my anxiety!”
- It gets better, but you have to quit drinking.
- FAQs on Alcohol and Anxiety
- Are you struggling with anxiety and alcohol abuse?
Why Alcohol Makes Anxiety Worse
Here’s the science part. 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.
Alcohol changes the levels of serotonin and neurotransmitters in the brain. These chemicals help regulate our mood, so we lose those safeguards when alcohol lowers these levels.
You may 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 can’t shake.
The bigger problems start when that anxiety pops up even when alcohol isn’t involved, which starts to happen if you binge for long enough.
The Relationship Between Alcohol and Anxiety Disorders
People who struggle with trauma and other mental health issues are more likely to abuse alcohol. The inverse is also true. There is a clear relationship between alcohol independence and mental health. They are co-occurring disorders.
Studies have shown that people with alcohol dependence have a 2.6 times higher risk for developing anxiety disorders than those who do not have alcohol dependence.
Unfortunately, anxiety disorders and alcohol abuse have a dark, cyclical nature. Having an anxiety disorder increases the risk of developing alcohol dependence. When someone quits drinking alcohol, the withdrawal symptoms exacerbate anxiety symptoms, ironically, a risk factor for relapse.
And round and round we go.
This is not to paint a hopeless picture but to give you an honest look at the complex relationship between alcohol and anxiety.
It may also help to know that this merry-go-round you’re on is not a sign of weakness.
Can alcohol cause anxiety?
Absolutely! Alcohol fundamentally changes the brain’s structure in ways that make it difficult for people to manage their behavior and moods, making them more susceptible to anxiety and anxiety disorders.
Alcohol is a depressant. It tamps down our body’s fight-or-flight response by suppressing the amygdala. We like this effect. It’s why we drink after a hard day.
The problem is that our brain will overcorrect for the depressant effects of alcohol in our system. Why? The brain likes balance.
It will seek to counteract the sedating effects of alcohol by releasing more excitatory neurotransmitters. As the alcohol wears off, we are left with an artificially high level of stress hormones in the body.
This is why so many people suffer from “hangxiety” the day after a night of heavy drinking.
The Impact of Alcohol on Anxiety Medication
If you take medication to help manage your anxiety symptoms and also consume alcohol, I’ve got some bad news for you.
You’ve probably seen the warning on the bottle, “Do not mix with alcohol.”
It’s not just empty words, particularly when we’re talking about anxiety medications. Alcohol does not interact well with these drugs. It can intensify the negative side effects of many of these medications, particularly if you take benzodiazepines.
Most anxiety medications work by calming your nervous system. They effectively slow things down, helping you to relax and reduce your anxiety.
Now, alcohol, being the good old depressant it is, does something similar—it slows down brain activity. Combine these two, and you’re essentially doubling down on the slow-down.
Antidepressants and Alcohol
If you take antidepressants to help manage your anxiety symptoms, you also do not want to drink alcohol.
Alcohol can also decrease the efficiency of your medication. In simpler terms, it might stop your meds from doing their job properly. There are a few reasons why:
- Alcohol counteracts your medication, because it increases feelings of depression and anxiety in the long-term.
- If you take MAOIs, alcohol may cause a dangerous reaction like spiked blood pressure.
- It may exacerbate cognitive impairments and feeling sleepy or drowsy.
Bottom line, if you’re going to treat your anxiety and depression with medication, you especially do not want to continue drinking.
The Anxiety and Alcoholism Cycle
You’re probably noticing a pattern between drinking to relax and increased anxiety.
A person starts drinking to self-medicate stress and anxiety in their lives. The brain adjusts to the large presence of alcohol by ramping up the production of excitatory neurotransmitters in the body. They feel more wound up after the alcohol wears off.
The physical symptoms of hyperarousal after a night of drinking include:
- Brain fog
- Increased heart rate
In more serious cases, it can include:
This person must now face the day and all its stressors with these physical effects, a recipe for disaster for anyone already struggling with anxiety.
The more someone drinks, the harder the brain must work to restore balance, intensifying anxiety symptoms as the alcohol wears off.
Alcohol and Anxiety Statistics
It’s important to address the reality of co-occurring alcohol abuse and anxiety disorders.
- 1 in 5 people with anxiety report using alcohol to manage symptoms
- 20% of people diagnosed with alcohol abuse or substance abuse disorder suffer from an anxiety disorder
- 50% of people receiving treatment for alcohol dependence meet the diagnostic criteria for one or more anxiety disorders
What the alcohol-anxiety relationship looked like in my life:
By the time I reached my early thirties and evolved into a nearly daily drinker, I noticed new symptoms.
I’d wake up with a racing heart, wanting desperately to crawl under my covers and disappear.
I wanted to jump out of my skin and didn’t know why. I spent countless hours in urgent care, worried my heart would explode or that I was suffering from a serious respiratory illness. My chest hurt, and I felt irrationally terrified.
I joked at the time that I had OCD moments, but I now realize that I was in the early clutches of a full-blown anxiety disorder. And, by the way, had actually developed OCD (obsessive-compulsive disorder).
Things started to get worse.
I don’t know when or how long I’d had anxiety, but by the time I was thirty, I found it difficult to leave for work on time. And not for the usual reasons.
I could not shake the feeling that I had left the gas to my stove on and was going to come home to a destroyed apartment.
Every morning, I would check that damn stove five or six times before leaving. Some days, I checked more. Did I turn the knobs off? Good. On bad days, I would leave my apartment and go back up to check once more.
I played this game with the door to my apartment as well and, when I had it with me in New York, my car door. Was it really locked?
I’ve turned around three blocks into my walk to the subway just to go back and check what I’d already checked a dozen times.
Can alcohol abuse cause OCD?
The quick answer is no. However, that does not mean there is no clear relationship between the two.
Abusing alcohol disrupts the brain’s chemistry and ability to communicate effectively with the rest of the body. The disruption of the brain’s pathways can impede the brain’s ability to regulate moods and behaviors.
This includes the ability to resist compulsive urges.
Whereas alcohol abuse may not directly cause OCD, it certainly exacerbates the symptoms.
It is not uncommon for people suffering from OCD to use alcohol to cope with symptoms. At first, it might seem like alcohol is an effective tool for quieting the mind. The reality is that alcohol can actually make compulsions more intense.
“But alcohol is the only thing that helps my anxiety!”
It’s the opposite. I know it might not feel that way, but it’s true.
I, too, used to drink to deal with unbearable anxiety, and I know the relief that a first drink or two can bring.
But those drinks are making your anxiety worse, not better.
It also disrupts your body’s ability to manage stress, lowering overall stress tolerance. Over time, you will become stressed more easily by everyday life and experience lower mood quality.
This is the vicious cycle I previously spoke about.
We drink to manage stress and anxiety, not realizing that alcohol changes our brain chemistry and hormones in ways that make us more stressed, anxious, and depressed.
So we keep drinking, hoping to feel better. And we might feel better for an hour or so, but then all those negative feelings come pouring back and round and round we go.
The only way to get off that merry-go-round is to quit drinking. But it’s hard to do that when those first few weeks or months are so difficult to get through as your brain tries to heal and adjust.
It takes most casual drinkers two to six months to restore neural circuits back to their normal state. For heavy drinkers, that recovery time can be significantly longer.
It’s really hard.
For more information on what alcohol does to the brain, I highly recommend listening to the Huberman Lab episode on alcohol. Here’s a short clip from that longer episode you may find helpful:
It gets better, but you have to quit drinking.
Most people don’t want to hear they should quit drinking alcohol, but sometimes our reality necessitates it.
The longer I drank, the more my mental health declined. It was not possible to manage my anxiety or depression without sobriety.
Now you may be saying to yourself, “Well, that’s all well and good, but you and I are different people! Just because you had to quit drinking doesn’t mean I have to.”
I used to have the same attitude. But here’s the thing. You can’t heal or manage an anxiety disorder and continue drinking any more than you can lose weight and eat McDonald’s every day.
The two things fundamentally cannot coexist.
This is not to say that one day in the distant future, you can’t have a glass of wine with dinner, but that will only be available to you after you’ve done some serious work on your relationship with alcohol and received treatment for your anxiety.
Surprisingly (or maybe not so), you may not even want that glass of wine by then.
I’ve chosen to abstain from alcohol indefinitely.
The stakes are too big for me to risk it. I won’t tell you to make the same choice, but quitting alcohol for the foreseeable future is your best option if you want to break free of this cycle.
FAQs on Alcohol and Anxiety
Can I drink alcohol if I have anxiety?
That all depends. When you drink alcohol, how much do you drink? Do you notice after a day of drinking that your anxiety symptoms feel worse? How often do you drink? There are so many factors that go into answering this question.
If you struggle with an anxiety disorder, the most honest answer is that you probably shouldn’t drink alcohol. Too much evidence suggests consuming alcohol will only worsen your anxiety and put you at a higher risk for alcohol dependence.
An occasional glass of wine or beer might be fine, but it depends on how your brain and body respond to it. Moderate to heavy drinking should be avoided.
Can alcohol cause panic attacks?
Whereas alcohol does not directly cause panic attacks, it can trigger them.
Alcohol increases anxiety levels, which can lead to panic attacks. A panic attack occurs when the body’s fight or flight response is activated without a threat.
Alcohol disrupts the balance of chemicals in our brains.
It slows everything way down. Our brains will then attempt to bring balance back to our brains by ramping up excitatory neurotransmitters.
As the alcohol wears off, we are left with an overstimulated nervous system which can lead to intense feelings of anxiety as well as panic attacks.
Can quitting alcohol cure anxiety?
Unfortunately, anxiety disorders are complicated, and quitting alcohol alone is not enough to “cure” anxiety, whatever that might mean to you. Quitting alcohol can, however, greatly reduce your anxiety symptoms and make your life more manageable.
We know that anxiety disorders and alcohol do not mix, and you can expect your anxiety to only worsen if you continue to drink.
Can drinking every night cause anxiety?
It depends. Drinking a small glass of wine every night with dinner will not likely cause anxiety. However, drinking two or more units of alcohol in the evenings disrupts your brain chemistry, leading to increased anxiety the following day.
If you have a nightly drinking habit, pay attention to how you feel in the morning. Are you wound up or more anxious than normal when you wake up?
If the answer is yes, then your drinking is likely to blame. Try cutting back or quitting to see if your anxiety improves.
Are you struggling with anxiety and alcohol abuse?
If you’re stuck in this awful cycle, please know that you are not alone. The first step is to seek help from an experienced medical professional.
Anxiety and alcohol abuse are co-occurring disorders. Your doctor will treat both. Common treatment plans include talk therapy, cognitive behavioral therapy, and/or medication. It truly depends on your individual situation and which problem came first – alcohol abuse or anxiety disorder.
As scary or overwhelming as that first step can seem, reaching out for help is the best thing you can do. Ultimately, you’ll have to quit drinking (even temporarily) and make big lifestyle changes to better manage your anxiety.
Please know that it is worth it in the end. (And so are you!)
What to know if you’re at risk for alcohol dependence?
The following quiz is called the AUDIT which stands for Alcohol Use Disorder Identification Test. It’s what medical professionals use to assess the risk level of their patients for alcohol dependence.
It is not an official diagnosis nor should it be mistaken for medical advice. You need to visit your doctor for that. But it’s a good starting point if you’re trying to get a reality check on your drinking. Take your results to your doctor or therapist and talk about next steps!