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 over the years an increase in anxiety symptoms in your day-to-day life.
Why does this happen? Does alcohol cause anxiety?
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 when alcohol lowers these levels we lose those safeguards.
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.
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.
The unfortunate reality is that 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, which, ironically, is 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 structure of the brain in ways that make it difficult for people to manage their behavior and moods, which makes them more susceptible to anxiety and anxiety disorders.
Alcohol is a depressant. It tamps down our bodies fight or flight response by suppresing the amygdala. We like this effect. It’s why we drink after a hard day.
The problem is that our brain is going to 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 nuerotransmitters. As the alcohol wears off, we are left with an artifically 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.
How self-medicating anxiety with alcohol becomes a vicious 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, which is a recipe for disaster for anyone already struggling with anxiety.
The more someone drinks, the harder the brain must work to restore balance, which leads to 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 had evolved into a nearly daily drinker, I noticed new symptoms pop up.
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 was going to 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 was having 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).
It only got worse.
I don’t know when or for 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 just to check one more time.
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 not a clear relationship between the two.
Abusing alcohol disrupts the brain’s chemistry and its 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.
It gets better, but you have to quit drinking.
Most people don’t want to hear they should quit drinking alcohol, but that’s exactly what I’m going to suggest to you.
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, possibly forever. The stakes are too big for me to risk it. I won’t tell you to make the same choice, but if you want to break free of this cycle, quitting alcohol for the foreseeable future is your best option.
FAQs on Alcohol and Anxiety
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 a combination of 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’re going to have to quit drinking (even temporarily) and make some big lifestyle changes in order to better manage your anxiety.
Please know that it is worth it in the end. (And so are you!)
Access should not be a barrier to help.
Soberish is proudly sponsored by BetterHelp. If you have tried (and failed) to find a therapist who has the knowledge and background to help you navigate your specific issues, try BetterHelp. Learn more about my counseling journey with BetterHelp or visit their website below.