Why Does Alcohol Cause Panic Attacks?

When some people feel the weight of stress and anxiety in their lives, they might choose to have a drink of alcohol to relax and decompress. Normal, right?

But what if I told you that drinking alcohol to soothe anxiety is actually making the problem significantly worse? What if I told you that drinking alcohol can actually lead to a panic attack?

Why Alcohol Causes Anxiety

To understand why alcohol causes anxiety and anxiety attacks, it’s important to understand how the brain works.

Your brain is designed to keep you at a baseline of happiness. This is called homeostasis. If you get too excited or, conversely, a little down, all your brain wants to do is return it to the baseline. In response, it will produce the necessary chemicals to get you there.

Alcohol Disrupts Brain Chemistry

Alcohol is a drug that alters your brain chemistry. In the first 30-40 minutes, it makes you feel calm and relaxed, even euphoric. But after that point, it’s a bit of a downhill slide. 

Why? Because your brain doesn’t like imbalance.

You see, alcohol is a depressant that affects your central nervous system, which means it slows down brain activity and can make you feel more relaxed and carefree initially. However, as you continue to consume alcohol, it can disrupt the balance of chemicals in your brain, including serotonin, a neurotransmitter responsible for regulating mood.

Here’s the catch: while alcohol may initially make you feel less anxious, it can actually make anxiety worse in the long run.

As alcohol leaves your system, your brain tries to compensate for the depressive effects by producing more excitatory neurotransmitters.

This rebound effect can lead to increased feelings of anxiety, agitation, and even panic. Additionally, alcohol can interfere with your sleep patterns and deplete essential nutrients, like B vitamins, which are important for maintaining good mental health.

Remember, the brain likes homeostasis.

Euphoria is not your brain’s natural state, so it’s going to try to readjust. 

This is why after a couple of drinks you might start to feel anxious or on edge. When you drink even more alcohol to counter those effects, you’ll get a temporary boost back up, but then the brain will spring into action, releasing more excitatory neurotransmitters to try to get your brain chemistry back into balance. 

Your brain is now engaging in a chemical tug of war with itself, spiking up past its baseline with every drink, and plunging back down below with every effort to correct for the artificial boost in dopamine brought about by drinking. 

We can see the impact of alcohol on people as they drink.

How many times have you seen someone start off the night in a happy, calm mood only to become increasingly agitated or sad? Maybe at the end of the night, they’re crying to strangers at the bar or picking fights. What happened? 

Alcohol induces emotional instability. If you are predisposed to emotional fluctuations, the effects can be even more pronounced. 

Alcohol Causes Dehydration

When you consume alcohol, it acts as a diuretic, which means it increases urine production and can lead to dehydration.

When your body is dehydrated, it disrupts the balance of various bodily functions, including those that contribute to your mental well-being. Here’s how dehydration can increase anxiety symptoms:

1. Your Brain Doesn’t Function Properly:

Your brain relies heavily on proper hydration to function optimally. When you’re dehydrated, the brain may not receive enough water to maintain its normal functions. This can affect neurotransmitter production and balance, including serotonin, which plays a crucial role in regulating mood. Low levels of serotonin have been linked to increased anxiety.

2. Your Cortisol Levels Increase:

Dehydration can trigger the release of stress hormones, such as cortisol. Cortisol is associated with the body’s stress response and can exacerbate feelings of anxiety and tension. Elevated cortisol levels can make you feel more on edge and prone to anxiety symptoms.

3. You Feel Really Uncomfortable:

Dehydration can also cause physical discomforts, such as headaches, dizziness, and fatigue – all of which can contribute to feelings of unease and distress, which can amplify anxiety. When your body is already experiencing discomfort, it becomes easier for anxious thoughts and sensations to take hold.

4. Your Nervous System Becomes More Sensitive:

Dehydration can make your nervous system more sensitive and responsive to stressors. This means that even minor stressors or triggers that wouldn’t typically provoke anxiety in you can have a stronger impact when you’re dehydrated. (Translation: you have a shorter fuse.) It’s as if your body’s alarm system becomes more sensitive which makes anxiety symptoms much worse.

Alcohol Lowers Blood Sugar

When you drink alcohol, it can actually lower your blood sugar. Here’s how it goes: your body treats alcohol as a toxin and tries to get rid of it ASAP.

So, while it’s busy processing the alcohol, your liver isn’t able to release glucose into your bloodstream like it normally would. This can lead to a drop in blood sugar levels, aka hypoglycemia.

And guess what? Low blood sugar can trigger anxiety-like symptoms, leaving you feeling jittery and on edge.

The combined effect of all of this can lead to some serious anxiety symptoms later in the night or the day after drinking. If you drink chronically, this can increasingly become your natural state.

Alcohol, Anxiety, and Panic Disorders

To consume large quantities of alcohol daily or even several times per week is to subject yourself to chemical spikes and dips which leave you more susceptible to developing anxiety disorders as well as panic disorders.

In fact, it’s estimated that 20% of people who seek treatment for panic disorders also struggle with alcohol abuse. It’s also estimated that up to 40% of alcoholics struggle with panic disorders.

I was one of them.

What is a panic attack?

Before we proceed, let’s establish what panic attacks even are and how they are related to anxiety.

The Mayo Clinic defines panic attacks as a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause.

They can come on suddenly and without warning.

Over time, repeated exposure to intense stress and heightened anxiety levels can trigger panic attacks.

Want to understand panic attacks more? This short video provides an excellent explainer:

Signs of a Panic Attack Include:

• Sense of impending doom or danger
• Fear of loss of control or death
• Rapid, pounding heart rate
• Sweating
• Trembling or shaking
• Shortness of breath or tightness in your throat
• Chills
• Hot flashes
• Nausea
• Abdominal cramping
• Chest pain
• Headache
• Dizziness, lightheadedness or faintness
• Numbness or tingling sensation
• Feeling of unreality or detachment

Alcohol makes you more susceptible to panic attacks.

The chemical spikes and dips you experience from heavy drinking catch up to you. People who consume large quantities of alcohol several times per week or more put themselves at risk for long-term damage.

Long-term alcohol abuse can fundamentally change the structure of the brain.

The constant overcorrection to the flood of dopamine brought about by alcohol leaves people unable to produce adequate levels of dopamine on their own.

What results is a vicious cycle of spiraling depression, increased anxiety levels, and a desperate attempt to feel better by drinking more, which ultimately makes the situation worse.

It all becomes too much. Eventually, you may develop a panic disorder.

Panic Attacks The Day After Drinking

Sometimes alcohol can produce panic attacks the following day. This is known as the dreaded ‘hangxiety.’ 

The same emotional swings cause next-day panic attacks from alcohol. It is just a delayed response. 

The day after heavy drinking, your brain is flooding the zone with excitatory neurotransmitters in an effort to restore balance back to your brain.

Alcohol also blocks glutamate, an excitatory neurotransmitter linked to anxiety. If you are someone who struggles with an anxiety disorder, this feels especially wonderful. For a time, it shuts all the brain chatter down.

The brain responds to an influx of alcohol by blocking GABA and increasing glutamate. In the absence of alcohol, that increase results in terrible anxiety.

For many people, those effects don’t happen until the following day, which is why some people will experience a panic attack from alcohol the day after drinking.

My Story With Alcohol and Panic Attacks

During the height of my drinking days, I used to wake up to a racing heart and the most intense feelings of dread. It was all I could do to get out of bed and go to work.

There were a few times at work when I suddenly felt dizzy. My ears would get warm and I wouldn’t be able to concentrate. I’d get spots in my vision and feel weak.

Eventually, those feelings intensified. My chest would feel tight and no amount of deep breathing could settle me down. I was terrified.

When I went to the doctor, my resting heart rate was over 140. They hooked me up to an ECG and ran breathing tests. After those tests didn’t produce clear answers, my doctor sat me down and said, “I think you have an anxiety disorder.”

What I didn’t know at the time was the extent to which my drinking was triggering all of it.

Alcohol Disrupts Sleep Which Can Also Cause Panic Attacks

A way that alcohol inadvertently causes panic attacks is by robbing your body of high-quality sleep. 

When we drink and pass out, we don’t actually sleep properly.

Our bodies don’t go through the proper REM cycles, which is why you can pass out for 10 hours and wake up still feeling as if you haven’t slept a wink. 

People who are prone to anxiety are especially sensitive to the effects of insufficient sleep. 

Getting a bad night of sleep due to heavy drinking is therefore a double whammy. Your brain chemistry is in the tank after a night of artificial dopamine spikes and now you’re sleep deprived as well. 

The combination can lead to an increased risk of panic attacks and crippling anxiety.

To learn more about alcohol’s impact on sleep quality, watch this video:

Long Term Alcohol Use and Anxiety Attacks

When you drink heavily on a regular basis, you are subjecting your brain and body to this cycle repeatedly.

Your body has no chance to rest, heal, or recharge. It is in a constant state of spikes and dips with no actual relief. 

This is unsustainable. It’s why you crash. 

It’s also why your body becomes so flooded with stress and anxiety that you may begin to experience panic attacks.

Once your mental health reaches this level, the road to recovery becomes significantly more challenging.

In addition to quitting alcohol, you will likely need medical intervention in the form of medication, cognitive behavioral therapy, or both.

This is further reason to not take alcohol-induced anxiety or panic attacks lightly. The longer you subject yourself to this cycle, the harder the road back to happiness and balance becomes.

What To Do If You Experience Panic Attacks From Alcohol

If you suffer from panic attacks after episodes of heavy drinking, there are a few steps you’ll want to take.

1. Do some mindful breathing.

Breathe in for four focused seconds, and then exhale for six focused seconds. Repeat this activity for 1-2 minutes. This will stimulate your parasympathetic nervous system, helping you to calm down.

2. Get outdoors.

The benefits of ecotherapy are well known. Spending time in nature can promote feelings of calm and well-being. You might also try a grounding technique. Take off your shoes and stand barefoot on the ground. Stretch tall and imagine yourself firmly rooted to the ground like a tree.

3. Quit drinking alcohol.

For people who drink, this is easier said than done. Even quitting temporarily has multiple benefits. Experiencing alcohol-induced panic attacks is a serious sign that it’s time to rethink your relationship with alcohol.

4. Get professional help.

Panic disorders are serious business. If you experience panic attacks or debilitating anxiety after drinking, consult a medical professional or trained therapist.

They can properly assess the severity of your case and recommend an appropriate treatment plan, which may be medication, cognitive behavioral therapy, or a combination of the two.

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