How Alcohol Can Increase Anxiety

We all feel anxious sometimes and to varying degrees. It’s perfectly normal to feel jittery or nervous before taking an exam or on the first day of a new job. When anxiety becomes problematic is when it is extreme and out of proportion with your current situation and when it persists for days or weeks at a time.

There are several types of anxiety disorders that can be diagnosed. They include generalized anxiety, social anxiety, panic disorder, agoraphobia, and other specific phobias. Women are more likely to be diagnosed, but many people experience an anxiety disorder at some point in their lives; these are the most common types of mental illness. The criteria used to diagnose general anxiety disorder include:

• Excessive anxiety on most days for six months or longer
• Difficulty controlling anxiety and worry
• Restlessness
• Getting fatigued easily
• Difficulty concentrating, a blank mind
• Irritability
• Muscle tension
• Difficulty sleeping

To be diagnosed with this condition the symptoms have to cause significant distress and impairment. However, even if you don’t quite meet all the criteria, anxiety can be a real problem in your life, one that alcohol can worsen and that can benefit from professional support.

It is a well-known fact that alcohol can trigger anxiety or make someone who’s already anxious feel even worse. Whether or not alcohol actually causes anxiety disorders is not clear, but it is definitely true that alcohol misuse is a risk factor.

Also well documented is the fact that withdrawal from alcohol triggers significant anxiety. This is a common symptom during detox for anyone going through treatment. The anxiety can be severe enough to warrant careful treatment with a benzodiazepine, a prescription depressant and anti-anxiety medication.

Research indicates that the strongest connection is between alcohol use disorder and anxiety, as compared to alcohol misuse. In other words, if you abuse alcohol you may develop an anxiety disorder, but it’s more likely if you actually become dependent on alcohol.

The evidence is clear and proves there is a connection between drinking and anxiety. What that research does not tell us, though, is why the connection exists. A tendency to drink and anxiety may have common risk factors that cause them to commonly co-occur, for instance. And, someone with an anxiety disorder may be more likely to use alcohol as a way to self-medicate.

These explanations are certainly possible for some situations and people, but there is also evidence that alcohol and drinking do actually cause or worsen anxiety. There are several ways to explain the phenomenon:

• Regular, heavy drinking changes the brain in important ways. It reduces a neurotransmitter called GABA, for instance. This, in turn, can increase anxiety.
• Anxiety may also result because of the social problems, or complications, caused by drinking. Things like relationship problems, a job loss, or financial difficulties caused by drinking can cause anxiety.
• Drinking disrupts sleep, and poor quality sleep or inadequate sleep can also trigger anxiety or worsen these feelings.
• Alcohol depletes the body of certain minerals and vitamins, like folic acid. Drinking also tends to lead to bad food choices. Resulting deficiencies or malnutrition impact mental health and increase anxiety.
• Feelings of embarrassment or shame are not uncommon after drinking too much. Worrying about what you did or said the night before is an anxiety trigger.
• Even one night of drinking can trigger withdrawal the next day. You don’t have to be alcohol-dependent to experience this, and withdrawal causes anxiety.

Any type of anxiety can lead you to drink. You may use alcohol as a coping strategy, which is not uncommon. Initially, alcohol will make you feel more relaxed, but the strategy backfires. One particular type of anxiety that often triggers drinking is social anxiety.

Social anxiety disorder causes abnormal levels of fear and anxiety in social interactions. This kind of anxiety disorder can be seriously disruptive, because it tends to cause people to be isolated. If you struggle with this kind of anxiety you are likely to avoid social situations, even including work.

This is a major reason some people turn to alcohol. If you have to face interacting with people, a prospect that causes fear and intense worry, you may drink to ease those feelings and to make interactions easier. A substance use disorder can easily develop from this behavior and is a recognized complication or co-occurring disorder with social anxiety. Ultimately, alcohol as a coping mechanism only makes the anxiety worse and creates other problems.