Does alcohol cause anxiety? Anxiety is often tied to both biological and situational factors, but if you feel more anxious in the hours or days after drinking heavily, it isn’t a coincidence. Many people experience an uptick in anxiety or what’s been dubbed “hangxiety” after drinking alcohol. Anyone can experience these effects, but it’s more common in people who have existing anxiety disorders like:
- Generalized anxiety disorder
- Panic disorder and panic attacks
- Social phobia
There is something to the belief that alcohol can “calm your nerves.” Ethanol, the main ingredient in alcohol, is a depressant, which means it slows down your central nervous system. It does this by suppressing neuron signaling related to feelings like fear and stress. This can temporarily reduce anxiety because it may make you feel calmer and more relaxed.
While drinking can initially feel like it’s calming you and loosening you up, drinking to ease anxiety can backfire. It’s a temporary feeling. Heavy drinking often causes rebound anxiety that is worse than the symptoms you were trying to self-medicate with alcohol.
Your chances of experiencing anxiety from drinking are low if you have your doctor’s blessing and follow the U.S. dietary guidelines for moderate drinking:
- No more than one drink a day for women.
- No more than two drinks a day for men.
If you’re drinking beyond that—especially if you already have an anxiety disorder—you should take a closer look at your alcohol use.
Alcohol can fuel anxiety in a few ways:
Drugs and alcohol affect your brain’s reward center. The reward center is tied to human survival. It reinforces actions that are central to your survival by sending pleasurable feelings. Examples of behaviors you’re rewarded for include:
- Drinking water
Alcohol and drugs influence chemicals tied to your reward center. They tell your brain to produce more of these feel-good chemicals. That’s what provides the desired feelings from drugs or alcohol.
The problem is that with ongoing alcohol abuse and overstimulation of feel-good chemicals like serotonin and dopamine, your reward center thinks you need alcohol to survive. It starts ranking alcohol right up there with food, sex, water, and sleep. Without alcohol, your brain starts sending you signals to do whatever you need to do to get more of it (survive). This can come in the form of mild or significant withdrawal symptoms.
So does alcohol cause anxiety?
Anxiety can be one of these alcohol withdrawal symptoms because your brain has begun relying on alcohol to suppress neurons tied to excitatory or fearsome chemical messages. When these neurons aren’t suppressed well enough, one of the results is often anxiety.
Though alcohol is a depressant, research suggests you may feel some stimulating effects based on your blood alcohol concentration (BAC). These may include feeling talkative, energetic, and uninhibited. Blood alcohol concentration is affected by factors like:
- How fast you drink over a period of time
- How much food is in your stomach
- What you mix alcohol with (soda, energy drinks, etc.)
In general, people may feel the stimulating effects of alcohol up to around 0.08 mg/l BAC. After that point, the initial energetic and happy feelings start decreasing and the depressant effects of alcohol kick in. For people with anxiety, the stimulating effects can feel troublesome. For others, after the stimulating effects wear off, anxiety can result from feelings of restlessness and unease.
Using alcohol to cope with anxiety can begin a cycle that brings on even more anxiety. If you drink regularly, you’ll develop a tolerance to alcohol. It will take increasing amounts to get the effects you desire. If anxiety relief is what you’re seeking, it will start taking more alcohol to ease those symptoms. Your tolerance to the self-medicating effects of alcohol can lead to stress and anxiety.
Indirect effects of alcohol can also be distressing. If you’re drinking to the point of memory loss or blackout, you’re likely to experience some anxiety over what went on during those lapses. Alcohol can make you feel uninhibited and act in ways you normally wouldn’t. This can cause embarrassment and anxiety after you sober up, especially for people with conditions like social anxiety who may already be sensitive to how others perceive them.
Anxiety from alcohol can last for hours, days, or months, depending on the scenario. Alcohol and anxiety affect people differently, but generally:
- Anxiety that accompanies a hangover may last up to a day.
- If you already struggle with anxiety symptoms, anxiety from alcohol may take longer than a day to subside.
- If you have an alcohol use disorder, anxiety may occur frequently when you go without alcohol. The imbalance of brain chemicals from alcohol dependence can make anxiety the norm except when you’re drinking.
About 20% of people with anxiety disorders also have a substance use disorder. When you have a mental health disorder and a substance use disorder, it’s known as a dual diagnosis or co-occurring disorders.
It’s often difficult to determine which came first: the anxiety disorder or the addiction. That’s because people with anxiety may unknowingly self-medicate their symptoms with alcohol. On the other hand, over time, alcohol abuse can cause symptoms of anxiety because of the way it impacts brain chemicals. In both cases, you can get stuck in the addiction cycle of:
- Using alcohol to soothe feelings of anxiety
- Experiencing rebound anxiety or more anxiety because of alcohol abuse
- Using more alcohol to combat the increased anxiety
Anxiety and depressive disorders are common underlying issues in substance use disorders. About half of people with substance use disorders have co-occurring mental health disorders. Other mental health disorders that may co-occur with alcohol addiction include:
- Mood disorders
- Bipolar disorder
- Personality disorders
Illicit drugs and some prescription drugs when abused are also tied to anxiety disorders. Like alcohol, drugs impact your brain’s reward center and interfere with brain chemicals responsible for:
Drug-induced anxiety can be a symptom from the direct effects of the drug. They can also be part of withdrawal when you go without the drug. Drugs linked to anxiety include:
- ADHD medications
- High doses of THC (cannabis, marijuana)
- Opioids (as part of withdrawal)
Alcohol addiction treatment must address underlying issues like anxiety, trauma, and other mental health disorders. Without getting to the root causes of drinking, you’re at high risk of relapse. Addiction treatment helps you manage mental health disorder symptoms and teaches you alternative ways to cope with anxiety and stress.
Anxiety treatment may include research-backed behavioral approaches like:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Acceptance and commitment therapy (ACT)
Anti-anxiety medications may be prescribed to also help manage symptoms.
Other components of professional treatment for substance abuse may include:
- Alcohol detox
- Individual therapy
- Group therapy
- Family therapy
- Medication management
- Holistic approaches like yoga, art therapy, and mindfulness
- Introduction to groups like Alcoholics Anonymous
- Aftercare planning
Looking for Help?
Whether or not alcohol has caused your anxiety, if you are struggling with alcohol abuse and co-occurring disorders like anxiety, call us for a free, confidential consultation. Footprints to Recovery provides evidence-based substance use disorders treatment that includes therapeutic approaches for anxiety and other psychiatric conditions.