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Alcohol & Anxiety: Connections & Risks

Published: March 31, 2021 Updated: January 5, 2023
Published: 03/31/2021 Updated: 01/05/2023
Headshot of Sonia Martin, LCSW
Written by:

Sonia Martin

LCSW
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • Can Alcohol Ease Symptoms of Anxiety?Ease Symptoms?
  • Can Drinking Alcohol Cause Anxiety?Cause Anxiety?
  • How Alcohol Can Worsen Anxiety SymptomsWorsens Symptoms
  • Alcohol Addiction & Anxiety as Co-Occurring DisordersCo-occurring
  • Treating Co-Occurring Anxiety & Alcohol Use DisordersTreatments
  • Final Thoughts On Alcohol & AnxietyConclusion
  • Additional ResourcesResources
Headshot of Sonia Martin, LCSW
Written by:

Sonia Martin

LCSW
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD

People have many methods of trying to ease their anxiety, and alcohol is one of them. It’s used as a sort of numbing agent for uncomfortable feelings. This form of self-medication tends to be common in social situations, including large gatherings of people or something more intimate like a first date; or, it can be used to cope with anxiety about a job, money, or relationship issues.

However, this coping mechanism can result in the development of an alcohol dependency.

Instead of drinking to lessen anxiety, would you consider trying therapy? BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp

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Can Alcohol Ease Symptoms of Anxiety?

While alcohol can lead to an immediate decrease in anxiety levels—lowering your inhibitions, causing a false sense of relaxation—drinking in excess can actually have the opposite effect, causing you to feel out of control. While it may seem like an appealing form of self-medication due to accessibility, the issue often becomes controlling the amount and frequency of alcohol consumption, as well as how dependent you become.2

Can Drinking Alcohol Cause Anxiety?

Ultimately, alcohol can cause anxiety. When you drink too much, you may do or say things that are out of character, leading to feelings of regret. Over time, drinking too much can also cause memory loss, blackouts, and brain damage. Naturally, coping with these outcomes causes stress.

Paradoxically, while alcohol can cause anxiety, anxiety can also lead to an alcohol use disorder. Someone with an anxiety disorder is three times more likely to develop an alcohol use disorder at some point in their life compared to someone who has never been diagnosed with anxiety.1

How Alcohol Can Worsen Anxiety Symptoms

Initially, alcohol may mask symptoms of anxiety, but it can worsen your condition in the long run.2 Heavy drinking produces physiological changes, including affecting neurotransmitter levels in the brain, which can cause anxiety. Blackouts can also cause severe anxiety, and in extreme cases, lead to panic attacks. Lastly, alcohol leads to interrupted sleep, which can worsen existing anxiety.

How Alcohol Can Interfere With Anxiety Medications

Many anxiety medications interact with alcohol, increasing risk of drowsiness, sedation, impaired judgment, trouble concentrating, and slowed reflexes. In some cases, alcohol can cause medication to become less effective or toxic.3 Combined negative effects of alcohol and certain medications on the liver even lead to liver toxicity. Specifically, benzodiazepines combined with alcohol can lead to overdose and death.3

Alcohol Addiction & Anxiety as Co-Occurring Disorders

Alcoholism and anxiety are often co-occurring and tend to feed off each other.4 Many people with anxiety seek out ways to self-medicate with alcohol before ever turning to a mental health professional. According to the Anxiety and Depression Association of America (ADAA), about 7% of Americans use alcohol to cope with anxiety, and approximately 20% people with social anxiety disorder suffer from alcohol dependence.

Some of the signs and symptoms of an alcohol addiction include:

  • Inability to control the amount of alcohol consumed
  • Withdrawing from normal activities of daily life
  • Experiencing alcohol withdrawal symptoms when alcohol is not consumed
  • Drinking even though one is aware of the negative impacts

In many cases, alcohol dependence develops when it’s used as a coping mechanism for stress, anxiety, and/or trauma. In general, it’s a commonly co-occurring disorder with other mental health conditions.5 Also, those who have a parent with an alcohol addiction are more susceptible to developing one of their own.

Options For Anxiety Treatment

Talk Therapy – Get help from a licensed therapist. Betterhelp offers online therapy starting at $60 per week. Get matched With A Therapist


Virtual Psychiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp and Talkiatry.

Treating Co-Occurring Anxiety & Alcohol Use Disorders

You can treat co-occurring anxiety disorders and alcohol use disorders with a variety of coping mechanisms, including therapy, medication, and health alternative practices like yoga and meditation. These methods work to treat underlying symptoms instead of masking them.

Therapy

Speaking to a therapist can be an effective way of managing symptoms of alcohol and anxiety. One of the most effective modalities is cognitive behavioral therapy (CBT), which works to identify and interrupt negative thought patterns. Another similar modality is dialectical behavioral therapy (DBT), which combines aspects of CBT and alternative mindfulness techniques. DBT is more structured and targets anxiety with mindfulness, distress tolerance, and emotional regulation.

Medication

Medication is often used in conjunction with therapy to target symptoms of anxiety, but it can be a sole treatment. Types of medications include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, and beta-blockers. All medications should be used with caution, especially by someone struggling with alcohol dependence, due to potentially dangerous interactions.

There are also medications that curb alcohol cravings or cause you to feel ill if you consume it.

Healthy Alternatives

Mindfulness exercises are a great way to quiet the mind, focus on positive affirmations, and challenge negative thought patterns. Developing healthy routines like exercise, yoga, and meditation also help you maintain a better sense of calm. When you’re experiencing anxiety, try doing a full body scan. Breathe deeply and take an inventory of where you’re holding tension; as you breathe, calm yourself and allow fear to melt away.

Final Thoughts On Alcohol & Anxiety

If you’re dealing with alcohol and anxiety, remember, you’re not alone. Reaching out to a mental health professional (or your personal medical care provider) can be a great first step in mitigating symptoms of alcohol anxiety. It is always a good idea to expand your support system, because the more people you have to help you through, the better.5 One way to find the right therapy is through an online directory.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Talk Therapy

Online-Therapy.com – Get support and guidance from a licensed therapist. Online-Therapy.com provides 45 minutes weekly video sessions and unlimited text messaging with your therapist for only $64/week. Get Started

Virtual Psychiatry

Hims / Hers – If you’re living with anxiety or depression, finding the right medication match may make all the difference. Get FDA approved medication prescribed by your dedicated Hims / Hers Healthcare Provider and delivered right to your door. Plans start at $25 per month (first month)*. Get Started

Anxiety Newsletter

A free newsletter from Choosing Therapy for those impacted by anxiety. Get helpful tips and the latest information. Sign Up

Learn Mindfulness, Meditation, & Relaxation Techniques

Mindfulness.com – Change your life by practicing mindfulness. In a few minutes a day, you can start developing mindfulness and meditation skills. Free Trial

Choosing Therapy Directory

You can search for therapists by specialty, experience, insurance, or price, and location. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Online-Therapy.com, Hims / Hers, and Mindfulness.com. *Hims / Hers Disclaimer: Subscription required. After first month, price is $85/month for a monthly subscription or $49/month for a three-month subscription ($123 for first order, $147 billed quarterly thereafter). Subscription automatically renews unless you cancel at least 7 days before renewal is processed.

For Further Reading

  • Best Books About Alcoholism
  • Best Apps to Maintain Sobriety
  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov
5 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Anker J. Co-occurring alcohol use disorder and anxiety: Bridging the psychiatric, psychological, and neurobiological perspectives. ARCR. 2019;40(1). doi:10.35946/arcr.v40.1.03

  • Abrams K, Kushner M, Medina KL, Voight A. The pharmacologic and expectancy effects of alcohol on social anxiety in individuals with social phobia. Drug Alcohol Depend. 2001;64(2):219-231. doi:10.1016/S0376-8716(01)00125-9

  • The Effects of Mixing Benzodiazepine and Alcohol. Alcohol.org. Accessed at https://www.alcohol.org/mixing-with/benzodiazepine/

  • Silberman Y, Bajo M, Chappell AM, et al. Neurobiological mechanisms contributing to alcohol-stress-anxiety interactions. Alcohol. 2009;43(7):509-519. doi:10.1016/j.alcohol.2009.01.002

  • Smith JP, Randall CL. Anxiety and alcohol use disorders: Comorbidity and treatment considerations. Alcohol Res. 2012;34(4):414-431.

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Headshot of Sonia Martin, LCSW
Written by:

Sonia Martin

LCSW
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • Can Alcohol Ease Symptoms of Anxiety?Ease Symptoms?
  • Can Drinking Alcohol Cause Anxiety?Cause Anxiety?
  • How Alcohol Can Worsen Anxiety SymptomsWorsens Symptoms
  • Alcohol Addiction & Anxiety as Co-Occurring DisordersCo-occurring
  • Treating Co-Occurring Anxiety & Alcohol Use DisordersTreatments
  • Final Thoughts On Alcohol & AnxietyConclusion
  • Additional ResourcesResources
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