Social Anxiety & Alcohol: What’s the Connection?

What Is Social Anxiety?

Social anxiety is an intense, sometimes debilitating fear of judgment from others. People with social anxiety often over-analyze their conversations, worry that they are embarrassing themselves, and feel perceived scrutiny. One review shows that between 7 and 8% of US adults struggle with Social anxiety disorder, and these are just the ones that have been diagnosed based on the criteria of the Diagnostic and Statistical Manual IV (DSM-5).¹ There is a spectrum of how people experience social anxiety.

Virtually every person experiences social anxiety at some point in their life. Whether it is becoming flushed when stepping up to present to an audience, noticing that your hands are sweaty and your heart is racing when talking to someone you’re attracted to, or struggling to maintain eye contact and stammering for words when meeting new people. These are just a few examples of how social anxiety can be identified.

Common negative effects of social anxiety include:²

• Low self-esteem
• Critical & negative self-talk
• Difficulty asserting needs
• Lack of social skills
• Hypersensitive to feedback and criticism.
• Isolation
• Limited relationships
• Substance abuse
• Avoidance
• Increased risk of suicide

Why People Use Alcohol For Social Anxiety

One study reported that around 15 to 20% of those struggling with social anxiety also struggle with alcohol abuse.³ A clinical review of studies suggests that those struggling with social anxiety geared more toward social interactions, such as meeting new people or attending events with larger crowds, are more likely to abuse alcohol than those with social anxiety that focuses on presentations, for example.⁴

People struggling with social anxiety use alcohol to help cope and decrease the anxiety and suppress the worries of social judgment to allow them to feel more sociable. If this experience feels positive or successful, it reinforces the use of alcohol during future social situations.⁵

Tension Reduction

Alcohol is a depressant and, when consumed, can suppress symptoms of anxiety for a brief period of time. This reprieve can be long enough for individuals with social anxiety to feel that it is helpful in calming their nerves during social engagements. Not only has research shown that people struggling with social anxiety increase their intake during social situations but also in preparation for attending the event.⁶

The effect of alcohol on anxiety is called Stress-Response Dampening. The effects alcohol has on stress depend on different biological factors like family history of alcoholism, gender, personality traits, and cognitive functioning.⁷ All of these play a role in how drinking alcohol will decrease the symptoms of anxiety.

Genetics

Anxiety and alcoholism are both known to be genetic. The American Addiction Center has found that there is a 50% increase in the likelihood a person will struggle with alcoholism if it runs in the family.⁸ Anxiety is also hereditary, and if it goes unmanaged, a person might be more inclined to lean into alcohol if they find it offers some relief from the constant and intense fear of social judgment.

Expectations Of Anxiety Relief

Expectations of alcohol relief for social anxiety are based on the hope that insecurities, fear of judgment, and discomfort will be alleviated. The thought is that the alcohol will provide a sense of confidence and allow for more social engagement or, at minimum, make conversations more manageable.

Does Alcohol Help With Social Anxiety?

Social anxiety can significantly impact a person’s ability to explore the world and put themselves out there. It can cause them to avoid going out, and connecting, and even cause them to skip going to school or work. Alcohol, when used to manage social anxiety, is used to decrease symptoms of avoidance, quiet the negative worry thoughts, and lower inhibitions.

Unfortunately, these perceived benefits don’t last very long. Eventually, the alcohol wears off and frequently causes an increase in negative physical and emotional symptoms. Heavy drinking can increase anxiety, impact sleep, and cause irritability. The effects of alcohol are not sustainable and can lead to alcoholism if abused.

Can Using Alcohol to Help Social Anxiety Lead to Alcohol Abuse?

Yes, there is a high rate of people who struggle with social anxiety and also find themselves struggling with alcohol abuse. However, the effects of alcohol don’t last, and they don’t alleviate the symptoms of social anxiety permanently. There becomes a need to continue utilizing alcohol when in social situations. This creates a reliance, which based on other factors mentioned above, can lead to alcohol abuse. According to a survey taken in 2021, 28.6 million adults ages 18 and up meet the criteria for alcohol use disorder.⁹

Common examples of signs of alcohol abuse include:⁸

• You feel guilt or remorse after drinking
• You’re prone to binge drinking, or heavy drinking in a short amount of time
• Inability to control or cut down on drinking
• Continued use regardless of consequences
• You have to increase your drinking to get the same effect.
• Impacts your ability to function in life
• Trying to hide when you are drinking
• Blacking out frequently
• You start experiencing withdrawals

Signs of Alcohol Misuse

If someone is anticipating going to an event where there will be a group of people, the social anxiety will have already started to sink in. This could prompt a glass or two of liquid luck with the intent of feeling more comfortable walking into the event. If they continue to experience anxiety, critical thoughts, and irrational beliefs about being judged, they might be prompted to continue drinking.

Tips for Overcoming Social Anxiety Without Alcohol

Social anxiety is a common and difficult mental health issue to manage, and it can be a lifelong experience. Fortunately, there are many other ways to manage social anxiety that don’t involve the misuse of alcohol. Because there are many options, each person can try out different techniques and find ones that work best for them.

Tips for managing social anxiety without alcohol include:

• Mindful breathing: Learning breathing skills can help to regulate the nervous system. Noticing each breath can help with grounding to the moment, keeping the mind out of the spiral of negative thoughts.
• Therapy: There are many different evidence-based treatments that have been shown to be very effective, including CBT for social anxiety.
• Medication: talk to a clinician to explore if medication would be beneficial. SSRIs are commonly prescribed for social anxiety.
• Notice & challenge negative thoughts: By noticing negative beliefs, like “They think I’m stupid” or “I shouldn’t have said that” they can then be challenged and reframed.
• Grounding Techniques: Utilizing skills that engage one or more of the five senses helps to keep the mind present in the moment and out of the worried thoughts. Noticing the different colors and sounds, working to stay present and focused on the conversations, and even playing the ABC game of identifying something in the area that starts with each letter of the alphabet.
• Role-play conversations and have topics in mind: going to an event prepared to engage can be very helpful. If the conversation starts to simmer out, have topics ready to go to start it back up.
• Positive affirmations: Consider some positive affirmations that can be repeated throughout the social event. Whatever helps remind you that you can make it through and it’s okay to be yourself.
• Keep trying: It’s important to continue to challenge the anxiety and work to engage in different social situations. Avoidance only increases the severity of the anxiety. Challenge the anxiety by going out and practicing social skills to build confidence.

It’s important to seek additional support from a professional if social anxiety and alcohol use don’t seem to be decreasing. Starting therapy has many benefits and can offer different techniques that allow for a life without the heaviness of anxiety and alcohol.

When to Seek Support For Managing Social Anxiety

Seeking social anxiety treatment can be very beneficial, and there are many therapeutic interventions that can help. If you’d find yourself avoiding social situations, isolating, or feeling symptoms of panic, it might be time to consider additional support. If you’re struggling to make it to work or school due to an overwhelming fear of social interactions or presenting, it is highly encouraged to seek therapy. If going in person feels distressing, then consider virtual sessions. Therapists who offer virtual visits can be found on an online therapist directory or online therapy for anxiety platform. If you are considering medication and have explored this with a clinician, there are many online psychiatrist options.

In My Experience

In my experience, the use of alcohol for social anxiety is a pretty common occurrence. Alcohol is frequently used to lower inhibitions in many different scenarios, and the use of alcohol socially is a long-standing cultural norm. It makes sense that it is an easy habit to fall into. Fortunately, there are many ways to seek support, and treatment is effective when there is commitment and an ability to be open about the struggles.