Sometimes, people turn to alcohol or other substances to help them cope with symptoms of mental illness. In some cases, people with certain mental health conditions, such as anxiety or panic disorder, might develop an unhealthy relationship with alcohol. This article explores the reasons people use alcohol to cope with anxiety and the effect it may have. It also discusses how to recognize when you have an alcohol problem and how to get treatment for anxiety and alcohol use disorders.
Alcohol’s Effects
Alcohol depresses the central nervous system (CNS). When someone first has a drink of alcohol, it often has a sedative effect. However, the long-term effects of alcohol can cause anxiety or make the symptoms of an anxiety disorder worse. Additionally, chronic alcohol use can lead to tolerance or dependence, as well as cause physical damage to the body (including the brain, liver, and heart).
Why People Use Alcohol for Anxiety
People with anxiety disorders, including panic disorder and agoraphobia, sometimes use alcohol to cope with feelings of fear and anxiety. There are a number of theories to explain why this happens:
Tension Reduction
One theory of why this happens is called the “tension reduction hypothesis.” This theory suggests that alcohol is used as a self-medicating method to reduce stress and anxiety.
Genetics
Other researchers have proposed a genetic link influencing a person’s anxiety level and alcohol consumption. These biological theories suggest that there could be a brain mechanism that is responsible for both anxiety symptoms and drinking behaviors.
Expectations for Anxiety Relief
Another proposed theory refers to an expectancy component in people with anxiety who use alcohol. In this situation, a person expects to get relief from their anxiety symptoms when they consume alcohol because of its effect on the central nervous system (CNS). A person’s drinking behavior becomes associated with their level of anxiety and how much relief they expect alcohol will provide. In this scenario, the more anxiety a person experiences, the more they tend to drink to alleviate their anxiety.
How Alcohol Affects Anxiety Disorders
A review of studies published in 2012 found that anxiety disorders and alcohol use disorders often occur together. Several proposed explanations exist for the link, including genetics, a person’s environment, and the brain mechanisms related to addiction and anxiety symptoms. Given the possible connection, it’s not surprising that additional research has shown that treating one condition requires adequately addressing the others. Studies have shown that alcohol use disorders are more prevalent in people with specific mental health conditions, including agoraphobia, generalized anxiety disorder, social anxiety disorder, and panic disorder.
Social Anxiety Disorder and Agoraphobia
The onset of symptoms related to social anxiety disorder and agoraphobia can be a trigger for some people to develop unhealthy relationships with alcohol. For example, a person with social anxiety might be afraid of going to a party where there will be many people they do not know. Even simply thinking about attending the gathering might cause them anticipatory anxiety. When these symptoms become overwhelming, the person might have an alcoholic drink to try to calm down. They might also consume alcohol at the gathering to feel more relaxed or less inhibited around others. If they continue to use alcohol to help them feel more relaxed or at ease, they might eventually feel the need to avoid any social situations where they would be unable to drink. Long-term alcohol use also often leads to tolerance, when a person needs to drink more to get the desired effect. For example, a person might have started feeling more relaxed after just one glass of wine. As time goes on, however, they might find they need two, three, or more glasses of alcohol to get the same feeling.
Generalized Anxiety Disorder and Panic Disorder
Studies have shown a different trend of alcohol use in people who are diagnosed with generalized anxiety disorder or panic disorder. For many people with these mental health conditions, unhealthy drinking behaviors begin around the same time as the disorder’s symptoms. Researchers are not sure what the connection means. The initial symptoms of anxiety and panic may be related to alcohol withdrawal. It could also be that alcohol use provides a mechanism for these disorders to develop.
Side Effects of Alcohol Misuse
Even if someone starts drinking alcohol as a way to cope with anxiety, it can quickly have the opposite effect. For one, drinking alcohol more frequently or having larger amounts can cause hangovers. The symptoms of a hangover, such as nausea and vomiting, dizziness, dehydration, and low blood sugar, can make it hard to function. If someone is sick because of a hangover, they might not be able to attend to their responsibilities at home, school, or work—which can, in turn, fuel their anxiety. Heavy or regular alcohol misuse also often leads to withdrawal. The symptoms of alcohol withdrawal and anxiety disorders can be similar. Alcohol withdrawal symptoms can include:
Agitation Anxiety Elevated blood pressure and heart rate Increased body temperature Nausea Panic attacks Vomiting
How Much Alcohol Is Too Much?
The Centers for Disease Control and Prevention (CDC) offers specific definitions for “heavy drinking.” The CDC considers one standard drink to be the equivalent of:
One 12-ounce bottle of beer (5% alcohol)OR one 5-ounce glass of wine (12% alcohol)OR one 8-ounce bottle of malt liquor (7% alcohol)OR 1.5 ounces of 80-proof distilled spirits or liquor (40% alcohol)
Signs of Alcohol Misuse
Whether you have a mental health condition like anxiety or not, certain behaviors can signal that your relationship with alcohol could cause concern.
For women, heavy drinking is considered 8 or more drinks per week. For men, heavy drinking is considered 15 or more drinks per week.
You might recognize these behaviors in yourself, or someone in your life may have made you aware of them. Signs of alcoholism can include:
You drink alcohol frequently or excessively. According to the ADAA, this would be drinking alcohol four or more times per week. It can also mean having five or more drinks in one day. You feel that you need to consume alcohol and are unable to stop. You might feel that you need a drink to function in your daily life. This might take the form of feeling that you need a drink before you can wake up and start your day. You need alcohol to get through the day. You might feel the need to have more drinks throughout the day to keep yourself going. You drink to avoid withdrawal. You might feel that you need to continue drinking to prevent withdrawal symptoms. You feel guilt, shame, remorse, or other intense emotions about your drinking. Having these feelings about your relationship with alcohol without having the support you need to confront them can make it more difficult to cope. You might find that the intense shame you experience drives you to drink more as you try to escape your uncomfortable feelings.
Another sign to consider is external rather than internal: when the people in your life express concern about your relationship with alcohol. When they talk to you about your drinking behavior, your loved ones might:
Ask you to stop drinking or to drink less Ask (or tell) you to get help or support Express worry and concern, anger, frustration, sadness, grief, fear, or a combination of many emotions Give you clear consequences (such as losing your job or being kept from seeing your kids) should you refuse to stop drinking or seek treatment
Treatment for Alcohol Use and Anxiety Disorders
If you are using alcohol as a self-medicating measure, you might feel it “works” to help you cope with your symptoms. While you might feel that it works in the short term, it’s more likely to cause you problems in the long run. If you have an anxiety disorder, alcohol misuse and withdrawal can make your symptoms worse. If you have anxiety and are using alcohol to cope, it’s important that you seek support from your doctor or mental health professional. It’s never too late (or too soon) to reach out for help if you are trying to cope with a mental health condition or substance use disorder.
A Word From Verywell
While it might be tempting to turn to alcohol to manage feelings of anxiety, it can be a slippery slope that worsens anxiety problems and increases your risk of developing an alcohol use disorder. Instead of alcohol, consider talking to a mental health professional about effective anxiety management options, which may include psychotherapy and medication. If you suspect that you have an alcohol use problem, effective treatments are available. Talk to your doctor about medications, therapy, and support groups that can help you manage your alcohol consumption. For more mental health resources, see our National Helpline Database.
