The Risks of Using Alcohol to Relieve Anxiety

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Limited alcohol use is often considered acceptable in many situations. The occasional nightcap to unwind or a couple of celebratory drinks during a social gathering are usually not problematic and may even be considered socially customary. But if you have panic disorder or another anxiety disorder, alcohol use may become a problem.

Studies are increasingly showing a correlation between anxiety disorders and alcohol use disorders. According to a 2001 study cited by the Anxiety and Depression Association of America, about 20% of people with social anxiety disorder also suffer from alcohol abuse or dependence. 

Alcohol is a drug that depresses the central nervous system (CNS). Initially, alcohol consumption has a sedative effect and produces a sense of euphoria and decreased inhibitions, seemingly providing relief from anxiety. Unfortunately, the long-term effects of alcohol abuse aren't so pleasant. Chronic alcohol abuse may result in tolerance, dependency, and damage to many organs of the body, including the brain, liver, and heart.

Theories of Alcohol Use as a Means of Coping With Anxiety

People with anxiety disorders, including panic disorder and agoraphobia, often use alcohol as a primary means of coping with fear and anxiety. One theory of why this occurs is the “tension reduction hypothesis.” Simply put, this theory suggests alcohol is used as a self-medicating method to reduce stress and anxiety.

Some researchers have proposed that there may be a genetic link that influences a person’s anxiety level and alcohol consumption. These biological theories suggest that a brain mechanism is responsible for anxiety symptoms and drinking behaviors.

Other researchers have proposed an expectancy component in alcohol consumption and anxiety symptoms. One would expect relief of anxiety symptoms after consuming alcohol due to its effects on the CNS. Drinking behaviors are based on one’s level of anxiety and the expected relief alcohol will provide. Relief from very high anxiety levels would be expected to ease with greater consumption of alcohol.

Prevalence of Alcohol Abuse in People With Anxiety Disorders

People with anxiety disorders are up to three times more likely to have an alcohol use disorder at some point in their lives than those without an anxiety disorder. Studies have also shown that problem drinking is more prevalent in certain anxiety disorders. For example:

  • Social Anxiety Disorder and Agoraphobia: Problem drinking tends to begin after the onset of symptoms related to social anxiety disorder and agoraphobia. For example, someone who has a social anxiety disorder may fear to go to a social gathering where there may be many unfamiliar people. Just the thought of attending such a gathering produces a lot of anticipatory anxiety. To relax, the person self-medicates with alcohol.
  • Unfortunately, this type of drinking behavior has inherent problems. Alcohol consumption becomes a “crutch,” and social situations where drinking isn't possible may be avoided. Another problem is that long-term alcohol abuse usually means developing a tolerance to its effects. This results in increased alcohol consumption to get the desired result.
  • Generalized Anxiety Disorder and Panic Disorder: For generalized anxiety disorder and panic disorder, studies have shown a different trend of alcohol use. Problem drinking tends to begin after or around the same time as symptoms of a panic disorder or generalized anxiety disorder present. This may indicate that some of the initial anxiety and panic symptoms experienced are related to alcohol withdrawal or that alcohol use has somehow provided a mechanism for these disorders to develop.

Side Effects of Alcohol Abuse

What begins as a way to cope with anxiety can quickly have the opposite effect of increasing distress. Problem drinking leads to alcohol withdrawal (aka a hangover). The symptoms of alcohol withdrawal can include:

  • Anxiety
  • Panic attacks
  • Nausea
  • Vomiting
  • Elevated blood pressure and heart rate
  • Agitation
  • Increased body temperature

These symptoms tend to create a cycle of heightened anxiety and increased problem drinking.

How Much Is Too Much Drinking?

The Centers for Disease Control and Prevention (CDC) defines "heavy" drinking as:

  • For women, eight drinks* or more per week
  • For men, 15 drinks* or more per week

*One drink = one 12-oz bottle of beer (5% alcohol), one 5-oz glass of wine (12% alcohol), one 8-oz bottle of malt liquor (7% alcohol), or 1.5 oz of 80-proof distilled spirits or liquor (40% alcohol).

Some researchers believe that people with panic disorder or other psychological illnesses may have a lower threshold for alcohol tolerance. It may be possible to be “at-risk” even if you consume alcohol within the limits described above.

Treatment for Alcohol Abuse and Anxiety Disorder

If you have an anxiety disorder and are abusing alcohol, you should talk to your doctor or therapist. There are many effective treatments for both disorders, including ongoing individual and/or group therapy and prescribed medications

Although you may have begun alcohol use as a self-medicating measure, it's likely that it will cause you far more distress in the long run. It's never too soon or too late to get treatment for problem drinking.

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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