Alcohol and Anxiety

Alcohol and anxiety are closely intertwined and there are no positive outcomes from using alcohol to address the symptoms of anxiety. 

Additionally, alcohol abuse can sometimes trigger anxiety, another adverse consequence of alcohol anxiety. 

Developing alcohol use disorder or substance use disorder in isolation is challenging, but when these two serious mental health conditions co-occur in a dual diagnosis, this can lead to a vicious cycle that can be hard to break. This review of studies indicates that anxiety and alcoholism frequently co-occur. 

With co-occurring anxiety and alcohol use disorder, the symptoms of each disorder can inflame the symptoms of the other. This causes many people suffering from a dual diagnosis to self-medicate the symptoms with alcohol or illicit drugs. Self-medication provides little beyond fleeting relief at the cost of exacerbating both conditions. 

According to reports from ADAA (Anxiety and Depression Association of America) reports that 20% of those with anxiety disorder or depression also have alcohol use disorder or another substance use disorder. Among those with alcohol use disorders and substance use disorders, 20% also have anxiety disorders or other mood disorders. 

Anxiety and Alcoholism

It is commonplace for anxiety and alcohol use disorder to co-occur, and this usually leads to a complex presentation of symptoms. 

Anxiety disorders affect 40 million people in the US, according to ADAA. These are the five major anxiety disorders recognized by DSM-5, the APA’s benchmark diagnostic tool for both addictions and mental health disorders: 

• GAD (generalized anxiety disorder): GAD is characterized by chronic worry, tension, and anxiety with little or no provocation.
• OCD (obsessive-compulsive disorder): OCD is a less common anxiety disorder characterized by obsessions (unwanted thoughts) triggering compulsions (repetitive behaviors). Performing rituals like checking, cleaning, or counting provide only fleeting relief. Not performing rituals, on the other hand, prompts mounting anxiety.
• PTSD (post-traumatic stress disorder): According to the US Department of Veterans Affairs, 12 million people develop PTSD in any given year. Post-traumatic stress disorder can occur in some people who witness or experience traumatic events, from war crimes and violent personal assaults to natural disasters and accidents, PTSD causes distressing symptoms including flashbacks to the traumatic event.
• Panic disorder: Another common form of anxiety disorder, panic disorder is characterized by unexpected episodes of extreme fear accompanied by an array of physical symptoms, from chest pain and shortness of breath to dizziness and nausea.
• Social anxiety disorder: Also known as social phobia, this is a form of anxiety disorder characterized by self-consciousness and anxiety in social situations.

Alcohol use disorder (AUD) is the clinical descriptor for alcohol addiction or alcoholism. 

AUD is diagnosed according to the criteria in DSM-5, the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 

The previous edition of DSM recognized both alcohol abuse and alcohol dependence. In DSM-5, they are integrated into AUD, a single disorder. 

Alcohol use disorder can be diagnosed as follows according to the number of symptoms present: 

• Mild AUD: 2 or 3 symptoms
• Moderate AUD: 4 or 5 symptoms
• Severe AUD: 6 symptoms or more

The diagnostic criteria are versions of these eleven questions concerning your alcohol consumption over the previous year:

1. Are you neglecting hobbies and activities you once enjoyed?
2. Do you often drink more than planned or drink for longer than intended?
3. Have you experienced cravings for alcohol in its absence?
4. Are you spending lots of time drinking and recovering from the effects?
5. Have you tried and failed to moderate or stop drinking?
6. Do you continue to drink even after feeling depressed or anxious?
7. Do you need more alcohol to achieve the same effects due to tolerance?
8. Does your alcohol consumption and behaviors cause personal and professional problems?
9. Do you engage in risky behaviors as a result of alcohol?
10. Are you still drinking alcohol despite these problems?
11. Do you get withdrawal symptoms in the absence of alcohol?

While both alcohol use disorder and anxiety disorder can be debilitating in isolation, they frequently co-occur, but with what results?

How Alcoholism Affects Anxiety

How alcoholism affects anxiety and depression differs from person to person. There are two primary ways in which alcoholism and anxiety feed into each other: 

1. Self-medicating the symptoms of anxiety disorders with alcohol
2. Substance-induced anxiety disorder

Self-medicating the symptoms of anxiety disorders with alcohol

Anxiety disorders work on the CNS (central nervous system) by increasing blood flow and heart rate and overworking the brain. Treatment for anxiety disorders often involves CNS depressants like benzodiazepines in combination with behavioral interventions. Many people faced with distressing symptoms of anxiety – especially when diagnosed – self-medicate with alcohol. 

Self-medicating might provide some short-term relief, but over time will inflame both conditions, potentially leading to a co-occurring disorder requiring residential rehab. 

Substance-induced anxiety disorder

Substance-induced anxiety disorder or medication-induced anxiety disorder are the clinical descriptors for panic attacks or anxiety attacks triggered by prescription medications, illicit drugs, or alcohol.

This diagnosis requires that substance use and anxiety co-occur. If you experienced bouts of anxiety before using the substance in question, this is not diagnosed as substance-induced anxiety disorder, even when substance use inflames the symptoms. 

Mental health disorders are diagnosed per the criteria in DSM-5. Most of the diagnostic criteria require that symptoms are not triggered by substance use. The reverse applies with substance-induced anxiety disorder. The symptoms must coincide with substance use. 

Substance-induced anxiety disorder is diagnosed as follows:

• Panic attacks or anxiety attacks are predominant.
• The symptoms likely developed during or immediately after using a medication or addictive substance capable of triggering those symptoms.
• The condition is not more accurately explained by something other than a substance-induced anxiety disorder.
• Neither panic nor anxiety occurs exclusively during a delirium.

The criteria for substance-induced anxiety disorder in DSM-5 are the same as the criteria for other anxiety disorders.

Symptoms must present during intoxication or within 4 weeks of substance use. 

Is Alcohol Bad for Anxiety?

Abusing alcohol is almost always bad for anxiety. 

If you have been suffering from the symptoms of any of the anxiety disorders above, effective treatment is available. Social anxiety disorder often responds well to a combination of antidepressants and therapy. Many people with generalized anxiety disorder find psychotherapy like CBT combined with medications, and those with panic disorder often find short-term relief from benzodiazepines. 

Different types of anxiety disorder need treating differently, and many treatment plans will involve medications, many of which are potentially dangerous to combine with alcohol. 

Alcohol Addiction Treatment at The District Recovery

At The District Recovery Community, we provide gender-specific outpatient treatment for alcohol addiction, anxiety disorders, and co-occurring disorders. 

We have men’s rehab and women’s rehab programs at the following levels of intensity: 

• OP: regular outpatient program with 2 hours of treatment sessions weekly
• IOP: intensive outpatient program with 12 to 15 hours of treatment sessions weekly
• PHP: partial hospitalization program with up to 35 hours of treatment sessions weekly

If you need medical detox, we can connect you with suitable facilities near you, allowing you to purge your body of toxins before unpacking the psychological aspect of alcoholism. 

All of our treatment programs give you access to the following therapies and interventions: 

• MAT (medication-assisted treatment)
• CBT (cognitive behavioral therapy)
• DBT (dialectical behavior therapy)
• Counseling (individual and group)
• Family therapy
• Holistic therapy (adventure therapy)

Whether you choose to step down to a less intensive level of care or transition back into sober living, your treatment team will create robust relapse management and aftercare strategy to maximize your chances of seamless and ongoing recovery from alcohol abuse and anxiety. 

All you need to do is call admissions today at 844.287.8506 and we’ll help you every step of the way.