Alcohol and anxiety: Causes, risks, and treatment

Instead, so-called third variables are posited to account for their joint presence. The potential relevance of such factors was demonstrated in a 21-year longitudinal study of young people (Goodwin et al. 2004), in which early presence of anxiety disorders seemed to predict the later development of alcohol dependence. However, when the investigators controlled for other variables, such as prior other drug dependence and depression, the presence of anxiety disorders no longer was a significant predictor. The results of this study suggest that the link between anxiety and AUDs was not direct but instead may have been a consequence of those other variables studied. The potential range of common factors can be difficult to estimate, but a review of the literature shows that the most consistently proposed third variables are genetic factors and personality traits such as anxiety sensitivity. Support for the role of genetic factors as a cause for the co-presence of these disorders indirectly has been provided by family and twin studies (e.g., Merikangas et al. 1994, 1996; Tambs et al. 1997).

A substantial number of people who have problems with alcohol also experience strong anxiety and mood problems. This article provides an overview of the evolving perspectives of this association in the context of three related disciplines—psychiatry, psychology, and neuroscience. Psychiatric and epidemiological studies show that having either how to hide a vape from a drug dog an anxiety- or alcohol-related diagnosis elevates the prospective risk for developing the other disorder. From the psychological perspective, behavioral research demonstrates that drinking to cope with negative affect is a potent marker for current and future problems with alcohol.

Psychotherapy for AUDs

In fact, 50% of people receiving treatment for alcohol use disorder also live with an anxiety disorder. About 20 percent of people with social anxiety disorder also suffer from alcohol dependence. Another critical brain region affected by chronic alcohol use is the hippocampus, which plays a pivotal role in memory and mood regulation. Alcohol-related shrinkage of the hippocampus has been documented in numerous studies, with findings showing that heavy drinkers are at a higher risk of developing persistent sadness, memory loss, and cognitive decline.

Anxiety problems in the absence of alcohol misuse

1. A structured plan using imaginal and/or graded exposure to cues that elicit anxiety also may offer a practical balance of therapeutic risk and reward.
2. But trying to relax with a drink or two may not give you the long-term anxiety relief you want.
3. The models that give priority to AnxDs generally accept the idea that it is the effort of coping with situations that provokes anxiety, which in turn leads to alcohol abuse.
4. It has been estimated that nearly 1 in every 10 Americans has attended at least one AA meeting, and it is “the most frequently consulted source of help for drinking problems” (McCrady and Miller 1993, p. 3).
5. The continued viability of all these competing hypotheses suggests that further and more advanced research attention is essential to disentangle the predisposing factors, primary variables, sequencing, and early course involved with these co-occurring disorders.

In this study, we aimed to evaluate the effects of alcohol use on sleep quality. The start of the psychopharmacological treatment in patients with comorbid AnxD and AUD requires a detailed clinical evaluation of the benefits/risks profile. The pharmacological interactions should be taken into account when choosing the psychotropics. Much care should also be taken with the SSRIs, as some symptoms of abstinence from alcohol can become superimposed or even added to the serotoninergic activation.

Why You Feel Anxiety After Drinking (Hangxiety)

The remaining five criteria were behavioral signs of dependence, such as spending a great deal of time obtaining, drinking, or recovering from the effects of alcohol and drinking more alcohol, or for longer, than intended. A 2022 longitudinal study highlights a bidirectional relationship between AUD and anxiety disorders. The authors suggest someone with AUD has a higher risk of developing an anxiety disorder and vice versa.

Opponent process model

Women suffer from higher levels of stress and AnxDs than men, and they are also more vulnerable to maintaining alcohol consumption levels. Further research is needed in this comorbid patient population, including the study of different types of patients and gender perspectives. The notion of a simple, unidirectional, causal link between co-occurring disorders is not supported by the findings reviewed in this article. A prospective study has shown that either experiencing clinical-level anxiety or engaging in chronic alcohol misuse increases the risk of developing the other.21 In addition, clinical research shows that effectively treating one co-occurring condition does not substantively affect the other.

Remember to limit yourself to one to two drinks per day and pace yourself by drinking water between each drink. Research has shown that a negative frame of mind will likely get in the way of healthy coping strategies. 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. The NHS website, Every Mind Matters, has advice on how to access support and treatment for anxiety in England. This includes options for NHS support, links to charities, helplines and communities, and tips on self-care. It slows down processes in your brain and central nervous system, and can initially make you feel less inhibited.10,11  In the short-term, you might feel more relaxed – but these effects wear off quickly.

Naltrexone, an opioid receptor antagonist with approved indications for alcohol relapse treatment in AUDs, has alleviated the severity of the PTSD symptoms in various open trials (86, 88, 92, 93). However, a later 12-week naltrexone and disulfiram RCT in veterans did not show that naltrexone medication was significantly more effective than placebo in the reduction of PTSD symptoms (92). Posttraumatic stress disorder (PTSD) and SUD frequently co-occur, and their combination can increase poor health outcomes as well as mortality.