Alcohol and anxiety
Drinking alcohol can contribute to anxiety and panic attacks and develop into a vicious circle.
Anxiety is a feeling of worry or fear about what’s going to happen1. It can have physical symptoms, such as sweating, increased heart-rate and trembling.
Occasional anxiety can be useful – it can keep us alert or help us perform (in a job interview for example). But if anxiety is too intense, or goes on for too long, it can start to make life difficult.
There are different types of anxiety. One type of anxiety is ‘social phobia’4. This is more than just ‘shyness’ – it’s an intense fear of being around other people.
This fear can be particularly intense if you don’t know the people very well, causing you to worry more about what they think of you.
If you suffer from social phobia, also known as social anxiety disorder, the prospect of a social situation like a party can be very daunting as you fear won’t be able to talk to people.
‘General Anxiety Disorder’ (GAD) is more of a long-term condition where someone feels anxious about a wide range of situations and may replace one reason to feel worried with another1.
Anxiety is different to depression. Mental health charity Mind describes depression as a low mood that lasts for a long time. It can range from low spirits to feeling suicidal2.
But depression and anxiety often go together. Feeling anxious and worrying constantly can make you feel low, and about half of people who suffer from depression also get attacks of anxiety3.
Alcohol acts as a sedative, so it can help you feel more at ease. It may make you feel more socially confident at a party or help you forget your worries.
However, these benefits are short term. When we drink alcohol it disrupts the balance of chemicals and processes in the brain. The relaxed feeling you experience when you have your first drink is due to the chemical changes alcohol causes in your brain. The alcohol starts to depress the part of the brain that we associate with inhibition5.
But these effects wear off fast and the pleasant feelings fade. If you rely on alcohol to mask your anxiety problems, you may find you become reliant on it to relax, which may lead to alcohol addiction.
A likely side-effect of this is that the more you drink the greater your tolerance for alcohol will be. Over time you may need to drink more alcohol to get the same feeling. In the long term this pattern of alcohol use may affect your mental health.
Many people believe that having an alcoholic drink will help them feel more relaxed. However, if you’re experiencing anxiety, drinking alcohol could be making things worse.
The way your body processes alcohol can also have a direct effect on your mood.
As your body processes the alcohol you’ve drunk, the sedative effects wear off. You can begin to experience alcohol withdrawal symptoms similar to feelings people who are dependent on alcohol may have.
These symptoms can be psychological such as feeling depressed or anxious. Many people feel like this the morning after drinking alcohol. This is because they are withdrawing from the effects of alcohol.
This feeling often goes hand in hand with physical hangover symptoms such as a headache or upset stomach.
For some people, these feelings of anxiety or agitation may be barely noticeable. But if anxiety is already an issue for you, experiencing withdrawal from alcohol can make your symptoms feel worse.
If you’re prone to social phobia, you might find yourself worrying about what you said or did the night before. If you suffer from generalised anxiety disorder (GAD)1, you may wake in the middle of night (as the alcohol wears off) and lie awake worrying and feeling stressed.
If you suffer from anxiety, you might think that a couple of drinks will help you relax.
In fact, alcohol can make an anxious person feel worse. Here’s an example of a typical cycle:
But this only starts the process from the beginning. As the initial calm feeling fades you can feel anxiety after stopping drinking alcohol build again as the effects wear off.
Remember the more alcohol you drink, the greater your tolerance will be. Over time you may need to drink more alcohol to feel the same effects. Over-time this may negatively affect your mental health, resulting in heightened levels of anxiety and depression after drinking.
If you think you may be struggling with anxiety then you should consider cutting back on the amount of alcohol you drink. If you’re worried about how alcohol may be affecting your anxiety, try our four-step guide:
Track how much you’re drinking to help spot patterns so you can avoid triggers – the MyDrinkaware: Track and calculate units app can help.
If you’re drinking more than the UK Chief Medical Officers’ (CMO) low risk drinking guidelines (no more than 14 units a week for both men and women) try to cut down. Here are some useful tips and advice on how to take a break from alcohol. If you’re worried you may be dependent on alcohol talk to your GP or contact an alcohol support service.
Once you’ve cut down your drinking (or stopped drinking altogether), keep going like this for a couple of weeks. Most people can expect to see an improvement in their anxiety symptoms in this time as the brain’s balance of chemicals and processes start to return to normal and you experience better quality sleep6.
If you’re still feeling anxious after three weeks you should speak to your GP. Talking therapies like CBT (cognitive behavioural therapy), can help you learn to spot unhelpful patterns of behaviour. Your GP should be able to tell you about local services.
If you are concerned that you or someone you care about has a problem with alcohol there is a lot of help available. Here you can find useful links and phone numbers to get the support you need.Support services
 Gan, G., Guevara, A., Marxen, M., Neumann, M., Jünger, E., Kobiella, A., Mennigen, E., Pilhatsch, M., Schwarz, D., Zimmermann, U.S. and Smolka, M.N., 2014. Alcohol-induced impairment of inhibitory control is linked to attenuated brain responses in right fronto-temporal cortex. Biological psychiatry, 76(9), pp.698-707. Available at: biologicalpsychiatryjournal.com/article/S0006-3223(14)00015-8/abstract. [Accessed 23 February 2017].
 Driessen, M., Meier, S., Hill, A., Wetterling, T., Lange, W. and Junghanns, K. (2001). The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders. Alcohol and Alcoholism, 36(3), 249-255.