Alcohol and anxiety
Drinking alcohol can contribute to anxiety and panic attacks
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Anxiety is a feeling of worry or fear about what’s going to happen.1 It can be mild or severe and affect your thoughts, the way you feel, and often has physical symptoms like increasing your heart rate, making you sweat or tremble.2
Most people feel anxious from time to time. It’s a natural human response and usually passes once the situation is over - for example around a job interview. But if you have feelings of anxiety that are constant, overwhelming, or affect your daily life, there are things you can do, and support that is available to help you manage.
This page explains more about anxiety, why alcohol can trigger it or make it worse, and steps you can take to feel better.
Anxiety can become a health problem if it affects your ability to live your life as fully as you want to.
Several medical categories relating to anxiety are used by doctors – these include generalised anxiety disorder (GAD), social anxiety, panic attacks and phobias.3 One thing they have in common is they cause your body to go into ‘fight or flight’ mode, releasing hormones into your bloodstream to prepare you to react or run away.4
It can cause symptoms like feeling tired, having trouble concentrating or sleeping, headaches or tummy aches - as well as many others.5
And because of the way alcohol interferes with your ‘fight or flight’ response,6 drinking can make you more vulnerable to these anxiety disorders,7,8 and make symptoms worse.9
Alcohol is a depressant. 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.
In fact, if you’re experiencing anxiety, drinking alcohol could be making things worse.
Over time, if you regularly drink heavily, the central nervous system gets used to the supressing effect of the alcohol, which means your brain is affected if the alcohol level suddenly drops. You can go straight into ’fight or flight’ mode as the alcohol leaves your system – the same reaction as an anxiety disorder.12
If you suffer from anxiety, it’s important not to be tricked by the temporary feeling of relaxation from drinking alcohol, to avoid being trapped in a vicious circle:
But the last step only starts the process again from the beginning. As the initial calm feeling fades you can feel anxiety as the effects of the alcohol wear off.
The more you drink the greater your tolerance for alcohol - meaning you need to drink more alcohol to get the same feeling. If you rely on alcohol to mask anxiety, you may find you become reliant on it to relax – putting you at risk of alcohol dependence.
If you experience sudden, intense anxiety and fear, it might be the symptoms of a panic attack.13 Other symptoms may include a racing heartbeat, or feeling faint, dizzy, lightheaded, or sick.
A panic attack usually lasts 5 to 30 minutes. They can be frightening, but they're not dangerous and shouldn’t harm you.
If you suffer from panic attacks, cut right down on your alcohol consumption, if you drink.
Alcohol has an effect on brain chemistry - it can induce panic because of its effects on GABA, a chemical in the brain that normally has a relaxing effect. Small amounts of alcohol can stimulate GABA and cause feelings of relaxation, but heavy drinking can deplete GABA, causing increased tension and feelings of panic.14,15 Panic attacks can occur due to alcohol withdrawal.
If you feel like you’re struggling with anxiety, try cutting back on the amount of alcohol you drink. Try this four-step guide, to get started:
If you’re drinking more than the UK low risk drinking guidelines (no more than 14 units a week for both men and women) try to cut down. It’s safer to make gradual, small reductions (not sudden large changes).
We have advice on how to take a break from alcohol, but if you’re worried you are dependent on alcohol talk to your GP surgery 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 a few weeks, contact your GP surgery. Talking therapies like CBT (cognitive behavioural therapy), can help you learn to spot unhelpful patterns of behaviour and help you to develop coping strategies. Your GP should be able to tell you about local services.
Anxiety is different to depression, but they can sometimes go together – feeling anxious and worrying constantly can make you feel low. And depression is affected by alcohol too - find out more on our alcohol and depression webpage.
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.
if you are in Scotland, Wales or Northern Ireland, there is separate advice on getting help with anxiety.
Specific support is also available if you need help with your drinking.
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.Get support
 Mind website. What are anxiety disorders? (Accessed 20 April 2022) Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/anxiety-disorders/
 Holmes, A., Fitzgerald, P. J., MacPherson, K. P., DeBrouse, L., Colacicco, G., Flynn, S. M., Masneuf, S., Pleil, K. E., Li, C., Marcinkiewcz, C. A., Kash, T. L., Gunduz-Cinar, O., & Camp, M. (2012). Chronic alcohol remodels prefrontal neurons and disrupts NMDAR-mediated fear extinction encoding. Nature neuroscience, 15(10), 1359–1361. https://doi.org/10.1038/nn.3204
 Anker, J. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging the Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol Research: Current Reviews, 40(1), arcr.v40.1.03. https://doi.org/10.35946/arcr.v40.1.03
 Gorka, S. M., & Phan, K. L. (2017). Impact of anxiety symptoms and problematic alcohol use on error-related brain activity. International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 118, 32–39. https://doi.org/10.1016/j.ijpsycho.2017.05.011
 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].
 Cosci, F., Schruers, K. R., Abrams, K., & Griez, E. J. (2007). Alcohol use disorders and panic disorder: a review of the evidence of a direct relationship. The Journal of Clinical Psychiatry, 68(6)
 Gimeno, C., Dorado, M. L., Roncero, C., Szerman, N., Vega, P., Balanzá-Martínez, V., & Alvarez, F. J. (2017). Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment. Frontiers in Psychiatry, 8, 173. https://doi.org/10.3389/fpsyt.2017.00173
 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.
Last Reviewed: 1st July 2022
Next Review due: 1st July 2025