Anxiety And Alcohol Addiction: Breaking The Links

Substance use disorders (SUDs) are strongly associated with mental health disorders, and vice versa. In fact, according to the National Institute on Drug Abuse, of the more than 20 million American adults with substance use disorders in 2018, 37.9% also had some form of mental illness, primarily anxiety and depression/other mood disorders. 

This connection runs both ways, as one condition may lead to the development of the other, or both may develop together. Alcohol and anxiety are one example, as around one-fifth of the 40 million Americans living with some form of anxiety disorder use alcohol to cope with their symptoms, and alcohol use disorder (AUD) is known to trigger the development of anxiety over time. According to the Anxiety & Depression Association of America, more than 20% of people with an AUD eventually experience an anxiety or mood disorder of some kind, and a 2019 study published in Alcohol Research: Current Reviews reported that as much as 50% of people who are treated for AUD also have a co-occurring anxiety or mood disorder. 

However, anxiety disorders and alcohol addiction are treatable conditions, with personalized dual diagnosis treatment programs offering the best solution for people with these common co-occurring disorders. If you or someone you love has been struggling with one or both of these conditions, please consider reaching out and exploring your treatment options, including personalized addiction and mental health treatment services provided by Ark Behavioral Health. 

How Anxiety Can Lead To Alcohol Addiction

Anxiety is a feeling of nervousness, apprehension, or unease that is normal and appropriate in certain situations. However, when someone feels heightened anxiety over a prolonged period of time without a clear cause, or they experience acute symptoms of anxiety that are out of line with the situation at hand, they may have an anxiety disorder. 

These conditions can be highly disruptive and difficult to live with, negatively impacting one’s self-image, relationships, physical health, and overall behavior and life satisfaction. So, it should be no surprise to learn that many people who struggle with anxiety choose to use alcohol or other substances to help temporarily cope with their symptoms. Ethanol, or drinking alcohol, is a particularly popular option as it is legal for adults to consume, cheap, and highly accessible. Because alcohol is a strong central nervous system depressant with unique properties, it can strongly suppress one’s natural inhibitions, release physical and psychological tension, and allow people who might otherwise be paralyzed with anxiety to enter into new and unfamiliar social situations. 

However, these effects are temporary, and the longer a person chooses to use alcohol, the greater the risk that they will begin to become dependent on it and/or experience other serious side effects including alcohol poisoning (which can be fatal), accidental injury or death, victimization, and more. Self-medicating with alcohol may also evolve into full-fledged alcohol addiction, in which one is unable to control their use of alcohol despite it becoming increasingly harmful and damaging over time. 

Types Of Anxiety Disorders And Their Symptoms

Anxiety disorders do not always have a clear cause. Many people are naturally more susceptible to anxiety than others, likely due to environmental or genetic factors, though anxiety disorders have also sometimes been linked to contributing factors or triggers like traumatic experiences, periods of stress, difficult childhoods, other mental health disorders, physical health health problems, and more. 

Some of the most common types of anxiety disorders that are diagnosed include:

• generalized anxiety disorder, indicated by a persistent feeling of anxiety or dread along with related physical and psychological symptoms that can continue or recur frequently for long periods of time
• agoraphobia, anxiety that develops in response to public places, crowds, or other situations in which one may become endangered, trapped, or embarrassed 
• panic disorder, which involves occasions of sudden, intense, and disabling fear and dread known as a panic attack, which can trigger even more apprehension and avoidance in daily life
• social anxiety disorder, which occurs when one feels like they are being closely watched and judged by others, leading them to avoid or struggle with normal social interactions 
• phobias, unreasonable and intense fear and aversions related to specific objects and situations like heights, flying, driving, water, spiders, storms, small spaces, dentists, etc. 
• separation anxiety, fear that arises at the thought of being separated from the people that one feels safe with

The specific symptoms that a person may experience when experiencing an anxiety disorder can vary, but will include:

• physical symptoms like headaches, muscle tension, elevated heart rate and breathing, sweating, trembling, fatigue, and stomach problems
• psychological symptoms like restlessness, worry, an impending sense of danger, difficulty concentrating, low libido, and sleep problems
• behavioral symptoms including avoidance of specific situations, trouble speaking, social withdrawal, and more

The very nature of anxiety disorders can make it difficult for people who experience them to reach out and get the help they need. Fortunately, anxiety disorders are considered one of the most treatable forms of mental illness and treatment services for anxiety are widely accessible. 

How Alcohol Contributes To Anxiety

While alcohol may help moderate the symptoms of anxiety in the short-term, over time its effects on the body and the mind will tend to instead intensify anxiety symptoms. Alcohol use may even trigger the development of an anxiety disorder or a mood disorder, like depression, in those who have not had one in the past. 

While the precise relationship between anxiety and alcohol is not fully understood, it is clear that the more alcohol is used, the more it will tend to disrupt both the neurochemical balance of the brain and a person’s internal bodily functions. This disruption and cycling of emotions and mental states, including hangovers and alcohol withdrawal symptoms, can increasingly destabilize a person’s mental functioning over time, contributing to anxiety and mood disorder development. 

Also, because tolerance towards alcohol’s effects will naturally increase with use, those who regularly consume alcohol for anxiety must gradually drink larger and larger amounts more and more often in order to achieve the same calming effect. This slowly accelerates alcohol’s overall hazards, including serious health problems like high blood pressure, liver disease, heart disease, malnutrition, cancer, dementia, sexual dysfunction, and a weakened immune system, along with other risks like job loss and financial insecurity, homelessness, accidents, legal problems, relationship problems, domestic violence, and suicide. 

All of these negative effects together can also contribute to anxiety, producing a gnawing feeling that something is wrong and needs to change. Nevertheless, for as harmful as alcohol addiction is, recovery can be extremely challenging. Quitting drinking can even be dangerous to attempt alone without medical support and guidance, due to withdrawal symptoms. 

Signs And Symptoms Of AUD

There is some debate as to how much alcohol consumption is safe. While many public health organizations allow that “drinking in moderation” is generally not considered harmful, others, like the World Health Organization, point out that there is no known “safe” level of drinking, especially for people with pre-existing health conditions, genetic predispositions related to substance abuse, and those who may be pregnant. 

If you do choose to drink, there are certain signs published by AA that may suggest that you have an unhealthy relationship with alcohol, or have progressed all the way to a full-blown AUD.

For instance:

• you’ve decided to stop drinking in the past, but only lasted for a few days
• others have shared concerns about your drinking
• you’ve sometimes had to have a drink in the morning
• you get into trouble when you drink, or you sometimes drink in risky/inappropriate situations
• drinking has caused problems with your home life
• you try to get extra drinks at parties 
• you tell yourself you can stop drinking anytime you want to, but keep getting drunk when you don’t mean to
• you have missed days of work or school due to alcohol
• you have blackouts
• you sometimes feel that your life would be better if you didn’t drink

Dealing With ‘Hangxiety’

Hangover anxiety, or “hangxiety,” is a pattern of anxiety that emerges when a person is recovering after consuming alcohol, often in excessive quantities. It is also yet another potential warning sign that one is abusing alcohol and experiencing negative physical and psychological effects as a result. 

When it occurs, hangxiety may be mild, like a general feeling of unease, regret, or worry. Or it may be very severe and involve irritability, spiraling thoughts, paranoia, restlessness, insomnia, or even full-blown panic attacks.

While rehydrating, eating a healthy breakfast, going for a walk, and practicing other forms of self-care can help reduce hangxiety, the best way to deal with it is to avoid it in the first place by drinking less alcohol or not drinking at all. 

Anxiety And Alcohol Withdrawal

Alcohol withdrawal symptoms occur when someone who is dependent on alcohol quits cold turkey or significantly reduces their alcohol intake, throwing off their alcohol-adapted neurochemical balance. These withdrawal symptoms can vary from mild to severe, often including anxiety, agitation, changes in blood pressure, tremors, sleep problems, and, in extreme cases, seizures or delirium tremens (DT). 

Alcohol withdrawal can sometimes be especially difficult for people who have a history of anxiety, as the rebound effects of acute withdrawal can send this anxiety skyrocketing and, sometimes, trigger a relapse, a mental health crisis, or even suicidal activity. As a result, medical supervision is highly recommended for anyone experiencing alcohol withdrawal syndrome, especially if one has any severe form of either an anxiety disorder, AUD, or both. 

Medical detox programs provide close evaluation and monitoring of a client’s condition, nutrition and hydration support, administration of medications to reduce the risk of seizures, and emotional support and counseling. These services can help clients with anxiety feel more secure and confident during this difficult process, while also ensuring their continued safety and well-being prior to enrollment in other treatment services. 

Treating Anxiety Disorders In Alcohol Recovery

When someone is experiencing both an AUD and an anxiety disorder, it is important that they receive treatment and attention for both conditions. Otherwise, there is the potential that one condition or the other will remain a problem and destabilize their recovery over the coming days, months, or years. 

This comprehensive, dual diagnosis approach has been demonstrated to be highly effective, helping people find and adopt healthy, positive methods to manage their anxiety while also assisting them as they work through the detox and rehabilitation processes. 

Treatment options that are often used for anxiety disorders in dual diagnosis recovery programs include:

• psychotherapy (talk therapy), especially a combination of cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), and/or exposure interventions
• medication management, which can help clients find an appropriate and effective medication regime (e.g., anxiolytics, antidepressants, or other medications)
• peer support groups, which can be a safe and secure place to practice social skills and share one’s own story and other information with others in recovery
• aftercare coordination, especially a referral to longer-term outpatient therapy

Treatment center staff may also be able to provide special care and attention for clients who may be at risk of experiencing panic attacks, who may not be comfortable with group sessions due to social anxiety, or who may be facing other unique personal challenges due to their diagnosis. 

Finding Solutions At Ark Behavioral Health

If you or someone important in your life has been struggling with alcohol addiction and an anxiety disorder, you may understand just how damaging these conditions can be and how important it is that you find a treatment opportunity that fits your needs and works for you. 

At Ark Behavioral Health, we understand that anxiety disorders and AUD need to be treated effectively in order to support a long lasting recovery. We offer a variety of different programs built on evidence-based and compassionate treatment practices, including dual diagnosis care and treatment for both substance use disorders and mental health disorders individually. 

To learn more about these services or to explore your own unique treatment solutions, please reach out to our team today.