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Using Alcohol to Relieve Anxiety

The Risks of Using Alcohol When You Have an Anxiety Disorder

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Updated June 02, 2014

Limited alcohol use is often considered acceptable in many situations. The occasional night cap to unwind, or the couple of celebratory drinks during a social gathering, are usually not problematic and may even be considered socially customary. But, if you have panic disorder or another anxiety disorder, alcohol use may become a problem. Many studies are increasingly showing a correlation between anxiety disorders and alcohol abuse disorders.

Alcohol is a drug that depresses the central nervous system. Initially, alcohol consumption has a sedative effect and produces a sense of euphoria and decreased inhibitions, seemingly providing relief from anxiety. Unfortunately, long-term effects of alcohol abuse are not so pleasant. Chronic alcohol abuse may result in tolerance, dependency and damage to many organs of the body, including the brain, liver and heart.

The Tension Reduction Theory of Alcohol Use

People with anxiety disorders, including panic disorder and agoraphobia, often use alcohol as a primary means of coping with fear and anxiety. One theory of why this occurs is the “tension reduction hypothesis.” Simply put, this theory suggests alcohol is used as a self-medicating method to reduce stress and anxiety.

Other Theories of Alcohol Use

Some researchers have proposed that there may be a genetic link that influences a person’s anxiety level and alcohol consumption. These biological theories suggest that a brain mechanism is responsible for anxiety symptoms and drinking behaviors.

Other researchers have proposed an expectancy component in alcohol consumption and anxiety symptoms. One would expect relief of anxiety symptoms after consuming alcohol due to its effects on the central nervous system. Drinking behaviors are based on one’s level of anxiety and the expected relief alcohol will provide. Relief from very high anxiety levels would be expected to ease with greater consumption of alcohol.

Anxiety Disorders and Alcohol Abuse Disorders

People with anxiety disorders are up to three times more likely to have an alcohol or other substance abuse disorder than those without an anxiety disorder. But, studies have shown that problem drinking is more prevalent in certain anxiety disorders, and that typical alcohol use varies between these disorders. For example:

  • Social Phobia and Agoraphobia

    Problem drinking tends to begin after the onset of symptoms related to social phobia and agoraphobia. For example, someone who has social phobia may fear going to a social gathering where there may be many unfamiliar people. Just the thought of attending such a gathering produces a lot of anticipatory anxiety. To relax, the individual self-medicates with alcohol.

    Unfortunately, this type of drinking behavior has inherent problems. Alcohol consumption becomes a “crutch,” and social situations where drinking is not possible may be avoided. Another problem is that long-term alcohol abuse usually means building a tolerance to its effects. This results in increased alcohol consumption to get the desired result.

  • Generalized Anxiety Disorder and Panic Disorder

    For generalized anxiety disorder and panic disorder, studies have shown a different trend of alcohol use. Problem drinking tends to begin after or around the same time as symptoms of panic disorder or generalized anxiety disorder present. This may indicate that some of the initial anxiety and panic symptoms experienced are related to alcohol withdrawal or that alcohol use has somehow provided a mechanism for these disorders to develop.

Alcohol Abuse Can Increase Anxiety and Panic Symptoms

What begins as a way to cope with anxiety, can quickly have the opposite effect of increasing distress. Problem drinking leads to alcohol withdrawal. This is often called a “hangover.” The symptoms of alcohol withdrawal can include:

  • Anxiety
  • Panic Attacks
  • Nausea
  • Vomiting
  • Elevated blood pressure and heart rate
  • Agitation
  • Increased body temperature

These symptoms tend to create a cycle of heightened anxiety and increased problem drinking.

How Much Is Too Much?

The National Institute on Alcohol Abuse and Alcoholism has defined "at-risk drinking" as:

  • A woman who has more than seven drinks* per week or more than three drinks per occasion

  • A man who has more than 14 drinks* per week or more than four drinks per occasion

  • Older than 65 years and having more than seven drinks* per week or more than three drinks per occasion

*-One drink = one 12-oz bottle of beer (4.5 percent alcohol) or one 5-oz glass of wine (12.9 percent alcohol) or 1.5 oz of 80-proof distilled spirits.

Some researchers believe that individuals with panic disorder, or other psychological illnesses, may have a lower threshold for alcohol tolerance. It may be possible to be “at-risk” even if you are consuming alcohol within the limits described above. If you are concerned about your drinking behaviors, it is important to consult with your doctor or therapist.

Get Treatment

If you have an anxiety disorder and are abusing alcohol, you should talk to your doctor or therapist. There are many effective treatments for both disorders.

Although you may have begun alcohol use as a self-medicating measure, it is likely that it will cause you far more distress in the long run. It is never too soon or too late to get treatment for problem drinking.

Sources:

Anxiety Disorders Association of America. 2007 “Anxiety Disorders and Alcohol Abuse.”

Book MD, Sarah and Randall PhD, Carrie “Social Anxiety Disorders and Alcohol Use.” November 2002 NIAAA.

Brady MD PhD, Kathleen, Tolliver MD PhD, Bryan and Verdiun MD, Marcia. “Alcohol Use and Anxiety: Diagnostic and Management Issues” 2007 Am J Psychiatry 164:217-221.

Pandey, Subhash C, Zhang Huaibo, Roy Adip, and Xu, Tiejun. “Deficits in amygdaloid cAMP-responsive element-binding protein signaling play a role in genetic predisposition to anxiety and alcoholism.” J Clin Invest. 2005 115(10):2762-2773.

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