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Can alcohol increase anxiety


Hangxiety: The Link Between Anxiety And Alcohol | Henry Ford Health

Drink long enough — or hard enough — and you’re probably familiar with the dreadful feeling that comes the morning after a night of over-imbibing. Maybe you try to replay the evening’s conversations in your mind or scroll through text messages to make sure you didn’t send something you regret. Or maybe you immediately start issuing mass apologies to friends and family.

While this can be a normal reaction to binge drinking, it can also be a sign of a deeper issue, something called “hangxiety.”

“Anxiety is a common feeling when people drink too much,” says Elizabeth Bulat, M.D., a substance abuse specialist at Henry Ford Health. “And for people who are already prone to depression and anxiety, alcohol can worsen symptoms of those conditions.”

Hangxiety Explained

Hangxiety has become a buzzword that describes the uneasy feeling that often accompanies heavy alcohol use, but what does it really mean? We asked Dr. Bulat to explain what hangxiety is and how to manage it best.

Q: What is hangxiety?

A: Drinking alcohol dumps a flood of dopamine into the pleasure center of the brain. The feel-good chemical swirls through your head, but the rush only lasts for a short while. When dopamine levels dip back down, feelings of anxiety rebound. Researchers think that may be one reason why people who experience hangxiety, especially those who are extremely shy, may have a higher risk of developing alcohol use disorder (AUD).

Q: How does alcohol boost anxiety levels?

A: Heavy drinking produces physiological changes in the brain. When you’re drinking, there’s an influx of the GABA (gamma aminobutyric acid), which causes you to feel relaxed and calm. When you stop drinking, you have withdrawal symptoms. Your body gets used to that crutch to feel calm. Take it away and anxiety often follows. Add interrupted sleep to the mix, which often happens when people drink to excess, and feelings of depression and anxiety can get even worse.

Q: Who is most likely to develop hangxiety?

A: People who suffer from depression and anxiety are more likely to experience anxious feelings after drinking. Though alcohol can suppress anxious feelings while a person is imbibing, the rebound effect can be far worse than their baseline level of anxiety. Unfortunately, those uncomfortable emotions can drive people straight back to the culprit: alcohol.

Q: How does alcohol compare to medications used to treat anxiety?

A: Like alcohol, medications such as benzodiazepines that are used to treat anxiety target GABA in the brain. In fact, some people with depression and anxiety turn to alcohol to self-medicate. Unfortunately, self-medicating with alcohol or other substances increases the risk of developing substance abuse disorders, which can lead to negative effects on your heart, liver and other vital organs.

Q: How do you know if your hangxiety indicates an alcohol use disorder, or AUD?

A: If you’re using alcohol to soothe anxiety, that’s a red flag. It becomes a vicious cycle: You drink, you get anxious, then you drink more to relieve that anxiety. That’s how the trouble starts — and continues. Over time, you become dependent on the alcohol to function in your daily life. If alcohol becomes a coping mechanism, or you realize your body is getting used to the effects — not just anxiety, but also shakes, sweats and interrupted sleep — the risk of negative consequences skyrockets.

Q: How do doctors treat hangxiety?

A: If you’re drinking to manage feelings of anxiety — or if you regularly experience hangxiety after a night of drinking — talk to your primary care provider. There are a number of effective treatments available, not just for depression and anxiety, but also for AUD. Your doctor may suggest a variety of therapies ranging from cognitive behavioral therapy and psychotherapy to prescription medication for AUD or anxiety.

Related Topic: Are You a Weekend Alcoholic?

Put Hangxiety to Bed

Your best bet to avoid hangxiety is to drink responsibly, says Dr. Bulat. Pay attention to family members and loved ones who say they notice an increase in your drinking habits and stay within the recommended limits of alcohol consumption (one drink per day for women; two drinks per day for men).

If, despite these efforts, you still periodically wake up after drinking with feelings of anxiety, practice mindfulness. Pay attention to how you feel while you’re drinking and afterward. And when anxious feelings surface, turn to healthy alternatives like meditation, deep breathing or exercise.

To find a doctor or therapist at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).

Dr. Elizabeth Bulat is the medical director of addiction medicine at Henry Ford’s Maplegrove Center in West Bloomfield.


Alcohol and anxiety: Panic Attacks After Drinking

What is anxiety?

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.

Types of anxiety and symptoms

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

Find out more about different types of anxiety on the Mind website

How alcohol affects anxiety

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

Find out more about alcohol withdrawal

Alcohol and anxiety – the vicious circle

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:

  • You drink alcohol
  • You initially feel calm as the alcohol affects the brain
  • You feel anxious as a symptom of alcohol withdrawal
  • You may want to drink again to try to relieve your anxiety

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.

Alcohol and panic attacks

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.

NHS advice on getting help for panic attacks

How to prevent alcohol causing or worsening anxiety 

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:

Track

Track how much you’re drinking to help spot patterns so you can avoid triggers – the MyDrinkaware app can help.  

Download the app

Reduce

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. 

Take a break

Maintain

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. 

Better sleep

Review

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. 

Alcohol support

Anxiety and depression

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.

Alcohol and depression

Get help

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.

  • NHS Every Mind Matters – support and treatment for anxiety

if you are in Scotland, Wales or Northern Ireland, there is separate advice on getting help with anxiety.

  • Scotland – NHS inform
  • Wales – NHS mental health and wellbeing
  • Northern Ireland – NI Direct, mental health

Specific support is also available if you need help with your drinking.

Find out more about alcohol support services

Alcohol support 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

What to expect when you stop drinking The benefits of drinking less Alcohol and depression How to reduce your drinking

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References

[1] Mind website. What is anxiety? (Accessed 20 April 2022). Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/about-anxiety/

[2] NHS website, Every mind matters. What is anxiety? (Accessed 20 April 2022) https://www.nhs.uk/every-mind-matters/mental-health-issues/anxiety/#what-is-anxiety

[3] 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/

[4] NHS website, Every mind matters. What causes anxiety? (Accessed 20 April 2022) Available at: https://www. nhs.uk/every-mind-matters/mental-health-issues/anxiety/#causes

[5] ibid

[6] Day, E., & Daly, C. (2021). Clinical management of the alcohol withdrawal syndrome. Addiction.

[7] 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

[8] 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

[9] 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

[10] 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].

[11] Klenowski, P. M. (2018). Emerging role for the medial prefrontal cortex in alcohol-seeking behaviors. Addictive Behaviors, 77, 102–106. https://doi.org/10.1016/j.addbeh.2017.09.024

[12] Day, E., & Daly, C. (2021). Clinical management of the alcohol withdrawal syndrome. Addiction.

[13] NHS website. Panic disorder. (Accessed 18 May 2022). Available at: https://www.nhs.uk/mental-health/conditions/panic-disorder/

[14] 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)

[15] 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

[16] 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

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Tips to change your relationship with alcohol

Psychologist Gann explained why alcohol should not be used to suppress anxiety and fear

  • Lifestyle

A hangover after drinking alcohol is not the only reason to stop using alcohol as a sedative. There are other side effects as well.

March 7, 2022

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The desire to drink alcohol to drown out feelings of anxiety, fear, uncertainty about the future and negative thoughts can turn into even more mental problems. Psychologists and psychiatrists warn about this.

One more stress for the body

The next morning after drinking alcohol, your body is in a state of physiological stress. It is comparable to the impact on a person of illness or injury.

- Hangovers not only cause changes in our immune system, but also increase cortisol (the “stress hormone”) levels, blood pressure and heart rate,” says Craig Gann, a psychologist at the University of Bristol.

Anxious thoughts may flare up with renewed vigor in the morning, because the body is distracted by other problems, which are manifested by symptoms such as nausea, fatigue, headache.

The brain also suffers

Studies show that dopamine production decreases during a hangover. Namely, this hormone plays an important role in regulating feelings of anxiety. So any new stress in the morning after evening gatherings with alcohol will hit you even more painfully - it will be very difficult to cope with it.

Active stress relief with alcohol also affects cognitive functions - the ability to concentrate decreases, the ability to remember worsens.

Read also

Emotions run wild

The next day, after several servings of alcohol, a person feels even more negative emotions and it becomes more difficult to regulate them, it becomes more difficult to contain the negative, according to a study conducted by scientists at the University of Bristol.

In another study, scientists found that in the morning after drinking alcohol, the executive functions of the brain significantly deteriorate (they are important for many aspects of our daily life, including working memory, flexible thinking and self-control). They also help people cope with anxiety and suppress bad thoughts.

Affects the emotional state of a person after drinking alcohol and appearing headache or muscle pain. People who have a hard time with pain, catastrophize pain, and literally "die" from a mild cold are more likely to experience severe anxiety with a hangover.

Mood changes after drinking alcohol are not only unpleasant, but can also be associated with increased conflicts with other people and reduced productivity at work.

See also

Other problems will intensify

An attempt to reduce the feeling of fear or anxiety with the help of alcohol can increase a mental disorder if a person had it before - we are talking about paranoia, hysteria, phobias, psychiatrist Sergei Nurislamov is sure.

- You can resort to alcohol only if you want to increase your problems several times over . Some believe that they can get drunk and oversleep so that everything passes by. This is a form of escape from reality, and not a solution to the problem, the psychiatrist emphasized in an interview with Sputnik radio.

If you are experiencing increased anxiety, you should not drink alcohol, but seek help from over-the-counter sedatives, which can be recommended by a pharmacist at a pharmacy, the expert advises.

According to him, only a psychiatrist can prescribe stronger drugs. You should contact such a specialist if the level of anxiety is already noticeably preventing you from living.

Scientists have previously found that even one or two glasses of wine a day, which you drink regularly, can age your brain by several years at once. A new study by scientists on the effects of alcohol on the brain is published in Nature.

Alcohol also affects cholesterol levels. Narcologist Yevgeny Rysin explained which alcoholic drinks can increase it especially strongly.

Text author:Anna Mayskaya

7 reasons not to “treat” anxiety with alcohol

It is no secret that there is a connection between alcohol and anxiety. But a recent study found that alcohol exacerbates symptoms of anxiety and fear. Experts talk about this in detail and explain how to improve the situation.

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Alcohol

Hormone of happiness

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1.

At first, alcohol gives confidence

But this effect is short-lived. Many people loosen up under the influence of alcohol and stop experiencing social anxiety for a while. This is due to the fact that alcohol upsets the chemical balance in the brain, but pretty soon the pleasant sensations end.

2. The level of serotonin decreases

Since alcohol is a depressant, it negatively affects the level of serotonin, the "happiness hormone". As a result, anxiety rises.

3. You have to drink more and more

Alas, the body gradually becomes more and more tolerant to alcohol, more and more alcohol is required to achieve the same effect. It turns out a vicious circle, and if you constantly do this, the consequences will be devastating for mental health.

4. And then comes a disturbing hangover

You may not have a headache or nausea, but the feeling is very unpleasant. Heart palpitations, dizziness, trembling hands - all this can provoke an attack. You can also start to worry that these are symptoms of something more than a hangover. Dehydration and low levels of serotonin add their share to the unhealthy state.

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5. Short-term memory may deteriorate

Has it ever happened that after the next party you barely remember what you were doing? If an anxiety disorder is added to this, you feel even worse. Meanwhile, alcohol really impairs memory, and “here I remember, here I don’t remember” is a symptom that manifests itself in very many people.

5. Increased risk of developing alcohol addiction

A study in the United States showed that 20% of people with social anxiety have an alcohol addiction.

7. Sleep worsens

Alcohol changes the sleep pattern, which affects mood and vitality. As a result, a person often feels anxiety, it becomes more and more difficult for him to cope with everyday activities.

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