Are Alcohol and Anxiety Linked?

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Alcohol and anxiety are closely intertwined and there are no positive outcomes from using alcohol to address the symptoms of anxiety. Additionally, alcohol abuse can sometimes trigger anxiety, another adverse consequence of alcohol anxiety.

Developing alcohol use disorder or substance use disorder in isolation is challenging, but when these two serious mental health conditions co-occur in a dual diagnosis, this can lead to a vicious cycle that can be hard to break. Research shows that anxiety and alcoholism frequently co-occur.

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Alcohol and Mental Health

 With co-occurring anxiety and alcohol use disorder, the symptoms of each disorder can inflame the symptoms of the other. This causes many people suffering from a dual diagnosis to self-medicate the symptoms with alcohol or illicit drugs. Self-medication provides little beyond fleeting relief at the cost of exacerbating both conditions.

ADAA (Anxiety and Depression Association of America) reports that 20% of those with an anxiety disorder or depression also have alcohol use disorder or another substance use disorder. Among those with alcohol use disorders and substance use disorders, 20% also have anxiety disorders or other mood disorders.

In today’s guide, we’ll address the following concerns:

  • Is alcohol linked to anxiety?
  • Does alcohol affect anxiety?
  • Can alcohol increase anxiety?
  • Does alcohol affect depression and anxiety?
  • What are the effects of alcohol on anxiety treatment?

How Does Alcohol Affect Anxiety?

It is commonplace for anxiety and alcohol use disorder to co-occur, and this typically provokes a complex presentation of symptoms. 

Anxiety disorders affect 40 million people in the US, according to ADAA. These are the five major anxiety disorders recognized by DSM-5-TR, APA’s benchmark diagnostic tool for both addictions and mental health disorders: 

  1. GAD (generalized anxiety disorder): GAD is characterized by chronic worry, tension, and anxiety with little or no provocation.
  2. OCD (obsessive-compulsive disorder): OCD is a less common anxiety disorder characterized by obsessions (unwanted thoughts) triggering compulsions (repetitive behaviors). Performing rituals like checking, cleaning, or counting provides only fleeting relief. Not performing rituals, on the other hand, prompts mounting anxiety.
  3. PTSD (post-traumatic stress disorder): According to the US Department of Veterans Affairs, 12 million people develop PTSD in any given year. Post-traumatic stress disorder can occur in some people who witness or experience traumatic events, from war crimes and violent personal assaults to natural disasters and accidents, PTSD causes distressing symptoms including flashbacks to the traumatic event.
  4. Panic disorder: Another common form of anxiety disorder, panic disorder is characterized by unexpected episodes of extreme fear accompanied by an array of physical symptoms, from chest pain and shortness of breath to dizziness and nausea.
  5. Social anxiety disorder: Also known as social phobia, this is a form of anxiety disorder characterized by self-consciousness and anxiety in social situations.

AUD (alcohol use disorder) is the clinical descriptor for alcohol addiction or alcoholism.

AUD is diagnosed according to the criteria in DSM-5-TR. The previous edition of the DSM recognized both alcohol abuse and alcohol dependence. In the fifth revised edition of this text, the conditions are integrated into AUD, a single disorder.

Alcohol use disorder can be diagnosed as follows according to the number of symptoms present: 

  • Mild AUD: 2 or 3 symptoms
  • Moderate AUD: 4 or 5 symptoms
  • Severe AUD: 6 symptoms or more

The diagnostic criteria are versions of these eleven questions concerning your alcohol consumption over the previous year:

  1. Are you neglecting hobbies and activities you once enjoyed?
  2. Do you often drink more than planned or drink for longer than intended?
  3. Have you experienced cravings for alcohol in its absence?
  4. Are you spending lots of time drinking and recovering from the effects?
  5. Have you tried and failed to moderate or stop drinking?
  6. Do you continue to drink even after feeling depressed or anxious?
  7. Do you need more alcohol to achieve the same effects due to tolerance?
  8. Does your alcohol consumption and behaviors cause personal and professional problems?
  9. Do you engage in risky behaviors as a result of alcohol?
  10. Are you still drinking alcohol despite these problems?
  11. Do you get withdrawal symptoms in the absence of alcohol?

While both alcohol use disorder and anxiety disorder can be debilitating in isolation, they frequently co-occur, but with what results?

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How Alcoholism Affects Anxiety

How alcoholism affects anxiety and depression differs from person to person. There are two primary ways in which alcoholism and anxiety feed into each other

  1. Self-medicating the symptoms of anxiety disorders with alcohol
  2. Substance-induced anxiety disorder

1) Self-medicating the symptoms of anxiety disorders with alcohol

Anxiety disorders work on the CNS (central nervous system) by increasing blood flow and heart rate and overworking the brain. Treatment for anxiety disorders often involves CNS depressants like benzodiazepines in combination with behavioral interventions. Many people faced with distressing symptoms of anxiety – especially when diagnosed – self-medicate with alcohol.

Self-medicating might provide some short-term relief, but over time will inflame both conditions, potentially leading to a co-occurring disorder requiring residential rehab.

2) Substance-induced anxiety disorder

Substance-induced anxiety disorder or medication-induced anxiety disorder are the clinical descriptors for panic attacks or anxiety attacks triggered by prescription medications, illicit drugs, or alcohol.

This diagnosis requires that substance use and anxiety co-occur. If you experienced bouts of anxiety before using the substance in question, this is not diagnosed as substance-induced anxiety disorder, even when substance use inflames the symptoms.

Mental health disorders are diagnosed per the criteria in DSM-5-TR. Most of the diagnostic criteria require that symptoms are not triggered by substance use. The reverse applies with substance-induced anxiety disorder. The symptoms must coincide with substance use.

Substance-induced anxiety disorder is diagnosed as follows:

  • Panic attacks or anxiety attacks are predominant.
  • The symptoms likely developed during or immediately after using a medication or addictive substance capable of triggering those symptoms.
  • The condition is not more accurately explained by something other than a substance-induced anxiety disorder.
  • Neither panic nor anxiety occurs exclusively during delirium.

The criteria for substance-induced anxiety disorder in DSM-5-TR are the same as the criteria for other anxiety disorders.

Symptoms must present during intoxication or within 4 weeks of substance use.

Is Alcohol Bad for Anxiety?

Abusing alcohol is almost always bad for anxiety.

If you have been suffering from the symptoms of any of the anxiety disorders above, effective treatment is available. Social anxiety disorder often responds well to a combination of antidepressants and therapy. Many people with generalized anxiety disorder find psychotherapy like CBT (cognitive behavioral therapy) combined with medications, and those with panic disorder often find short-term relief from benzodiazepines.

Different types of anxiety disorders need treating differently, and many treatment plans will involve medications, many of which are potentially dangerous to combine with alcohol.

How Do I Stop Alcohol Anxiety?

 Alcohol can initially produce feelings of relaxation and euphoria, but it can also cause anxiety, especially if consumed in excess. Here are some pointers to help you manage drinking with anxiety:

  • Limit your alcohol consumption: In some cases, drinking too much alcohol causes anxiety, so it’s important to limit your consumption. Try to stick to a moderate amount of alcohol, such as one or two drinks per day.
  • Stay hydrated: Drinking water between alcoholic drinks can help you stay hydrated and reduce the likelihood of alcohol being linked to anxiety.
  • Eat something before drinking if you are prone to alcohol anxiety: Consuming food before drinking alcohol can help slow down the absorption of alcohol into your bloodstream and reduce the likelihood of anxiety.
  • Get enough sleep: Getting enough sleep can help reduce anxiety, so make sure you’re getting enough rest each night.
  • Practice relaxation techniques: Deep breathing, meditation, and other relaxation techniques can help reduce anxiety. Rather than relying on alcohol for anxiety, use some relaxation techniques instead.
  • Exercise: Exercise can help reduce anxiety and improve your overall well-being at the same time.
  • Seek professional help: If your anxiety persists, it may be helpful to seek the advice of a mental health professional who can help you develop a plan to manage your anxiety.

Can Quitting Alcohol Cure Anxiety?

If anxiety and drinking are becoming a concern, you should now have an understanding of alcohol’s effect on anxiety and why anxiety with alcohol is not a good mix.

Those suffering from anxiety from alcohol may find that quitting alcohol improves symptoms, especially those who experience alcohol-induced anxiety. Alcohol can initially provide temporary relief from anxiety, but it can also lead to increased anxiety levels, especially during withdrawal.

However, quitting alcohol alone may not be enough to remove the issue of anxiety drinking alcohol for everyone. Anxiety disorders are complex and can have various causes, including genetics, environmental factors, and psychological factors.

If you are struggling with anxiety, it’s vital to engage with professional treatment to identify the underlying causes and develop an appropriate treatment plan. Treatment for anxiety may include therapies, medication, lifestyle changes, and other interventions.

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Get Treatment for Alcohol Addiction and Anxiety at California Detox

If you have a dual diagnosis of alcohol addiction and anxiety, we can help you from detox to discharge and beyond at California Detox in Southern California.

Our alcohol detox and addiction treatment center provides programs at all levels of intensity, from inpatient rehab to intensive outpatient treatment. We specialize in the dual diagnosis treatment of anxiety disorder and alcohol use disorder.

Take the safest and most comfortable pathway to ongoing dual diagnosis treatment with a supervised medical detox at our luxury beachside facility in Laguna Beach, CA. The treatment team can prescribe medications to streamline the alcohol withdrawal process and reduce the intensity of cravings.

All treatment programs offer personalized treatment that combines science-backed treatments and holistic therapies that include:

  • Psychotherapy
  • Medication-assisted treatment
  • Group therapy
  • Individual counseling
  • Family therapy
  • Aftercare

When you’re ready to tackle alcohol and anxiety head-on and simultaneously, call 949.694.8305 for immediate assistance.


The timeline for anxiety to go away after quitting alcohol can vary based on individual factors like the severity of the anxiety and the duration and amount of alcohol use. That said, it’s commonplace for some improvement in anxiety symptoms to be noticeable within a few weeks to a few months of quitting alcohol.
Alcohol can initially produce a calming effect, but as its effects wear off, it can increase anxiety levels. Long-term alcohol use may also disrupt the body’s natural stress response system, making it more difficult to manage anxiety.


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