Alcohol and anxiety attacks can become a vicious cycle, each worsening the effects of the other. In an effort to settle down after something triggers an anxiety attack, it is common to reach for a drink, or two, or five. Alcohol is a central nervous system depressant, which can produce a temporary sense of calm and relaxation. But if an anxiety disorder exists, the constant use of alcohol to self-medicate can lead to increased alcohol tolerance and consumption. It is only a matter of time before alcohol use disorder becomes a co-occurring disorder to the anxiety disorder.
According to a analysis published in Alcohol Research Current Reviews, “Anxiety and Alcohol Use Disorders,” (Smith and Randall), not only are the comorbid disorders very prevalent, but evidence points to a higher incidence of women with the co-occurring disorders. The authors explain that anxiety disorders are more prevalent in women, while alcohol use disorder is more common in men. However, more women use alcohol to self-medicate anxiety symptoms than do men, explaining the gender difference in abuse of alcohol and anxiety attacks.
Another interesting fact about using alcohol to self-medicate anxiety symptoms, it seems that the specific type of anxiety disorder may dictate the alcohol abuse. Individuals struggling with panic disorder have a significantly higher rate of alcohol use disorder than those with obsessive-compulsive disorder, which has the lowest rate of alcohol comorbidity among the different anxiety disorders. Social anxiety and alcoholism are also highly comorbid. These nuances complicate the already challenging treatment planning for this particular dual diagnosis.
Anxiety Disorders and Alcohol Use Disorders
Anxiety disorders affect approximately 40 million Americans each year, being the most commonly experienced mental health disorder. Because the nature of anxiety is the fear response, symptoms can be very unsettling. Trembling, sweating, nausea, lightheadedness, chest tightness, heart palpitations, and irritability are upsetting and can disrupt normal daily functioning.
Alcohol is an inexpensive substance that is readily available without a prescription. The effects of an alcoholic beverage produce a sedating action on the central nervous system, which can quickly reduce some of the anxiety symptoms. Because of the availability of alcohol, it is a go-to for self-medicating the uncomfortable effects of anxiety.
The brain makes ongoing accommodations to the alcohol consumption. When the body becomes more tolerant of the alcohol intake, it is not as responsive to its effects. This causes the individual to increase alcohol consumption, in hopes of revisiting the initial response. From this point forward, alcohol misuse will begin to compound the clinical picture. Signs of an alcohol use disorder include:
- Drinking more than intended
- Unable to limit alcohol consumption
- Experience cravings
- Begin neglecting responsibilities
- Ever-increasing tolerance to alcohol
- Continue misusing alcohol, even with negative consequences
Alcohol and Anxiety Attacks
Ironically, the effort to use alcohol to self-medicate the symptoms of anxiety can actually backfire. This can happen in two ways: 1) alcohol dependency develops, and 2) alcoholism fuels anxiety. Anxiety disorder is a prevalent co-occurring mental health disorder with alcoholism. The long-term effects of alcohol on the brain can actually trigger anxiety.
The University of North Carolina School of Medicine found that chronic high alcohol consumption alters brain pathways. The study demonstrates that heavy drinking opens someone up to anxiety due to a molecular connection between anxiety and alcoholism. This can impact how someone with a history of alcoholism recovers from a traumatic event, potentially impairing the critical mechanism.
How to Treat Co-Occurring Alcohol Use Disorder and Anxiety Disorder
When someone reaches the point when they realize they need help, it is important that they seek treatment at a dual diagnosis program. These programs specialize in the unique nuances involved in treating co-occurring disorders such as alcoholism and anxiety disorder. These experts will know, for instance, the danger in prescribing benzodiazepines for treating anxiety, as this medication is highly addictive and may further complicate the situation.
Instead of benzodiazepines, there are other anxiety-reducing medications available that are non-habit forming. Use of holistic and experiential therapies are also very effective in treating someone who is recovering from alcohol addiction and anxiety. These stress-reducing activities might include:
- Regular exercise
- Massage therapy
- Gardening therapy
The bedrock of a quality dual diagnosis treatment program is psychotherapy and the 12-step program. Psychotherapy is the cornerstone of addiction and mental health treatment, provided in both individual sessions, one-on-one with the psychotherapist, and group sessions.
Cognitive behavioral therapy (CBT) is highly effective in treating both alcohol use disorder and anxiety. CBT involves identifying and altering the disordered thought patterns so fundamental changes can be made in the resulting behaviors. For example, a disordered thought/behavior pattern might be: I am freaked out about getting in front of my colleagues and making a presentation! No way can I do it without alcohol. A reframed thought/behavior pattern might be: I know I will need to practice a lot before getting in front of my colleagues to deliver the presentation. I should practice a little bit every day so I will be calm when I step up to present.
The 12-step program from Alcoholics Anonymous is a mainstay in addiction recovery because it helps individuals incrementally reach milestones, each helping to reinforce sobriety. The meetings provide a backdrop of social support, where those in recovery can share their triumphs and challenges, garnering strength from each other. 12-step meetings are an intrinsic element in aftercare as well, providing an opportunity to gain a sponsor, as well as to be of service to others.
Phoenix Rising Behavioral Treats Addiction and Dual Diagnosis
Phoenix Rising Behavioral is a leading outpatient recovery program located in Orange County, California. With a highly effective blend of evidence-based therapies and 12-step programming, Phoenix Rising can help individuals overcome this dual diagnosis in an outpatient setting. Offering detox and sober living resources to supplement treatment, Phoenix Rising also provides evening programming to better accommodate work schedules. For more information about our program, please reach out to Phoenix Rising today with your questions about alcohol and anxiety attacks at (877) 299-5694.