Anxiety Disorders and Alcohol Dependence: How the Two are Connected

Anxiety Disorders and Alcohol Dependence: How the Two are Connected
October 24, 2022
|   Updated:
April 17, 2024

Navigating Anxiety Disorder and Alcohol Use Disorder (AUD) can be emotionally and physically taxing. Understanding how the two are connected can empower you, someone you care for, or a loved one with greater insight when entering addiction recovery. Let’s take a closer look at how anxiety relates to AUD and some available treatment options.

Anxiety And AUD: What Studies Show

A recent study showed that anxiety and AUD are often connected in three ways: the common-factor model, the self-medication model, and the substance-induced anxiety model. Each model offers a way to begin contextualizing how anxiety and AUD coexist and how we might approach each regarding addiction treatment.

A man struggling with anxiety and AUD

The Common-Factor Model

The Common-Factor Model suggests no direct relationship between anxiety and AUD. Instead, a third variable may contribute to the development of the two disorders, like genetic predisposition and/or personality traits.

While this method is not commonly relied on to identify connections between anxiety and AUD, it can be useful to consider when seeking treatment for either disorder, as they both have the potential to stem from genetics or other environmental elements. Reviewing family or genetic history with a trusted treatment professional can give individuals a clearer sense of where their experience stems from and which recovery method(s) work best.

The Self-Medication Model

Sometimes those who experience anxiety turn to practices of self-medication. This could mean that they are consuming alcohol to soothe feelings of anxiety or to prevent the onset of anxiety. Though it may feel like an immediate catharsis, over time, this practice of self-medicating with drinking can lead to the development of an AUD.

The Self-Medication Model is often given the most attention when it comes to clinical research, as many people report using alcohol to cope with symptoms of anxiety. Understanding that anxiety may be behind an impulse to drink can be a powerful jumping-off point when exploring treatment options.

The Substance-Induced Anxiety Model

For those experiencing an AUD, there may be periods of prolonged alcohol consumption, which can contribute to increased feelings of anxiety. Long stretches of alcohol use can create an imbalance in your brain’s chemical makeup, leading to anxiety.

Additionally, someone undergoing withdrawal symptoms may experience anxiety disorder symptoms, like panic attacks, or be more susceptible to stress-induced anxiety.

 How Do I Know If I Have Anxiety?

How Do I Know If I Have Anxiety?

If you suffer from AUD, it may be difficult to recognize if you are experiencing an anxiety disorder, as both symptoms can be similar. If you fear you may be suffering from anxiety, it is beneficial to understand the symptoms associated with this disorder. Some of the main symptoms of an anxiety disorder include:

  • Excessive fear, nerves, or tension
  • Increased panic or restless behavior
  • Elevated heart rate
  • Hyperventilation or panic attacks
  • Extreme fatigue or weakness
  • Sleep difficulty
  • Excessive sweating
  • Stomach aches or other gastrointestinal issues

What Are the Most Common Forms of Anxiety for People With AUD?

The most common forms of anxiety disorder for those suffering from an AUD include generalized anxiety disorder, panic disorder and social anxiety or social phobia disorder. Though these are the most common, they are not exclusive, as there are many other forms of anxiety disorders.

Suppose you are experiencing any of the aforementioned symptoms and they become too difficult to manage. In that case, it is crucial to reach out to your primary care doctor to see if a diagnosis or specific treatment may help you deal with this disorder.

How Does Alcohol Cause Depression and Anxiety?

In recent years, the term “Hangxiety” has been used to describe the feelings of intense anxiety following a night of heavy drinking.

“Hangiexty” includes feeling dread or regret as one plays over the conversation’s and decisions they made the night before while under the influence. While these symptoms mimic the usual anxiety disorder symptoms, they are directly related to an individual's alcohol consumption.

Because alcohol is a depressant, its very nature puts one at risk for depression and anxiety, even without a personal history of either of these disorders. This is because, when you drink, the brain is affected in multiple ways.

A sad woman laying down who is dealing with anxiety because of alcohol

How is the Brain Affected When You Drink Alcohol?

First, alcohol affects the brain’s serotonin levels, which control mood and behavior. Second, it enhances the dopamine levels in your brain. Dopamine is released when we are happy or experiencing something pleasurable; this is why many feel joyful and carefree when drinking. Lastly, it affects the brain’s ability to produce GABA, another way for the brain to regulate the body’s central nervous system.

After multiple days, or simply one long night, of over-consuming alcohol, the drop or “come down” of these brain functions cause an increase in anxiety. With the brain's levels of serotonin, dopamine, and GABA being manipulated by alcohol, one may begin to feel the onset of anxiety symptoms. Prolonged use affects the brain's ability to return to its normal levels until the drinking ceases or an individual finds treatment for their anxiety symptoms.

Can Drinking Every Night Cause Anxiety?

Consuming alcohol just once a week can cause anxiety, as previously mentioned. One person’s anxiety levels may heighten after just drinking one night a week, where someone else may not feel the same symptoms.

However, if you are drinking every night, there is a high probability you will experience an enhanced amount of anxiety symptoms. Unfortunately, alcohol and anxiety do not complement each other and have a toxic relationship of feeding off each other. If you are drinking every night to placate your anxiety, understand there are tools out there better suited to managing the root issue. If not adequately addressed, one can get into a continuous cycle of drinking to ease anxiety, then experience anxiety because of the alcohol, etc.

Should I Drink If I Have Anxiety?

If you suffer from an anxiety disorder, you may want to avoid drinking. Unfortunately, alcohol and anxiety do not mix well; when they fuse together, the outcome can be detrimental to your health.

Because of its effects on the brain, alcohol should be avoided for those currently suffering from anxiety symptoms or those with a family history of anxiety or depression, as it can exacerbate its effects. In doing so, an individual may be able to avoid anxious symptoms that can eventually develop into depression.

A woman comforting a guy who is dealing with anxiety

Anxiety And AUD: Options For Treatment

Everyone’s experience of anxiety and AUD is unique, and addiction treatment isn’t one-size-fits-all. It’s a complex process that involves a dedicated Recovery Circle of support. Taking steps to care for themself or someone else can be incredibly difficult, yet every single step counts. People in recovery should make sure to congratulate themselves and celebrate each small win along the way.

Similarly, anxiety management or treatment is also unique to each individual. Triggers differ from person to person; therefore, the tools needed to combat anxious thoughts or behaviors are most often individualized. When someone finds a tool or treatment that subsides their anxiety, that should be noted and celebrated.

Because it can be hard to determine if anxiety predates an AUD or vice versa, a thorough assessment of medical records, behavioral patterns, and observing symptoms over a sustained period of time is often necessary to find proper care.

Additionally, the type of anxiety one experiences may impact the kind of treatment they receive when simultaneously living with an AUD. While certain medications may help treat generalized anxiety, OCD, panic disorders, or social anxiety, care providers may also consider how those medications interact with treatments for AUD.

The following list includes some of the most commonly used methods when treating AUD and anxiety, but the list is by no means exhaustive. If you are experiencing anxiety and/or AUD symptoms, reach out to your care provider immediately to find a treatment plan that works best for you and your medical history.

Rehabilitation Centers

If an individual is looking for a treatment option that can assist in managing their alcohol abuse and anxiety, rehabilitation centers are an effective first step. Whether you are aware of how alcohol and anxiety play a role in your life or if you are unsure of your individual relationship to the two, you may find that an organized program such as a rehab center is where you can find answers and begin to treat your disorder(s).

Rehabilitation centers, like AUD and anxiety, have main components that differ slightly. The length of stay, types of required therapy, and methodologies all change from center to center, but the core mission is the same: help people manage their alcoholism. Finding the right treatment center for your disorder(s) is crucial. It is imperative that you or someone you care for should feel seen and heard throughout this sensitive process.

For example, if an individual struggling with AUD is looking for addiction treatment in New Jersey, Maryville Addiction Treatment Center offers holistic and empathetic care for short- and long-term residential stays and intensive outpatient treatment.

Cultural or identity-based rehabilitation centers also offer a unique perspective and are often more accessible to certain groups of people. For the California Native American population, for example, there are treatment centers that offer free admission to their tribe members, like the Sierra Tribal Consortium in Fresno.

If you or someone you love is looking for a treatment center near you, utilize the Substance Abuse And Mental Health’s (SAMHSA) National Hotline or online treatment service locator to find the best options local to you. Your care provider may also be able to provide you with insurance-covered treatment options.

A guy telling his story in a rehabilitation center


Nearly all Rehabilitation Centers will have some form of psychotherapy as part of their AUD recovery programs. This is due to the overwhelming success that many people have experienced after consistently attending therapy.

Psychotherapy works because of the intensive years of schooling therapists must complete as well as the scientifically backed methodologies they utilize in each therapy session. The most common forms of therapy for those with AUD are Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT).

The former is based on learning how to recognize the thought patterns and triggers that lead an individual to abuse alcohol and, in turn, train them to learn new ways of thinking or healthier coping mechanisms to change their behavior. DBT grew from CBT; therefore, it works similarly by recognizing and altering thought patterns to invoke a positive change. However, DBT is usually for those with heightened feelings of emotion as it aims to teach an individual how to move on from, but accept, the negative situations they will inevitably face in life.

Therapists often choose specialties, like working with postpartum women or clients with addiction. These specialty-focused therapists have worked to understand the processes and struggles of their specific clientele and are often the most beneficial for those struggling with something specific, like addiction.

Therapy can not only help you manage your AUD but your anxiety symptoms as well. Working with a therapist can equip you with the tools to manage both disorders in hopes of landing you in recovery.

Group Support for Anxiety Disorders and Alcohol Dependence

Group Support

Those struggling with AUD and anxiety often feel isolated and lonely once they have decided to receive help. As their life is changing drastically, it is not uncommon for anxiety to rise as they learn to navigate a new normal.

AUD is a disease that needs constant care and attention that cannot be managed alone. Finding a supportive and inspiring Recovery Circle can help ease anxious thoughts while concurrently helping an individual stay sober and in recovery. 

Some may find a Recovery Circle after attending rehabilitation or a treatment center. Many people are also able to rely on friends and family who are supportive in their new journey of getting sober. However, that is not the case for all people going through recovery.

AUD is a disease that sometimes shows the worst sides of people, leaving them with a community that may find it hard to now support them while in the early stages of recovery; healing can take place, but it does not always happen.

For those looking for a community of like-minded individuals experiencing the same stage of life that is recovery, a group like Alcoholics Anonymous (AA) is a beneficial place to start. Not only is it a free service, but it also is one of the most accessible resources for those with AUD. With meetings taking place worldwide, virtually and in person, those looking for a community can start immediately by using their meeting finder.

If you are here not because you have an AUD but because someone you love does, know there are resources for you too. Al-Anon is a similar support group for people with a loved one who struggles with drinking. Like AA, Al-Anon is free of charge and accessible all over the world.

Though finding a support group cannot cure your AUD or anxiety, it can help you remain motivated and encouraged to continue your path of recovery.

Anxiety And AUD: Accountability Tools

If you choose to utilize accountability tools in your recovery, you are more likely to sustain long-term sobriety. For those suffering from both AUD and anxiety, remote alcohol monitoring is a productive first step.

Using accountability tools like Soberlink during a treatment session

Soberlink’s Alcohol Monitoring System

If an individual’s anxiety is worsening due to alcohol abuse and they are interested in building accountability, Soberlink may be a consideration. Remote alcohol monitoring can be an invaluable tool early on, and Soberlink’s technology streamlines the process so that the focus is on empowering addiction recovery.

Features like facial recognition, Advanced Reporting, and tamper detection are built into each device to keep Recovery Circles connected, foster accountability, and document and share sobriety in real time. Clients can also test two to three times a day at their convenience, helping them replace bad habits with healthier ones over time. Additionally, having scheduled tests allow for a decrease in anxiety as there are no surprises or unexpected tests with the system; each user knows exactly when their results will be recorded.

Lastly, this alcohol monitoring system allows users to send their results to friends, family, and others in their Recovery Circle. Including loved ones in the recovery journey can help rebuild the trust that may have been damaged due to an AUD while helping an individual stay accountable to sobriety. All things worthy of celebration.

As the only company that offers this kind of comprehensive system, Soberlink is proven to improve recovery outcomes, build recovery capital, and is the Gold Standard when it comes to something as vital and important as alcohol monitoring.

About the Author

Jenn Walker is a freelance writer, blogger, dog-enthusiast, and avid beach goer operating out of Southern New Jersey.

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