Alcohol and Anxiety Disorders: a Dangerous Dance

This week in Question Corner, an anxious teen turns to alcohol to soothe his transitional fears. Melody addresses a mom’s worries about the toxic combination of alcohol abuse and anxiety disorders.

Got a question for Melody?

Dear Melody, 

I’m worried about my son. He has just finished his final year at high school and is planning to go to university away from home. He has been spending a lot of time alone in his room this summer and when he does come down he is often quite unpleasant and moody. I’ve asked him to tell me so often what’s wrong but he just shuts down. He had been drinking with his friends a lot since graduation but, the last month or so he hasn’t been going out and we’ve not seen anything of his best friend. Recently he started taking a can of beer when he goes to bed. His dad and I are starting to worry he’s going down the wrong path. Maybe even taking drugs. 

He needs to start applying for accommodation in dorms or searching for housemates asap but as far as I know he hasn’t even looked at the university’s information about it. How do I make him see that he needs to get his act together and stop putting it off before it’s too late? 

Yours, 

Concerned mom 

Dear Concerned Mom,

The adolescent years can be filled with lots of ups and downs, and it can be confusing for many who are learning to navigate the complexities of the world and understand hormones and emotions. It sounds like your son is going through some big life changes and is showcasing some symptoms of anxiety, depression, and alcohol use.

Anxiety is a natural human response to stress or fear, something most people experience. However, when feelings of anxiety persist even without obvious triggers and significantly affect daily life, it may indicate an anxiety disorder.¹ 

Anxiety disorders, marked by excessive worry and fear, can manifest in various forms. Common types include generalized anxiety disorder (GAD), characterized by chronic worry about everyday issues, panic disorder, marked by sudden and intense panic attacks, and social anxiety disorder (SAD), which involves intense fear of social situations.¹ These are often intertwined with substance use disorders, including alcohol abuse, creating a complex challenge for those affected.²

Does alcohol make anxiety worse?

While alcohol may seem like a quick fix for anxiety, offering temporary relief from stress, new research highlights the dangers of this deceptive coping mechanism. Not only can alcohol worsen existing anxiety, but it can also trigger new-onset anxiety and increase the risk of developing panic disorder.

Studies have shown that chronic alcohol use negatively impacts the brain’s ability to manage stress, leading to heightened anxiety levels.³ This is attributed, in part, to alcohol’s effects on the amygdala, the brain’s emotional center.⁴ By numbing anxiety in the short term, alcohol masks the root causes of distress, preventing individuals from addressing their underlying issues and finding healthy coping strategies.

The relationship between alcohol and panic disorder is particularly concerning. A recent study revealed that a significant number of people seeking treatment for panic disorder had a history of alcohol dependence.⁵ This suggests that self-medicating anxiety with alcohol can create a dangerous cycle, leading to increased vulnerability to panic attacks.

Alcohol’s effect on the brain

Alcohol’s impact on brain chemistry, particularly the neurotransmitters GABA, serotonin, and dopamine, plays a crucial role in this phenomenon. While moderate drinking may initially boost GABA levels, providing temporary relaxation, heavy alcohol use depletes GABA, leading to heightened tension and anxiety.⁶

For those struggling with panic disorder, turning to alcohol for relief can have dire consequences. Prolonged heavy alcohol use can lead to dependence, and the withdrawal symptoms upon quitting can include severe anxiety, exacerbating the very problem alcohol was meant to alleviate.²

Contrary to popular belief, the type of alcohol you consume does not determine its impact on anxiety levels. While wine and beer may be perceived as less anxiety-inducing than hard liquor due to lower alcohol content, there are no studies showing differences between the types of alcohol in terms of their effect on anxiety. Instead, the frequency and quantity of alcohol consumption are the primary factors influencing anxiety levels.

All this research underscores the importance of seeking professional help for anxiety and avoiding self-medication with alcohol. Addressing the root causes of anxiety through therapy and appropriate medication is essential for long-term recovery. Remember, while alcohol may offer temporary solace, it ultimately fuels the flames of anxiety, leading to a destructive cycle that is difficult to break.

Sincerely,

Editor

References

1. Anxiety Disorders (no date) National Institute of Mental Health. Available at: https://www.nimh.nih.gov/health/topics/anxiety-disorders (Accessed: 21 July 2024). 
2. Mental health issues: Alcohol use disorder and common co-occurring conditions (no date) National Institute on Alcohol Abuse and Alcoholism. Available at: https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/mental-health-issues-alcohol-use-disorder-and-common-co-occurring-conditions#pub-toc2 (Accessed: 21 July 2024). 
3. Sinha, R. (2022) Alcohol’s negative emotional side: The role of stress neurobiology in Alcohol Use Disorder, National Institute on Alcohol Abuse and Alcoholism. Available at: https://arcr.niaaa.nih.gov/volume/42/1/alcohols-negative-emotional-side-role-stress-neurobiology-alcohol-use-disorder (Accessed: 21 July 2024). 
4. Gorka SM, Fitzgerald DA, King AC, Phan KL. Alcohol attenuates amygdala-frontal connectivity during processing social signals in heavy social drinkers: a preliminary pharmaco-fMRI study. Psychopharmacology (Berl). 2013;229(1):141-154. doi:10.1007/s00213-013-3090-0
5. Canan F, Ataoglu A. Panic disorder after the end of chronic alcohol abuse: a report of 2 cases. Prim Care Companion J Clin Psychiatry. 2008;10(4):332-333. doi:10.4088/pcc.v10n0411d
6. Smith JP, Randall CL. Anxiety and alcohol use disorders: comorbidity and treatment considerations. Alcohol Res. 2012;34(4):414-431.