Giving Up Alcohol Because Of Anxiety

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In This Guide
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KEY TAKEAWAYS

Giving up alcohol due to anxiety is achievable by:

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How To Give Up Alcohol Because Of Anxiety

The process of giving up alcohol due to anxiety includes:

  • Acknowledging and accepting that alcohol is causing anxiety, and is not functioning as a useful coping mechanism
  • Identify how alcohol contributes to anxiety triggers, patterns of isolation, and others enable the pattern of addiction
  • Consider supervised detox and re-establishing balance in neurotransmitter levels exacerbated by both alcohol and anxiety combined
  • Establish new resources for overcoming anxiety, before alcohol as a coping mechanism is taken away
  • If the above does not reduce anxiety, consider cognitive behavioural therapy (CBT) or mindfulness and meditation practices

Precautions to consider when quitting alcohol due to anxiety are:

  • If the patient is already using benzodiazepines for anxiety treatment, as these are used in alcohol detox, there is a risk of overdose
  • Whether the patient has had several previous unsuccessful detoxes

How Alcohol Causes Anxiety

Heavy drinking depletes levels of GABA receptors, which increases stimulation in the brain, causing panic attacks in 40% [2].

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Hangxiety

Hangxiety occurs after a short-term period of drinking alcohol and affects either episodic or social drinkers.

Hangxiety is a form of acute withdrawal where anxiety symptoms such as guilt, worry or shame are experienced shortly after drinking alcohol, as opposed to chronic drinkers experiencing anxiety before.

Anxiety Before Drinking vs. Anxiety After Drinking

Precursors

Precursors in mindset in anxiety before drinking (chronic alcoholism) are:

  • Worrying about whether there will be an opportunity to drink enough at social gatherings
  • Experiencing guilt for past behaviour caused by alcoholism

Precursors in mindset in anxiety after drinking (episodic) are:

  • Exaggerating hangxiety symptoms or expecting the worst after alcohol - those scoring 4 or higher on the pain catastrophising scale report higher hangover and anxiety rates [3]
  • Short-term negative emotions cause the individual to drink more than usual - leading to regret or shame
  • Pre-existing social anxiety

Causal Issues

Causal issues in anxiety before drinking (chronic alcoholism) are:

  • Brain chemistry reaction to depletion of GABA
  • As a response to withdrawal symptoms
  • Cycle of using alcohol as a coping mechanism to deal with anxiety, further increasing alcoholism

Causal issues in anxiety after drinking (episodic) are:

  • Drop in endorphins causing temporary feelings of withdrawal symptoms
  • Increase in noradrenaline (the fight or flight response)
  • Block in the glutamate system - stopping new memories from being formed, and leading to anxiety about memory gaps

Physical Symptoms

Physical symptoms of anxiety before (chronic alcoholism) are:

  • Withdrawal symptoms - delirium tremens, shakiness, sweating and tremors
  • Panic attacks
  • Restlessness

Physical symptoms of anxiety after drinking (episodic) are:

  • Increased heart rate
  • Feeling of restlessness
  • Hangover symptoms - sluggish, thirst, nausea and headaches
  • Depleted endorphins and a 3% increase in cortisol [4]
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Emotional Symptoms

Emotional symptoms of anxiety before drinking (chronic alcoholism) are:

  • Long-term triggers - memories, trauma or guilt
  • Worry or guilt about losing jobs or access to children
  • Rationalising alcohol intake
  • Ignoring the needs of others
  • Deliberately misinterpreting the actions of others

Emotional symptoms of anxiety after drinking (episodic) are:

  • Overanalysing conversations or actions with others
  • Suspicion
  • Difficulty focusing or relaxing
  • Regret

Mindset And Motivation

The mindset of those experiencing anxiety before consumption is that of a chronic alcoholic, who has developed a chemical dependence on alcohol.

40% of chronic alcoholics suffer from panic attacks due to anxiety as a result of drinking [5].

The mindset of those experiencing anxiety after consumption is that of a social or moderate drinker.

Instead of being motivated by alcohol itself, they are motivated to use alcohol to reduce social anxiety, stress or social expectations of drinking alcohol.

Reasons For Giving Up Alcohol

Those who experience anxiety before alcohol is attempting to reduce long-term background anxiety secondary to chronic alcoholism.

Those who experience anxiety after alcohol want to give up due to shame and embarrassment.

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Hanxiety (Short Term Episodic Drinking)

Giving Up Alcohol Due To Anxiety (Chronic)

Anxiety BEFORE drinking

No

Yes

Anxiety AFTER drinking

Yes

No

Social drinking?

Yes

No

Chronic drinking

No

Yes

GABA levels

Unchanged

Depleted

Giving Up Alcohol Due To Anxiety - The Numbers

55% of those in recovery require support for anxiety or other mental health disorders [6].

85% of those in recovery have experienced anxiety or other psychiatric disorders, 62% higher than those without an alcohol use disorder [7] [8].

60.7% of women experience comorbid anxiety and alcohol use disorder, higher than 35.8% in men [9].

80% of those not seeking help for alcohol abuse are white males, with 65% of those also meeting the criteria for anxiety disorder. This suggests a correlation between the avoidance of recovery and the incidence of anxiety symptoms [10].

84.6% of women experienced a 1-4 scaled reduction in anxiety after music therapy [11].

Those giving up alcohol due to anxiety also have:

  • 2.6% incidence of agoraphobia
  • 2.7% incidence of obsessive-compulsive disorder
  • 2.8% incidence of social phobia [12]

Motivators In Giving Up Alcohol Due To Anxiety

Motivators for giving up alcohol due to anxiety are:

  • Seeking to escape a family pattern of using alcohol to cope with anxiety
  • Anxiety caused by PTSD or trauma from sexual assault
  • Anxiety and isolation caused by divorce or bereavement

Side Benefits After Giving Up Alcohol Due To Anxiety

Side benefits for those who give up alcohol due to anxiety before drinking (chronic alcoholism) are:

  • Improved cognitive function - memory and reaction times
  • No longer having to rely on family or friends to make excuses or rationalise behaviour of alcoholism caused by anxiety - improved relationships and decreased codependency
  • Improved sleep - giving up alcohol improves sleep quality and pattern, improving anxiety
  • Improved digestion - better digestion from stopping drinking alcohol also improves anxiety

Side benefits for those who give up alcohol due to anxiety after drinking (episodic) are:

  • Improved confidence - no longer relying on alcohol to cope with social events reduces anxiety
  • Improved overall health - not having a hangover means there is a reduction in physical health issues that exacerbate anxiety
  • Increased disposable income - helps to reduce financial-related anxiety
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What Giving Up Alcohol Due to Anxiety Doesn't Fix

  • Family issues - alcohol may be used to numb anxiety caused by fractured family relationships, which then appear worsened when alcohol is removed
  • The original cause of anxiety that led to alcohol being used as a coping mechanism
  • Others' attitudes towards not drinking - peer pressure, questioning not drinking, and taking offence may increase anxiety

Recovery from alcoholism is a lifelong endeavour, meaning emotional work such as therapy, support groups or inpatient rehabilitation is required [13].

When Anxiety Doesn't Reduce After Quitting Drinking

Anxiety may not reduce after stopping drinking due to:

  • Brain chemistry readjusting - alcohol changes the brain's ability to function through thiamine deficiency, causing anxiety in chronic drinkers as it readjusts to being without alcohol
  • Thyroid disease - causes a chemical imbalance leading to anxiety
  • Past underlying trauma that continues to cause anxiety
  • The absence of alternative coping mechanisms, other than alcohol

Experiencing anxiety after quitting alcohol is not a reason to go back to alcoholism.

While alcohol provides short-term relief for anxiety, it will exacerbate it long-term.

To deal with anxiety without a coping mechanism, consider addressing the underlying causes via:

  • Cognitive behavioural therapy [CBT]
  • SSRI antidepressants or benzodiazepines - as advised by medical professionals

When Giving Up Alcohol Due To Anxiety Is NOT Useful

Giving up alcohol due to anxiety is not useful when:

  • The patient has co-occurring epilepsy - increasing the possibility of seizures in withdrawal
  • Personal circumstances (living conditions/ housing concerns, unemployment and money concerns) mean that giving up alcohol would cause anxiety to increase to unmanageable levels
  • Underlying pre-existing trauma/ PTSD has not been resolved
  • Alcohol and anxiety have caused suicidal ideation
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About the author

Harriet Garfoot

Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: November 7, 2023