Can alcohol cause anxiety and panic attacks?
As a sedative, alcohol is known for its relaxing effects. Many people are familiar with the feeling of having a few drinks to help them ease into social situations.
But when the effects of the alcohol wear off — especially during a hangover — you might notice a sharp spike in anxiety. This is sometimes casually referred to as “hangxiety.”
The link between alcohol and anxiety
Alcohol affects many chemicals in your brain (neurotransmitters), including gamma-aminobutyric acid (GABA).
GABA helps regulate your nervous system. Research from 2020 says that alcohol use releases GABA, which has a relaxing effect, but when the alcohol wears off, you’re left with too little GABA.
In fact, people with alcohol use disorder (AUD) have chronically low levels of this neurotransmitter.
Without enough GABA in your body, such as during a hangover, you might notice increased feelings of worry, anxiety, and guilt.
Having a few drinks is not an issue for many people. But if you develop a pattern of drinking to avoid anxiety or need alcohol to feel relaxed, this can start a vicious cycle where alcohol worsens your anxiety long term.
Many people use alcohol to cope with social anxiety. According to the Anxiety & Depression Association of America, 20% of people with social anxiety disorder have alcohol misuse or dependence.
According to 2019 research, people who drink alcohol to cope with anxiety have an increased risk of alcohol dependence.
Along with anxiety, alcohol may also have an association with panic attacks. A 2001 study on 14 people showed that panic disorder was related to reduced GABA in certain brain areas.
Anxiety and alcohol dependence have similar roots
Many people who have issues with alcohol also have difficulty with anxiety and mood. In fact, 2019 research says alcohol misuse and anxiety may share some biological and brain processes, such as atypical amygdala function. This area influences our emotion regulation and responses to stress.
The researchers also found a link between a family history of alcohol issues and developing anxiety disorders. Experiences of trauma and chronic stress were associated with both alcohol and anxiety disorders.
Alcohol and other mental health conditions
The National Institute on Alcohol Abuse and Alcoholism states that AUD often occurs along with other mental health conditions, including:
- sleep disorders
- other substance use disorders
- disorders related to trauma and stress
Are some types of alcohol worse for anxiety?
There is no research to suggest certain types of alcohol are better or worse for anxiety.
Some believe that alcoholic drinks with a high sugar content may lead to worse hangovers and that “lighter” alcohols — for example, vodka, gin, or white wine — are better for hangovers than “darker” alcohols such as whiskey, dark beer, and red wine.
However, there is little evidence to support this idea.
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Coping with alcohol-related anxiety
After drinking alcohol, it can take some time for your brain chemicals to return to their usual state. You may need to wait it out, but rest assured that you’ll feel better when your body regulates itself.
It helps to focus on self-care to guide you through anxious times.
If you’re dealing with the anxious after-effects of alcohol, you may feel calmer by:
- Drinking plenty of water: Hangovers often come with dehydration, so make sure you’re well-hydrated.
- Sleeping it off: You might find that a long nap helps you feel more refreshed.
- Talking with your friends: If you’re worried you might have said something inappropriate while drinking, try reaching out to your friends for reassurance.
If you regularly experience alcohol-related anxiety, it might help to talk with a mental health professional, such as a therapist. They can help you develop tools for coping with anxiety and offer advice if you’re having issues with the amount of alcohol you’re drinking.
Alcohol and anxiety medication
Healthcare professionals caution against taking antianxiety medication while drinking alcohol. This is because both alcohol and anxiety drugs are sedatives.
Side effects of anxiety medication can be more pronounced if you take them with alcohol. Your breathing might slow, and you may feel drowsy.
Common antianxiety medications include:
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While alcohol can have relaxing effects shortly after a few drinks, changes to your brain chemistry can lead to spikes of anxiety as the alcohol wears off.
If you’re concerned about alcohol use or experience frequent feelings of anxiety, consider talking with a medical or mental health professional.
- Alcohol and depression. (2018). https://www.rcpsych.ac.uk/mental-health/problems-disorders/alcohol-and-depression
- Alcohol use and your health. (2022). https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
- Anker JJ, et al. (2019). Co-occuring alcohol use disorder and anxiety. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927748/
- Fairbanks J, et al. (2020). Evidence-based pharmacotherapies for alcohol use disorder. https://www.mayoclinicproceedings.org/article/S0025-6196(20)30088-4/fulltext
- Goddard AW, et al. (2001). Reductions in occipital cortex GABA levels in panic disorder detected With 1H-magnetic resonance spectroscopy. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/481784
- Mental health issues: Alcohol use disorder and common co-occurring conditions. (2022). https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/mental-health-issues-alcohol-use-disorder-and-common-co-occurring-conditions
- Social anxiety disorder and alcohol abuse. (2022). https://adaa.org/understanding-anxiety/social-anxiety-disorder/social-anxiety-and-alcohol-abuse