Anxiety and alcohol, and why alcohol calms anxiety at first but then makes it worse

You arrive at the party with your chest tight and your thoughts racing. Twenty minutes and one drink later, your shoulders drop and the conversation feels easier. Then the next morning arrives, and the worry comes back louder than before: what did I say, why did I do that, why do I feel so on edge? If you'd like support, we offer alcohol addiction counselling in Kitchener-Waterloo, in person or online anywhere in Ontario.

This article explains the link between anxiety and alcohol: why a drink can feel calming, why anxiety often returns stronger afterwards, and how the two can feed each other over time. It also covers practical ways to cut back and how therapy can help.

Does alcohol cause anxiety?

Alcohol doesn't cause every kind of anxiety, but it can trigger it, worsen it and keep it going. Many people notice that they feel more anxious the day after drinking, even if they don't usually struggle with anxiety. For people who already live with anxiety, alcohol can make symptoms more frequent and more intense.

The relationship goes both ways. Some people drink because they feel anxious, and some people feel anxious because they drink. Over time, it can become hard to tell which came first.

Why alcohol feels calming at first

Alcohol is a depressant. It slows down the brain and the nervous system, which is why the first drink can feel like a release. Tension eases, worries feel quieter, and social situations can seem less threatening.

That relief is real, which is exactly why alcohol can become a go-to way of coping. If something reliably takes the edge off stress, it makes sense that you'd reach for it again. The problem is what happens a few hours later.

Hangxiety: anxiety after drinking

As alcohol leaves your system, your brain works to rebalance itself. The calming effect fades, and your nervous system can swing the other way, leaving you jittery, restless and on edge. Many people call this hangxiety.

What happens in your body

Several things combine to make anxiety worse after drinking:

• Rebound in the brain. The brain's calming and alerting systems take time to settle back into balance.
• Poor sleep. Alcohol may help you fall asleep, but it disrupts sleep later in the night, so you wake up tired and less able to cope.
• Physical symptoms. A racing heart, shakiness, sweating and an upset stomach can feel a lot like anxiety, and can set off anxious thoughts.
• Memory gaps. Not remembering parts of the night can lead to worry and shame about what you said or did.
• Low mood. As a depressant, alcohol can leave your mood flat or low for a day or two.

If you notice shakiness, sweating or anxiety every time you go without a drink, that may be a sign of physical dependence. Talk to a doctor before stopping, because withdrawal can be medically serious.

Alcohol-induced panic and panic attacks

For some people, the anxiety after drinking reaches the point of panic. A racing heart, tight chest, shortness of breath and a sense that something is very wrong can come on suddenly, often the morning after a heavy night.

Panic attacks are frightening, but they pass. If they keep happening after drinking, it's a strong sign that alcohol is affecting your mental and physical health, and that it might help to cut back and talk to someone. If you're ever unsure whether chest pain or breathing problems are panic or something medical, get checked out.

Social anxiety and drinking

Social anxiety is one of the most common reasons people drink. A drink before a party, a date or a work event can make it feel possible to show up at all. Over time, though, alcohol can become the only way you feel able to socialize.

That creates a trap. If you always drink in social situations, you never get the chance to learn that you can manage them without it. The anxiety stays, and so does the need for a drink. This often shows up as feeling especially uneasy at events where you can't drink, or leaving early because you don't feel like yourself without alcohol.

When anxiety and drinking feed each other

You might notice a cycle like this:

Anxiety builds. Stress, worry or a difficult situation leaves you tense.

Alcohol brings relief. A drink takes the edge off, and it works, for now.

The rebound arrives. As the alcohol wears off, anxiety returns, often stronger, along with tiredness and low mood.

The next drink feels more necessary. Because you feel worse, the urge to drink to cope grows.

Over months and years, this cycle can make both anxiety and drinking harder to manage. Some people find they need more alcohol to get the same relief, which can lead toward dependence.

Alcohol and anxiety over the long term

Regular drinking can affect your mental health in ways that build slowly. It can disrupt sleep for long stretches, strain relationships, and make it harder to deal with everyday stress. It can leave you in a kind of mental fog. It also takes up mental energy: planning when you'll drink, worrying about how much you drank, and managing how you feel the next day.

Heavy drinking over time is also linked to depression, and to physical health problems that can add to anxiety. If you take medication for anxiety or any other mental health concern, ask your doctor or pharmacist about alcohol, because some combinations are risky.

Signs alcohol is affecting your mental health

It might be worth taking a closer look if:

• you drink mainly to calm down or get through social situations
• you feel more anxious, irritable or low on the days after drinking
• you've had panic attacks after drinking
• you find it hard to relax without a drink
• your sleep, mood or concentration have changed since you started drinking more
• you've tried to cut back and found your anxiety got worse at first

None of these mean something is wrong with you. They're signs that alcohol may be doing an emotional job, and that the stress or worry underneath needs a different kind of care.

Cutting back when you live with anxiety

Drinking less is one of the most practical things you can do for both your mental and physical health. If you want to drink less, it can help to plan for the anxiety that may surface when alcohol isn't there to numb it.

Start small. Try a few alcohol-free days a week, or set a limit before you start drinking.

Have another way to calm your body. Slow breathing, a walk, or stepping outside for a few minutes can help when anxiety spikes.

Prepare for social events. Have a non-alcoholic drink in hand, plan what you'll say if someone offers you a drink, and give yourself permission to leave early.

Look after the basics. Sleep, regular meals and movement all support your health and make anxiety easier to manage.

Expect a few harder days. Anxiety can feel louder at first when you stop using alcohol to quiet it. That usually eases as your sleep and mood settle.

Our next article looks at how to stop alcohol cravings, which can be especially strong when anxiety is high. If drinking a lot in one sitting is part of the pattern, our previous article on how to stop binge drinking has practical steps that help.

How therapy helps

In therapy, we can work on anxiety and alcohol together rather than one at a time. That might mean understanding what your anxiety is trying to protect you from, learning practical skills for coping with stress and worry, changing the mental habits that keep anxiety going, and gradually facing situations you've been using alcohol to get through.

Treatment for anxiety often includes approaches like cognitive behavioural therapy, which helps you notice anxious thoughts and respond to them differently. Treatment for drinking problems looks at triggers, cravings and what alcohol gives you. When both are part of the picture, working on them together tends to help each one improve. Some people want to stop drinking, others want to drink less, and either goal is a reasonable place to start. Therapy can also sit alongside any medical treatment you're receiving for anxiety or addiction.

If you're in crisis, you can call or text 9-8-8 any time. If anyone is in immediate danger, call 911.