I’ve spent a lot of time working with clients to understand and treat the nuance of their addiction, especially when it comes to alcoholism. Anxiety disorders and alcohol use disorders are two of the most common mental health conditions, affecting millions worldwide. These comprise many individuals I’ve helped treat and guide throughout my career.
According to the Anxiety and Depression Association of America, around 20% of those with an anxiety or mood disorder also have an alcohol or substance use disorder, and vice versa.
Many turn to alcohol to cope with overwhelming anxiety, desperately seeking relief. I understand that urge. Anxiety can be incredibly uncomfortable both physically and mentally, even frightening at times with symptoms like a racing heart, shortness of breath, chest pain, dizziness, and panic attacks.
Why Does Alcohol Seem Like the Solution to Anxiety?
Consumption of alcohol has the effect of depressing the central nervous system, which can provide a feeling of relaxation or relief from the symptoms of anxiety.
That’s why so many individuals use it to self-medicate anxiety symptoms, numb social anxiety, or momentarily escape stressful situations.
Having trouble getting to sleep because of your racing thoughts? A drink or two might help you fall asleep, despite studies showing that drinking before bedtime ultimately has a negative impact on sleep quality.
The “Anxiety Rebound” Effect: What Happens When You Stop Self Medicating for Your Anxiety
Unfortunately, the anxiety relief that comes with alcohol use is short-lived.
Once the drinks wear off, typically within a few hours, anxiety comes back often worse than before. This is sometimes referred to as the “anxiety rebound” effect.
Alcohol changes levels of serotonin and other neurotransmitters in the brain, disrupting the balance of the brain and the chemicals that help to regulate anxiety.
When consumption is stopped, withdrawal can trigger anxiety symptoms like irritability, agitation, and even panic attacks.
With repeated alcohol use, anxiety tends to worsen over time. You may find you need to drink more alcohol, more frequently, to get the same anxiety-relieving effects. It’s a vicious cycle that can be difficult to break without help.
Genetic Predisposition for Anxiety Disorders & Alcoholism
Genetic predisposition could be another factor at play. It’s well documented that alcoholism tends to run in families. From a hereditary perspective, some of the same genes that increase the risk for anxiety disorders may also increase the risk of alcohol use disorders.
The ingrained biological response to both anxiety and alcohol consumption may have roots in an individual’s genetic makeup.
However, it’s essential to recognize that alcoholism is the result of many personal, circumstantial, and societal factors. The perspective of family history simply helps us to understand our relationship with alcohol better.
Drinking to Cope with Social Anxiety
The majority of people have a fear of public speaking, but these individuals aren’t all diagnosed with a social anxiety disorder. However, many claim that one or two drinks help them open up to strangers, maintain conversations, and improve their dancing skills.
That sentiment, which is pretty normalized in society, is a slippery slope for someone with more severe social anxiety.
Maybe a few drinks can help quiet your worries about being judged by others, reduce self-consciousness, and make it a bit easier to socialize.
The problem is that using alcohol as a band-aid for social anxiety can prevent you from developing fundamental social skills and healthier coping mechanisms. While alcohol dependency advances, it ultimately has the compounding effect of worsening anxiety or causing additional health consequences.
Elephant in the Room: Managing PTSD through Alcohol Use
Post-traumatic stress disorder (PTSD) and alcohol use disorders also frequently co-occur.
The nature of trauma brings with it an array of intrusive thoughts, distressing memories, nightmares, and even flashbacks.
The path to resolving trauma is certainly not easy, and professional assistance may not even be easily accessible to some. Alcohol is an affordable and fast-acting salve that numbs the pain around past trauma.
However, drinking alcohol as a solution to trauma prevents accurate processing and healing. As long as the trauma is unresolved and remains a catalyst for drinking, it will perpetuate a cycle of anxiety and harmful self-medication.
Seeking Outside Help: Integrated Treatment for Dual Diagnosis
The most effective treatment for co-occurring anxiety and alcohol use disorders is integrated treatment that addresses both conditions simultaneously. In my experience, treating one without the other is rarely successful. This is why Burning Tree places a heavy emphasis on dual diagnosis.
For example, our program leverages cognitive behavioral therapy (CBT) as part of our approach to treatment. CBT teaches skills to better cope with anxiety symptoms, challenge anxiety-provoking thoughts, and change behaviors around alcohol use. Exposure therapy may also be used to gradually face anxiety-triggering situations without needing to self-medicate.
Certain non-addictive medications that regulate brain chemistry can also be very beneficial alongside therapy. Of course, all substance use needs to be carefully monitored by a physician in early recovery.
Essential Strategies for Coping with Anxiety
Developing healthy ways to cope with anxiety is crucial for recovery. There are many practical ways to handle and process the stress that comes with anxiety without needing to turn to alcohol use.
Some essential coping strategies I recommend:
- Deep breathing exercises
- Progressive muscle relaxation
- Meditation and mindfulness practices
- Regular exercise like walking, swimming, or yoga
- Adequate sleep and a balanced diet
- Journaling and other expressive activities
- Building a solid support network
Something Different: Long-Term Treatment for Chronic Alcoholism
The road to recovering from co-occurring anxiety and alcohol addiction isn’t an easy one. It takes time, professional help, and a strong support network. But with commitment and the right tools, I truly believe healing and a fulfilling life are possible. I’ve seen it happen.
If your loved one is struggling with anxiety and addiction, please reach out for help – especially if you’ve undergone previous (failed) rehab attempts. Our long-term treatment program at Burning Tree Ranch is explicitly designed to help individuals with a history of chronic relapse.
Your family doesn’t need to suffer alone. It’s always worth taking the next step and trying something different.
Until next time,
Brook
