Alcohol and anxiety are often linked, with those suffering from anxiety disorders more likely to self-medicate with alcohol. However, this can lead to rebound anxiety and worsen clinical symptoms. Heavy drinking can also mask underlying anxiety disorders, making them difficult to treat. A study shows that chronic alcohol exposure impairs a protein in the amygdala, leading to a chemical imbalance that can cause anxiety. Treating both conditions simultaneously is the best approach.
The relationship between alcohol and anxiety stems, in part, from the tendency of people suffering from various anxiety disorders to self-medicate for the condition. Using alcohol to relieve symptoms of disorders such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD) can lead to rebound anxiety and a worsening of clinical symptoms in general. Alcohol abuse, by itself, can also lead to the development of anxiety and related anxiety disorders, the most serious of which is acute withdrawal anxiety from chronic alcohol use, often requiring hospitalization for several days. A prolonged condition, protracted withdrawal syndrome, can prolong anxiety symptoms for several months, which may require medication and psychological counseling.
The Anxiety Disorders Association of America (ADAA) reports that more than 40 million Americans suffer from GAD, and that these individuals are two to three times more likely to abuse alcohol and other psychoactive substances. Another statistic states that nearly 20% of people with SAD abuse alcohol in social situations. Many times it is difficult to determine which condition came first, anxiety disorder or substance abuse, but the most common method of treatment is to work with a “dual diagnosis”. By treating both conditions, alcohol and anxiety, at the same time, one is unlikely to cause a relapse of the other. Heavy drinking has also been shown to mask an underlying anxiety disorder, which makes the psychological problem difficult to treat effectively.
Research is emerging that shows the various mechanisms by which alcohol and anxiety are related. A study conducted at the University of Illinois shows that a certain protein, Arc, found within the part of the brain associated with stress response and emotions, the amygdala, is impaired in animals exposed to the chronic alcohol. Nerves communicate via dendritic spines, and dendritic spines containing Arc, a natural anxiety inhibitor, grow when exposed to alcohol. The growth of dendritic spines that contain Arc is one of the physiological processes in the brain that contribute to the initial relaxation response after a person has been drinking. If alcohol use becomes chronic, however, the brain becomes tolerant of the relaxation response, and the result is a chemical imbalance in the brain that can cause significant anxiety.
The hangover experienced by healthy alcohol drinkers is a small anxiety reaction to alcohol withdrawal. When people develop a long-lasting anxiety disorder from alcohol, the reaction tends to become progressive and sometimes chronic. If alcohol and anxiety disorder are treated simultaneously, however, there is a greater chance of recovering mental health.
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