By Steven Booth, CEO, Elevation Behavioral Health
It’s quite ironic how so many people use alcohol as a means of reducing the symptoms of anxiety, only to end up experiencing worse anxiety because of the alcohol. Alcohol has become a cultural panacea for calming the nerves and winding down after a hectic, stressful day. Happy hour is a perfect example of the cultural phenomenon that illustrates this custom. Had a stressful day? Let’s grab a drink (or two) after work.
This seemingly innocuous solution to quelling anxiety can backfire, however. While alcohol is a central nervous system depressant, over consumption of alcohol can lead to alcohol-induced anxiety. For those with risk factors toward addiction, such as genetics, biology, or environmental factors, alcoholism can evolve out of the habit of using alcohol to calm symptoms of anxiety. Alcoholism and anxiety are common co-occurring disorders that play off each other, worsening the symptoms of each disorder. In fact, anxiety is one of the common alcohol withdrawal symptoms.
If someone struggles with chronic anxiety, such as generalized anxiety disorder, alcohol should be avoided. Learning other means of relaxation to replace the daily alcohol intake is the best strategy when the goal is to reduce anxiety symptoms. Anxiety symptoms typically include restlessness, sweating, racing thoughts, insomnia, palpitations, trembling, lack of concentration, excessive worry and fear.
How Alcohol Induces Anxiety
Excessive alcohol consumption can have a profound effect on mental health, including provoking an anxiety disorder. After heavy drinking a slew of unpleasant effects will emerge that can stoke anxiety, including:
- Dehydration. Alcohol is extremely dehydrating, which can leave someone feeling lightheaded, dizzy, nauseas, and weak. For someone with an anxiety disorder, this may lay the foundation for a panic attack.
- Low blood sugar. The effects of drinking on reducing blood sugar can leave the person feeling nervous, dizzy, weak, confused, and anxious.
- Increased heart rate. Heavy drinking can increase heart rate and cause feelings of anxiety. Fear of an impending heart attack may lead to a panic attack.
- Hyperactivity. Following a bout of heavy drinking, the central nervous system will attempt to stabilize after being suppressed by the alcohol. The body may respond by shaking, insomnia, or elevated sensory sensitivity.
- Disorientation. Drinking can lead to feelings of confusion, fuzzy headedness, lack of focus, and disorientation.
Once alcohol dependency develops, anxiety and depression are common co-occurring disorders. The effects of the alcohol on the brain chemistry and central nervous system, as well as mounting negative consequences related to the alcoholism, can lead to feelings of anxiety.
Getting (and Staying) Sober Helps Anxiety Disorder
If one is abusing alcohol in an attempt to manage anxiety symptoms, the best way to improve their mental health is to stop drinking. Drinking only exacerbates the anxiety. If alcohol addiction has not yet evolved, start to reduce alcohol consumption incrementally for best results, rather than quitting cold turkey. This allows your body to become accustomed to less and less alcohol over a period of weeks, and should not fan the anxiety symptoms.
However, if alcohol addiction is present, it will be necessary to go through a medical detox. Alcohol detoxification can present sudden, unpredictable health risks, so a supervised detox is the recommended route. The trained detox team will be prepared to help ease the discomforts associated with alcohol detox and withdrawal using medications and providing emotional support. Vital signs will be monitored throughout, and the team will be trained to quickly intervene should severe withdrawal symptoms emerge. Many of the withdrawal symptoms are related to anxiety, including tremors, sweating, nausea and vomiting, diarrhea, irritability, racing heart, anxiety, depression, mental confusion, and seizures.
Treatment for Alcoholism and Anxiety Dual Diagnosis
When seeking treatment for an alcoholism/anxiety dual diagnosis it is important to locate a rehabilitation program that specialized in treating co-occurring disorders. These programs will provide treatment for each disorder, both the alcoholism and the anxiety disorder, simultaneously. Research has shown that recovery results are superior using this method, versus treating one disorder first and then the other.
A dual diagnosis program will offer an array of treatment elements within a residential inpatient mental health facilities setting. These treatment elements may include:
- Individual psychotherapy. During these sessions a therapist will guide the individual toward examining underlying factors that may be contributing to either or both disorders. These might include a history of trauma, childhood abuse or neglect, grief and loss, or other sources of emotional pain. Behavioral therapies, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT) are evidence-based therapies that help both alcoholism and anxiety disorder.
- Group therapy. Meeting in small groups with a therapist facilitating the topics of discussion allows participants to share their own unique challenges, discuss triggers, and share personal experiences.
- Medication management. In most cases, individuals with anxiety disorder will be prescribed anti-anxiety medication called benzodiazepines. Alcoholism recovery may include the drug naltrexone to help curb alcohol cravings.
- Coping skills. Gaining the tools for managing stress in recovery is essential. Learning new ways to cope with stress, anger management skills, improved communication skills, and conflict resolution skills.
- 12-step or similar programming, including guest speakers
- Holistic practices, such as meditation, yoga, or acupuncture
Relaxation Techniques to Replace Alcohol
When someone has learned to habitually attempt to manage anxiety symptoms through the use of alcohol, they must replace alcohol with healthy stress-reduction methods. There are a variety of holistic therapies and experiential activities that promote relaxation and emotional regulation. By practicing these techniques when anxiety surfaces one is better equipped to self-regulate without having to rely on drugs or alcohol. Some of these stress-reducing activities include:
- Mindfulness. Involves focusing on the present moment, the rhythm of breathing, physical sensations
- Yoga. Involves purposeful poses that engage muscles and involve stretching, while focusing on breathing in and out
- Massage. A relaxation massage can help relax muscle tension and release toxins
- Guided imagery. Meditation using a recorded track that invokes mental imagery to produce inner calm
- Deep breathing. Exercises that involve slow, measured breath work to a certain number of counts, holding the breath, and then slowly releasing the breath
- Acupuncture. Ancient eastern practice of using small needles placed along meridians to open up energy flow in the body
Removing alcohol from the picture, and replacing it with these stress-reducing practices will safely manage symptoms of anxiety without the risk of acquiring a substance addiction.