Understanding the Anxiety and Alcoholism Cycle

Drinking alcohol is a coping method for some people struggling with anxiety. When someone first starts drinking, alcohol relieves the symptoms of anxiety and makes them feel good. However, short and long-term alcohol misuse can lead to more stress, which then leads to more alcohol misuse. A troubling alcohol-anxiety cycle develops and affects a person’s physical and mental health.

Many individuals find themselves caught in a troubling cycle where anxiety leads to alcohol use as a coping mechanism, which in turn exacerbates anxiety, creating a vicious cycle.

This cycle can be challenging to break, as the temporary relief provided by alcohol often leads to increased dependence and potentially more severe anxiety symptoms, complicating recovery efforts. Understanding the dynamics of the anxiety and alcoholism cycle is crucial. Recognizing the triggers and effects can empower individuals to seek appropriate intervention strategies, such as therapy, medication, or support groups, which are designed to address both anxiety and substance use effectively.

This article explores the anxiety and alcoholism cycle.

Anxiety Leads to Drinking

Some people report drinking alcohol to help them relax in social settings or to unwind after a long day of hard work. Others drink to cope with an anxiety disorder.

Multiple anxiety disorders exist today, including generalized anxiety disorder, panic disorder, and phobias. Some people turn to substances, like alcohol, to help reduce anxiety symptoms. Studies show that 50% of people with any anxiety disorder also have an alcohol use disorder.

Anxiety creates symptoms that make it difficult to function in daily tasks, including the following:

  • Excessive worrying
  • Restlessness
  • Irritability
  • Trouble making decisions
  • Sleep disturbances
  • Heart palpitations
  • Sweating
  • Trembling or shaking

Alcohol is a depressant, and when someone drinks a small amount, they receive the sedative effects of feeling calm, relaxed, and friendly. Some feel a sense of euphoria. They may increase the amount of alcohol they drink, trying to increase the feel-good effects. Instead, the opposite occurs because the feel-good effects are temporary.

Alcohol Temporarily Reduces Anxiety

When alcohol enters the body, it eventually enters the bloodstream and travels to the brain. Upon reaching the brain, alcohol first alters the prefrontal cortex, the area responsible for balance, decision-making, and speech.

Alcohol also causes an initial reaction involving neurotransmitters in the brain, such as dopamine, GABA, and serotonin, which are also known as feel-good chemicals. A boost of feel-good chemicals temporarily reduces anxiety and makes a person feel calm, happy, and more confident.

Blood alcohol content (BAC), or the amount of alcohol in your bloodstream, determines intoxication. With each drink, BAC rises, and initially, it feels good. As alcohol leaves the body, BAC drops, and so do the number of feel-good chemicals in the brain, causing someone to experience depression and anxiety.

Drinking over a long period can have the reverse effect on Gaba, dopamine, and serotonin. Instead of boosting them, it depletes them.

Withdrawal Increases Anxiety Levels

The more a person drinks alcohol, the more likely they will experience withdrawal symptoms when they stop drinking or cut back on drinking. While people with an alcohol use disorder experience withdrawal symptoms, so do binge or heavy drinkers. Withdrawal symptoms can be physical and psychological, both leading to anxiety.

Physical symptoms of withdrawal include the following:

  • Headache
  • Nausea
  • Vomiting
  • Increased heart rate
  • Shaking or trembling

The physical symptoms often lead to psychological symptoms, including nervousness, agitation, irritability, sadness, and anxiety.

The reason withdrawal increases anxiety levels is because the central nervous system becomes excited. The brain develops an alcohol dependence, and when the brain goes without the substance, it experiences a change in neurotransmitter communication. The feel-good chemicals drop and trigger a stress response that increases anxiety.

Anyone who experiences withdrawal symptoms knows how painful they can be. Occasionally, the fear of withdrawal symptoms can cause someone to have an increase in anxiety.

Dependence on Alcohol Develops

Alcohol dependence is why people continue to drink even when they want to stop. To avoid uncomfortable withdrawal symptoms, some people continue drinking alcohol. They get stuck in a cycle of drinking alcohol to prevent withdrawal symptoms. Eventually, the body develops an alcohol dependence.

Not everyone who drinks alcohol excessively will develop a dependence. Many factors play a role, including tolerance and neurological changes in the brain. The criteria for alcohol dependence include one or more of the following:

  • Tolerance, or needing to drink more alcohol to achieve the same initial effects.
  • Withdrawal syndrome, or experiencing painful symptoms when trying to stop drinking.
  • Cravings or intense urges to drink alcohol.
  • Avoid withdrawal symptoms by continuing to drink.
  • Drink more significant amounts for more extended periods than intended.
  • Loss of control over alcohol.
  • The compulsion to drink is unavoidable.
  • Continue to drink despite negative consequences.

The Impact on Your Mental Health

Alcohol misuse and alcohol use disorders directly impact mental health. Because alcohol alters brain functioning and the neurotransmitters that regulate emotions, someone may experience a range of mental health symptoms.

Alcohol use disorder co-occurs with mental health disorders, like anxiety, depression, trauma, sleep, psychosis, and drug abuse. Anyone with an existing mental health concern can expect it to worsen when drinking alcohol. Here are a few examples of the impact alcohol has on mental health:

  • Increases stress
  • Links to self-harming or suicidal ideations and behaviors
  • Damages memory
  • Leads to self-medicating
  • Delays recovery from mental health issues
  • Makes it hard to focus and concentrate
  • Reduces inhibitions
  • Impairs memory and learning
  • Drains feel-good chemicals in the brain

Alcohol can lead to long-term effects on mental health, including dependence, tolerance, blackouts and memory lapses, hallucinations, delusions, and confusion. Alcohol misuse changes a person’s personality. It may cause mood swings and a lack of emotional stability.

Breaking the Cycle

Breaking the cycle of anxiety and alcoholism must include multiple approaches to address the co-occurring disorders. A combination of the following therapies given simultaneously is effective:


Medication to reduce cravings and manage withdrawal symptoms are available. Benzodiazepines treat alcohol withdrawal. Acamprosate, naltrexone, and disulfiram treat alcohol dependence. Antidepressants reduce and often eliminate anxiety symptoms.

Behavioral Therapies

Therapists use behavioral therapies to teach coping and life skills, relapse prevention, peer support, and recovery management. Effective therapies include cognitive-behavioral therapy (CBT), dialectical-behavioral therapy (DBT), eye movement desensitization and reprocessing (EMDR), trauma-focused CBT (TF-CBT), family systems therapy, and various alternative therapies.

Lifestyle Changes

If someone does not change their lifestyle, it will be tough to overcome alcohol and anxiety issues. To reduce anxiety, it’s important to improve your diet and exercise daily. Participating in individual and group therapy for both anxiety and alcohol misuse is crucial. Also, build a support system of sober friends, family, and associates. Attend peer support groups multiple times a week when possible.

Anxiety and Alcohol Addiction Treatment in Los Angeles

Finding a doctor who specializes in treating anxiety and alcohol addiction in Los Angeles can be a critical step toward regaining control of your life and achieving mental stability.

The Mental Health Center at Cedars-Sinai Medical Towers in Los Angeles can connect you with Los Angeles psychiatrists committed to developing personalized treatment strategies for dual diagnosis.

Contact us today to learn how we can help you connect with a doctor who can provide comprehensive support and treatment for anxiety and alcohol addiction.


People with anxiety may use alcohol to cope, and they may experience temporary relief. However, the more someone drinks alcohol, the more likely it is they will develop alcohol dependence and experience withdrawal symptoms and mental health problems when trying to quit. They get stuck in a vicious cycle.

To break the cycle, contact The Mental Health Center in Los Angeles.