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Can alcohol cause anxiety?

People with social anxiety disorder may rely on alcohol to self-medicate, a decision that often backfires.
People with social anxiety disorder may rely on alcohol to self-medicate, a decision that often backfires.

Alcohol abuse and anxiety disorders exist together in a very tangled web. There's a fairly high rate of comorbidity between the two: If one disorder is present in a patient, there's a decent chance the other one is there, too. But alcohol doesn't necessarily have to be the cause -- it can sometimes be a chicken-or-the-egg situation because one is equally likely to cause the other. And each one, sadly, can also make the other disorder worse.

In the United States, about 40 million people suffer from diagnosed anxiety disorders, making it the most common mental illness. People with anxiety disorders are two to three times more likely to have drug and alcohol problems than those without anxiety disorders [source: ADAA].

Most people with anxiety disorders or alcohol problems just have one issue, but about 20 percent of people with anxiety disorders also have an alcohol or substance abuse disorder, and the same percentage of people with alcohol or substance abuse disorders also have an anxiety disorder. Women are more likely than men to suffer from both conditions [source: ADAA].

The alcohol connection is especially strong among the 15 million people in the United States who've been diagnosed with social anxiety disorder [source: ADAA]. People with social anxiety disorder, or social phobia, have an extreme fear of being embarrassed or humiliated in public. The anxiety and stress about social situations is often so intense that they avoid them altogether, which obviously has a negative effect on work, daily routines and personal relationships.

It's not surprising that many people with social anxiety disorder turn to alcohol to help them relieve the mental pressure or survive a potentially stressful event. This self-medication often backfires, though. Alcohol can feel good at first and relieve the anxiety temporarily, but it can easily spiral out of control and almost always makes things worse in the long run.

A 2011 study published in the Archives of General Psychiatry showed that self-medication with alcohol among people with anxiety symptoms made them two to five times more likely to develop alcohol abuse problems within three years. Many of those who self-medicated undiagnosed anxiety symptoms ended up receiving official diagnoses over the course of the study [source: Robinson].

People with social anxiety disorder and alcohol problems have more severe symptoms than those who have only anxiety. A 2012 study at the University of North Carolina found that alcohol abuse can interfere with the "extinction of fear" related to past traumatic experiences, making it more difficult for people to recover from trauma [source: Holmes].

Trying to overcome an anxiety disorder or alcoholism can be a lifelong effort even if you're coping with only one of the disorders. But because one tends to exacerbate the other, it's an especially rough road to recovery for those who live with both.