Alcohol and Anxiety: Understanding the Connection

Alcohol has a profound impact on the brain—even casual drinking can shift your mood. But for many people, drinking brings more than next-day regret; it can trigger full-blown panic attacks and worsen anxiety symptoms. At Next Step Psychiatry in Lilburn, Georgia, we help patients throughout Gwinnett County and Metro Atlanta understand and address the complex relationship between alcohol and mental health.

How Are Alcohol and Anxiety Related?

Research consistently shows significant overlap between alcohol use disorders and anxiety disorders. This connection involves both physiological and psychological factors:

• Brain chemistry changes: Alcohol directly affects neurotransmitters that regulate mood and stress responses
• Post-drinking regret: Memory gaps and impaired judgment while drinking can lead to next-day anxiety
• Self-medication: Some people use alcohol to cope with existing anxiety, creating a harmful cycle

What Is "Hangxiety"?

"Hangxiety" describes the regret, worry, and anxiety felt after a night of heavy drinking. While informal, the science behind it is solid:

• Cortisol disruption: Alcohol disrupts natural cortisol production, a stress hormone that regulates metabolism, heart rate, and cognitive function. Heavy drinkers often have elevated cortisol levels, leading to anxiety and restlessness.
• Neurotransmitter changes: Alcohol affects neurotransmitter levels in the brain. Over time, these changes make it harder to relax when not drinking and may lead to persistent worry and intrusive thoughts.
• Memory gaps: "Blacking out" or experiencing memory loss creates uncertainty about what happened, naturally increasing anxiety and regret.

Can Alcohol Cause Panic Attacks?

Yes, alcohol can trigger panic attacks. Here's why:

GABA is a neurotransmitter that helps regulate your nervous system by promoting relaxation. Alcohol mimics GABA's calming effect by binding to GABA receptors—that's why drinking initially helps you feel relaxed.

However, your body constantly seeks equilibrium. A heavy influx of alcohol causes your body to block its own GABA receptors to compensate. With fewer receptors available, your body absorbs less GABA, inhibiting your natural ability to calm down—which can trigger panic attacks.

Preventing Anxiety After Drinking

The more you drink, the more likely you are to experience chemical changes that trigger panic attacks. The best prevention strategies include:

• Know your limits and avoid drinking to excess
• Stay hydrated while drinking
• Eat before and while drinking
• If you're prone to anxiety, consider abstaining entirely

Is Hangxiety a Sign of Alcohol Dependence?

Anyone can experience anxiety after drinking, but frequent hangxiety—especially following heavy drinking—may indicate a more serious problem. Signs of alcohol use disorder include:

• Being unable to limit how much you drink
• Devoting significant time to drinking or recovering from drinking
• Experiencing withdrawal symptoms when not drinking
• Drinking in unsafe situations
• Developing tolerance, needing more to feel effects
• Continuing to drink despite relationship, work, or health problems
• Using alcohol as a coping mechanism

When to Seek Professional Help

If you regularly experience anxiety symptoms—including panic attacks—it's important to seek help. Other signs of an anxiety disorder include:

• Persistent restlessness or irritability
• Excessive, difficult-to-control worry
• Racing heart or chest pain
• Sweating or shaking
• Sleep problems
• Gastrointestinal distress

Only a qualified healthcare professional can diagnose alcohol use disorder or anxiety disorder and provide appropriate treatment.

This article is for educational purposes only. If you or someone you know is experiencing a mental health crisis, call 911 or the National Suicide Prevention Lifeline at 988.