Why Getting Drunk Makes Your Anxiety Turn Up

Photographed by Natalia Mantini.
You've had a bit of a day, and are headed to happy hour to crack open a cold one with your friends. They all love to chill and drink, but alcohol always seems to make you feel more anxious. Don't worry — you're not imagining it, and it's definitely not just you. There are some very real reasons why you feel like you can't hang when alcohol is involved, but that doesn't mean you can't hang at all.
Drinking is supposed to make you feel relaxed. But, paradoxically, sometimes it makes you feel more anxious instead, which is "kind of peculiar," says Thomas Kash, PhD, a professor of alcohol studies in the department of pharmacology at the University of North Carolina School of Medicine.
"Alcohol is a depressant, so it relaxes your nervous system overall," says Aarti Gupta, PsyD, clinical director at TherapyNest, a center for anxiety and family therapy. Alcohol can even dampen anxiety or just sedate people, Dr. Kash says. So it's understandable that we'd associate drinking with relaxation, de-stressing, or letting loose.
Sounds like a good thing for someone who's anxious, right? Not exactly. Alcohol also temporarily changes the way serotonin a neurotransmitter that plays a role in regulating your mood and anxiety — works in your brain, Dr. Gupta says. Some research also suggests that "alcohol can drive increases in the stress hormone, cortisol," Dr. Kash adds. Both of these neurological changes could contribute to feelings of anxiety.
But there are also more nuanced psychological reasons why drinking can bring out anxiety in some people. For instance, when you're drunk, you might experience blurred vision, an increased heart rate, a sense of disorientation, and a drop in blood sugar that causes dizziness, Dr. Gupta says. "These are all symptoms that anxious people regularly identify during an anxiety attack," she explains. So there's a possibility that being hyperaware of these changes in your mood and physiology while drunk could contribute to anxiety.
If that sounds familiar to you, keeping this tendency in mind can help you feel more comfortable the next time you drink. "Try to tolerate any feelings of uncertainty or discomfort associated with mood shifts by reminding yourself" that it's probably just because you're drinking, Dr. Gupta advises.
But in some cases, there may be stronger forces involved, such as social anxiety, that make this much harder to overcome. When you've been drinking, you might feel your symptoms of social anxiety are heightened, or you may start overanalyzing everything you do, thanks to something called "self-focused attention from alcohol myopia," says Joshua P. Smith, PhD, clinical director of the Center for Drug and Alcohol Programs at the Medical University of South Carolina. Basically, "alcohol myopia" is a term for alcohol-induced shortsightedness. The idea is that alcohol narrows your focus to only what's directly in front of you and keeps you from seeing the big picture.
According to Dr. Smith, alcohol myopia is also responsible for the "boneheaded mistakes" people make when they've been drinking (e.g. every keg stand or karaoke solo ever). And, when you're drunk, you're more likely to make errors in speaking, slur your words, or engage in embarrassing behavior, Dr. Gupta says. Even though these errors might not make you panic when you're sober, just the thought of actually doing them could make you very anxious when drunk because it's harder to think beyond what's happening in that moment.
However, using alcohol to cope with your anxiety isn't the best idea. "Downstream, this psychological dependence can create more anxiety," Dr. Smith says. Essentially, the more you drink to quell the anxiety, the more anxious you feel, so you drink more, and so on. This pattern can develop into alcohol use disorder if left unchecked. If you feel like you need to drink in order to feel less anxious, it's worth discussing your habits with your doctor or a mental health professional. They can help you pinpoint what's causing these feelings and develop healthier coping mechanisms to deal with them.
If you feel like you generally have a hold on your drinking habits but tend to get overwhelmed when you have to drink at a social function, Dr. Smith suggests making a plan before you dive into that cocktail party. "Put yourself in situations which minimize chances of problems," he says. That doesn't necessarily mean you don't go to the party — it just means, for example, giving yourself permission to go for a walk instead of having another drink, having a glass of water between drinks, or going with a group of friends who you trust and feel comfortable around. And another timeless piece of wisdom that bears repeating: If drinking isn't your idea of fun, you don't have to do it just because everyone else is — especially if it just makes you nervous.
If you are struggling with substance abuse, please call the SAMHSA National Helpline at 1-800-662-4357 for free and confidential information.

More from Mind

R29 Original Series