Research Indicates Higher Likelihood of Alcohol Use Disorder Symptoms in Individuals with Anxiety

A new study has found that individuals with anxiety or depression may experience more severe symptoms of alcohol use disorder (AUD) than others, even when drinking the same amount of alcohol.

While many people experience physical symptoms, such as a headache or nausea, after a night of drinking, some also report heightened anxiety or depression after just a few drinks. According to the study, experiencing depression after drinking affects over 15% of people, while increased anxiety affects around 12%.

Therefore, the study suggests that individuals who have been diagnosed with depression or an anxiety disorder should examine their alcohol consumption to make sure it is not exacerbating their symptoms and putting them at risk of AUD.

The study, which included data on almost 26,000 adults from the National Epidemiological Survey on Alcohol-Related Conditions, found that those with an anxiety disorder or major depressive disorder had greater AUD symptoms in comparison to people without these disorders, even when drinking the same amount of alcohol.

“Individuals with anxiety and depression disorders have, as a group, greater sensitivity to the downsides of alcohol use,” said Matt G. Kushner, PhD, a professor of psychiatry at the University of Minnesota and corresponding author of the study. “This is important for individuals to know since it constitutes a health risk.”

The study revealed that the “harm paradox” effect impacts the majority of demographics with a mental illness, where individuals experience more negative consequences from consuming the same level of alcohol compared to others. This was particularly true for those with more than one anxiety or depression disorder, even if their mental health condition was in the past.

According to Colleen Hanlon, PhD, a neurobiologist, these symptoms include physiological effects of alcohol drinking, behavioural effects of drinking such as craving and tolerance, and social effects such as an impact on family and employment relationships.

Furthermore, according to previous research, it is well known that people with anxiety and mood disorders have a higher risk of developing alcohol and other substance use problems.

“Historically, this risk was attributed to ‘self-medication’—that is, escalating alcohol use stemming from the temporary relief from anxiety and depression symptoms when intoxicated,” said Kushner. “This view implies that those with anxiety and mood disorders routinely drink more alcohol than their non-anxious-depressed peers and that the causal/temporal direction of this risk runs exclusively from anxiety and mood disorders to AUD.”

However, further research has suggested that additional factors are driving the AUD-anxiety/mood disorder relationship. Kushner said, “The harm paradox effect we identified is consistent with the idea that both addiction and anxiety [and other] mood disorders share an underlying neurobiological vulnerability. That is, a single neurobiological pathway that leads to both disorders.”

The complicated relationship between mood disorders and AUD is something scientists have been trying to understand for a long time, according to John Mendelson, MD, a clinical professor of medicine at the University of California, San Francisco.

If you have an anxiety disorder or have been diagnosed with depression, it is important that you take an inventory of your substance use so that you know how it is impacting you—especially if you are taking medication for your condition.

Many antidepressants and anti-anxiety medications should not be taken with alcohol and could cause harmful side effects. Talking to a healthcare provider or mental health professional about your situation is also helpful.

Being mindful of your alcohol consumption and taking steps to reduce your risk of developing AUD, is an important first step suggested Jonathan Belolo, LCSW, a licensed clinical social worker and vice president of clinical services at GIA Miami. “Even moderate alcohol consumption can have negative effects on health and well-being, including an increased risk of certain cancers, liver disease, and mental health problems.”

It’s important to consider how much you are drinking and how often. After all, the more you drink, the more your brain will respond to the alcohol it is receiving. Instead, try to limit your alcohol consumption—especially if you are experiencing worsening anxiety or depression.

“You also may need to consider the reasons you gravitate towards substances,” Ernesto Lira de la Rosa, PhD, licensed clinical psychologist and media advisor for Hope for Depression Research Foundation told Health.

“Often, substances do such a good job at relaxing our bodies and minds—or help us escape our current reality—which is why many people use them,” he explained. “However, over time this increased use and coping mechanism may take a negative toll on our bodies and minds.”

Because alcohol use can temporarily alleviate symptoms of anxiety and depression, most people tend to reach for a drink when they want to deal with a bad day or to boost their mood. But, this approach can backfire leading to more anxiety or increased depression when the alcohol wears off.

“Often referred to as ‘the dark side of addiction’ people use alcohol to relieve a negative mood state,” Hanlon explained. “However, this strategy is short-sighted as withdrawal from excessive alcohol further decreases mood.”

If you find you have a tendency to reach for a glass of wine to destress, you may need to find other ways to cope with your negative feelings.

Lira de la Rosa noted that meditation, mindfulness, therapy, or even a support group might be a healthier way of coping with the challenges you are facing than having a few drinks with friends. You also can go on a walk, read a book, listen to music, or host a game night with your friends. 

“These healthier coping skills can begin to replace their alcohol use and may ultimately lead to better mental health outcomes,” he said.

If you find that you are having trouble cutting back on your alcohol consumption, or if you feel like you are caught in a vicious cycle of reaching for alcohol to boost your mood, it is important to talk to a healthcare provider or mental health professional about your symptoms.

“Also, familiarize yourself with the NIAAA website, Rethinking Drinking,” encouraged Hanlon. “It is an excellent educational source for all of us.”

If you think you have anxiety or depression and aren’t currently being treated, it is important to seek help. Hanlon noted, “There are multiple treatments available that can be customized to your specific needs.”