Quick Summary
Alcohol can take the edge off anxiety for a little while. NIAAA describes that relief as short-term, and anxiety can come back stronger as the drink wears off and during withdrawal.[2] Anxiety and alcohol problems show up together more than chance would predict, but the size of the link depends on who you study: large in treatment samples, modest in the general population.[1][3] This article covers the loop, what we know and do not know about “hangxiety,” medication safety, and when anxiety is a medical issue.
Key Takeaways
- Alcohol may quiet anxiety briefly, but NIAAA describes the relief as temporary, and heavy drinking and repeated withdrawal can make anxiety worse.[2]
- In a large national survey of US adults, the link between alcohol use disorder and anxiety disorders was modest. Among people in alcohol treatment, researchers report that roughly half also have anxiety or depression.[1][3]
- Drinking to cope with anxiety is the habit that appears to hold the two problems together.[4]
- Anxiety is a common symptom of alcohol withdrawal. Seizures, fever, severe confusion or hallucinations are emergencies: call 911.[8]
- If you take a benzodiazepine, the FDA says not to drink alcohol with it, and warns that stopping it abruptly can cause serious withdrawal reactions. Any change should be directed by your prescriber.[9]
How Common Is the Overlap Between Anxiety and Alcohol Problems?
It depends on which group you look at, and the numbers often get quoted as if they describe the same people.
The general population. The NESARC-III survey interviewed 36,309 US adults in 2012 and 2013. Alcohol use disorder (AUD) was strongly linked to other substance use disorders, major depression and bipolar I disorder, with odds ratios up to 6.4. Panic disorder, specific phobia and generalized anxiety disorder showed weaker links. The authors called those modest, with odds ratios of about 1.2 to 1.4 across most levels of AUD severity. (An odds ratio of 1 means no link, so 1.2 to 1.4 is a small bump and 6.4 is a big one.)[1]
People in treatment. Researchers studying people in AUD treatment report that anxiety and depression disorders together occur in approximately 50% of patients, and that they mark a 2-fold increase in relapse in the months after treatment.[3] That figure covers anxiety and depression combined, in people seeking treatment. It is not the share of everyone who drinks, and it is not anxiety alone.
The other direction. NIAAA reports that AUD prevalence among people treated for anxiety disorders ranges from 20% to 40%.[2] Treatment samples run higher because they include people with more severe or complex symptoms than the general population.
What Alcohol Does in the Brain
NIAAA says alcohol produces pleasurable effects by increasing activity in reward systems, and may temporarily reduce negative emotional states in part by dampening activity in the extended amygdala. GABA and glutamate are among the chemical messengers involved in heavy drinking.[5]
With repeated heavy drinking, tolerance develops and alcohol’s ability to relieve discomfort decreases. When the person stops, reward circuit activity decreases while stress circuits activate, and the amygdala circuits become hyperactive.[5] That is one reason temporary relief from a drink can be followed by worse anxiety once it wears off. It does not play out the same way for everyone. We left out the exact GABA percentages you may see online because we could not confirm them in a primary source.
The Calm, Then the Rebound: What About “Hangxiety”?
What is supported. NIAAA states that anxiety-like symptoms can appear after a single heavy drinking episode, and can rise between episodes, reaching high levels during withdrawal.[2]
What is limited. A small Utrecht University study followed 29 drinkers (15 who said they get hangovers, 14 who said they do not). Hangover symptoms were most severe in the morning, eased through the day and were still present in the afternoon. The most common and severe complaints were sleepiness, fatigue, concentration problems and headache.[6] It gives no human anxiety timeline. The only time course we found was in mice (anxiety-like behavior for about 4 to 14 hours, depending on the test), and animal results cannot tell you how long a person will feel anxious.[7]
The Self-Medication Cycle
NIAAA notes that because alcohol is easy to get, it is commonly used to cope with anxiety, even if it ultimately makes the problems worse.[2] University of Minnesota researchers studied 362 people with both an anxiety disorder and AUD at the start of residential alcohol treatment. Drinking to cope was the most connected element in their analysis and accounted for the relationships between anxiety symptoms and drinking.[4] A follow-up analysis identified two modeled pathways linking anxiety and stress to drinking to cope: a direct one starting with social anxiety, and an indirect one starting with perceived stress. These describe patterns across a group, not what will happen to one person.[3] Our plain-language reading of how it plays out:
| Stage | What tends to happen |
|---|---|
| 1. Anxiety or stress shows up | Alcohol is easy to reach for.[2] |
| 2. A drink brings relief | Negative feelings ease for a while.[5] |
| 3. Alcohol wears off | Anxiety-like symptoms can return, sometimes stronger.[2] |
| 4. Tolerance builds | It takes more alcohol for the same relief.[5] |
| 5. Drinking to cope becomes the habit | It links the anxiety and the drinking and leaves both harder to treat.[4] |
A lot of people tell me the first drink was the first time their mind went quiet, and that is what makes the pattern hard to see. The relief is real, but it doesn’t last, and the anxiety is still there when the alcohol wears off. Once people see that loop, they usually stop blaming themselves for it.
Donnita Smart, LCDC
Can Heavy Drinking Cause Anxiety or Panic Attacks Over Time?
Less settled than many articles claim. NIAAA describes a two-way relationship: an existing anxiety disorder can lead to AUD, and alcohol use can lead to psychiatric problems, with genetic and environmental factors contributing. Heavy drinking and repeated withdrawal can escalate both the anxiety and the drinking.[2] A research review found the two conditions co-occur far more than chance would predict, but the nature of the relationship is unclear, and panic disorder, generalized anxiety disorder and alcohol withdrawal share many symptoms.[10]
So we cannot say alcohol causes panic attacks in everyone who drinks heavily. NIAAA suggests building a timeline to sort out which came first: when the anxiety and drinking started, the longest stretch without alcohol, and whether anxiety stays when the person is not drinking.[2] Jot that down before an appointment.
Anxiety During Alcohol Withdrawal
Anxiety or nervousness is a common symptom of withdrawal in people who drink heavily and regularly, along with sweating, headache, trouble sleeping, nausea, fast heart rate and tremors. Symptoms usually begin within 8 hours of the last drink and typically peak at 24 to 72 hours, but timing varies and symptoms can start days later.[8] Severe withdrawal can bring seizures, fever, severe confusion and hallucinations. Those signs, or an irregular heartbeat, mean call 911 or go to the emergency room, no matter how long it has been since the last drink.[8] If you drink heavily every day, do not quit alone to settle your anxiety. Our guides on alcohol withdrawal and delirium tremens explain what to watch for.
What to Do If You Are Anxious and Drinking
- Notice the pattern. Write down when you drink, how anxious you feel before, and how you feel the next morning.
- Do not stop suddenly if you drink heavily every day. Talk to a doctor first.[8]
- Do not add a pill on your own, including anything for anxiety or sleep. See the medication question below.[9]
- Tell your doctor about both. NIAAA says integrated approaches such as cognitive behavioral therapy (CBT) can address both problems, and that treatment can begin in primary care.[2] A clinician can decide whether primary care is appropriate or whether a higher level of support is safer.
When to Reach Out for Help
Reach out soon if you drink to get through anxiety and it takes more than it used to, your anxiety is worse the day after you drink, you have tried to cut back and could not, or anxiety is getting in the way of work, sleep or relationships. If you have thoughts of harming yourself, call or text 988 now. If you have seizures, fever, severe confusion or hallucinations after stopping alcohol, or cannot stay safe, call 911.
Treating Anxiety and Alcohol Use Together at Discovery Point Retreat
Treating only the drinking leaves the anxiety in place, and the reverse is also true. NIAAA says integrated approaches can address both.[2] Discovery Point Retreat offers dual diagnosis treatment for mental health and substance use. Our anxiety page explains that care involves therapy and, if necessary, medication, and we offer cognitive behavioral therapy. Medical detox is available at our Ennis and Waxahachie facilities, both with around-the-clock medical supervision. Detox is not delivered at the Dallas outpatient center. More on our anxiety and addiction treatment page.
Part of our job is figuring out which came first. Some people had anxiety long before they ever drank, and for others it built up alongside the drinking. We treat both together, with therapy and medication if it is needed.
Donnita Smart, LCDC
Talking With a Professional
You do not need it figured out before you call. Be honest about how much you drink and when, what your anxiety feels like, and everything you take, including over-the-counter products. A clinician can screen for both conditions, check whether withdrawal is a risk, and walk you through options.
Frequently Asked Questions
How long does hangxiety last?
There is no solid human number. NIAAA recognizes anxiety-like symptoms after heavy drinking, but research on how long they last in people is limited.[2][6] If anxiety lingers for days after you drink, tell a doctor.
Does alcohol help with social anxiety?
It can feel like it does, since alcohol may temporarily reduce negative emotional states.[5] But in people with anxiety disorders in alcohol treatment, one analysis found a direct path from social anxiety to drinking to cope.[3] A therapist can teach other ways to handle social situations.
Is it safe to take anxiety medication with alcohol?
Do not assume it is. For benzodiazepines, the FDA’s patient guidance says: “Do not drink alcohol with benzodiazepines. Alcohol can increase the risk of serious and life-threatening side effects.” The FDA also says combining these medicines with other central nervous system depressants has resulted in serious side effects. Those include severe respiratory depression and death.[9] Alcohol can also interact with many other prescription and over-the-counter anxiety and sleep medicines, so ask your pharmacist or prescriber about your exact medicine. Do not stop a prescribed medicine on your own: the FDA warns that stopping benzodiazepines abruptly can cause serious withdrawal reactions.[9] If you took both and cannot stay awake or have trouble breathing, call 911.
Will my anxiety go away if I stop drinking?
It may ease, but can get worse first. Anxiety is a common withdrawal symptom, and MedlinePlus says withdrawal symptoms can go on for weeks, with the worst usually at 24 to 72 hours. Seizures, hallucinations, severe confusion, fever or an irregular heartbeat are emergencies at any point.[8] If anxiety stays when you are not drinking, NIAAA treats that as a sign to look for an anxiety disorder.[2] Anxiety disorders involve more than occasional worry or fear.[11]
Is my anxiety a reason to drink less?
Yes. If alcohol is how you cope, cut back or stop with medical guidance if you drink heavily, and get the anxiety treated directly.[2]
References
- Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 alcohol use disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015;72(8):757-766. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
- National Institute on Alcohol Abuse and Alcoholism. Mental health issues: alcohol use disorder and common co-occurring conditions. Core Resource on Alcohol. Accessed October 2026. niaaa.nih.gov
- Anker JJ, Kummerfeld E, Rix A, Burwell SJ, Kushner MG. Causal network modeling of the determinants of drinking behavior in comorbid alcohol use and anxiety disorder. Alcohol Clin Exp Res. 2019;43(1):91-97. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
- Anker JJ, Forbes MK, Almquist ZW, et al. A network approach to modeling comorbid internalizing and alcohol use disorders. J Abnorm Psychol. 2017;126(3):325-339. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
- National Institute on Alcohol Abuse and Alcoholism. Neuroscience: the brain in addiction and recovery. Core Resource on Alcohol. Accessed October 2026. niaaa.nih.gov
- Mackus M, van de Loo AJAE, van Neer RHP, et al. Differences in next-day adverse effects and impact on mood of an evening of heavy alcohol consumption between hangover-sensitive drinkers and hangover-resistant drinkers. J Clin Med. 2023;12(6):2090. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
- Karadayian AG, Busso MJ, Feleder C, Cutrera RA. Alterations in affective behavior during the time course of alcohol hangover. Behav Brain Res. 2013;253:128-138. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
- MedlinePlus. Alcohol withdrawal. National Library of Medicine. Accessed October 2026. medlineplus.gov
- U.S. Food and Drug Administration. FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. Accessed October 2026. fda.gov
- Brady KT, Lydiard RB. The association of alcoholism and anxiety. Psychiatr Q. 1993;64(2):135-149. Accessed October 2026. pubmed.ncbi.nlm.nih.gov
- National Institute of Mental Health. Anxiety disorders. Accessed October 2026. nimh.nih.gov
We’re here to make treatment as accessible and affordable as possible — and are in network with many insurance providers. Not sure about your coverage? We can help.
Related Reading
- Anxiety and Addiction Treatment
- Co-Occurring Mental Health and Substance Use Disorders
- Alcohol and Sleep
- Delirium Tremens and Alcohol Withdrawal
- Alcohol Withdrawal
- Understanding Alcoholism: Risks, Effects, and the Path to Recovery
Resources
- 988 Suicide and Crisis Lifeline: call or text 988
- SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7)
- Emergency: call 911
This article is general education and is not medical advice.
If anxiety and alcohol have become tangled together, you do not have to sort it out alone. Call Discovery Point Retreat at (855) 245-7133 to talk through your options.
