Anxiety and alcohol use often show up together, quietly reinforcing each other over time. Many people do not start drinking because they want to lose control. They drink because they are trying to feel calm, steady, or normal, even if only for a short while.

At first, alcohol may seem to ease anxiety. But over time, it often makes anxiety worse. Understanding why these two conditions are so closely linked is a key step toward real, lasting recovery.

This article explains why anxiety and alcohol use often co-occur, how the cycle develops, and how treating both together can support long-term healing.

Understanding Anxiety Disorders

Anxiety is more than everyday stress. Anxiety disorders involve ongoing fear, worry, or tension that interferes with daily life.

Common anxiety disorders include:

Generalized anxiety disorder (GAD)
Panic disorder
Social anxiety disorder
Phobias
Trauma-related anxiety

According to the National Institute of Mental Health (NIMH), nearly 19% of U.S. adults experience an anxiety disorder each year, making it one of the most common mental health conditions.

Anxiety affects both the mind and body, often causing restlessness, racing thoughts, muscle tension, rapid heartbeat, and difficulty sleeping.

Why People with Anxiety Often Turn to Alcohol

Alcohol is a central nervous system depressant. In the short term, it can slow brain activity and create a temporary sense of calm.

For someone living with anxiety, alcohol may:

Reduce nervousness in social situations
Quiet racing thoughts
Ease physical tension
Help with sleep

This short-term relief can feel like a solution. But it does not last.

According to the Anxiety and Depression Association of America (ADAA), about 20% of people with anxiety disorders also struggle with alcohol use disorder.

What begins as coping can slowly become dependence.

How Alcohol Makes Anxiety Worse Over Time

While alcohol may reduce anxiety at first, it often worsens anxiety in the long run.

Alcohol disrupts the nervous system by:

Interfering with brain chemicals that regulate mood
Increasing stress hormones after drinking wears off
Disrupting sleep cycles
Lowering emotional resilience

As alcohol leaves the system, anxiety often returns stronger than before. This is sometimes called rebound anxiety.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), chronic alcohol use can increase anxiety symptoms, especially during withdrawal or periods without drinking.

This creates a cycle: anxiety leads to drinking, drinking worsens anxiety, and the cycle continues.

The Anxiety–Alcohol Cycle

The relationship between anxiety and alcohol use is often self-reinforcing.

Anxiety causes distress
Alcohol is used to cope
Temporary relief occurs
Anxiety returns or worsens
Drinking increases

Over time, the brain begins to rely on alcohol to manage anxiety. This increases tolerance, dependence, and emotional instability.

Breaking this cycle requires addressing both anxiety and alcohol use at the same time.

Why Treating Only One Condition Often Fails

Many people try to quit drinking without addressing anxiety. Others focus on anxiety treatment while continuing to drink.

Both approaches can fall short.

According to the National Institute on Drug Abuse (NIDA), treating substance use without addressing underlying mental health conditions significantly increases the risk of relapse.

If anxiety remains unmanaged:

Stress becomes overwhelming
Cravings increase
Emotional regulation remains difficult

If alcohol use continues:

Anxiety treatment becomes less effective
Sleep and mood remain unstable
Progress stalls

Integrated care matters.

What Integrated Treatment Looks Like

Integrated treatment addresses anxiety and alcohol use together, in a coordinated and trauma-informed way.

This approach recognizes that:

Alcohol use may be a coping response
Anxiety symptoms are real and valid
Healing requires safety, patience, and support

According to SAMHSA, integrated treatment leads to better engagement, lower relapse rates, and improved long-term outcomes.

Evidence-Based Therapies That Treat Both Anxiety and Alcohol Use

Cognitive Behavioral Therapy (CBT)

CBT helps people understand how anxious thoughts and avoidance behaviors contribute to drinking. It teaches practical skills to manage anxiety without substances.

CBT is considered a first-line treatment for both anxiety disorders and substance use disorders.

Trauma-Informed Therapy

Many people with anxiety and alcohol use have a history of trauma. Trauma-informed care focuses on safety, choice, and emotional regulation.

Rather than asking “why can’t you stop,” trauma-informed therapy asks, “what does your nervous system need to feel safe?”

Medication Management (When Appropriate)

In some cases, medication may support treatment by:

Reducing anxiety symptoms
Improving sleep
Stabilizing mood during early recovery

Medication is carefully monitored and combined with therapy, not used alone.

Group Therapy

Group therapy helps reduce isolation and shame. When facilitated with emotional safety in mind, groups offer connection and shared understanding.

According to the Journal of Substance Abuse Treatment, integrated group therapy improves outcomes for people with co-occurring anxiety and alcohol use disorders.

The Role of Lifestyle and Wellness Support

Recovery also includes learning new ways to regulate stress and anxiety.

Supportive practices may include:

Mindfulness or breathing exercises
Gentle movement or yoga
Sleep hygiene education
Stress management skills

These tools help the nervous system relearn how to calm itself without alcohol.

What Recovery Can Look Like

Recovery does not mean anxiety disappears overnight. It means anxiety becomes manageable.

With integrated treatment:

Anxiety symptoms become less intense
Cravings decrease
Emotional confidence grows
Coping skills strengthen

According to NIAAA, individuals who receive treatment for both alcohol use and anxiety have significantly better recovery outcomes than those treated for only one condition.

A Compassionate View of Healing

Anxiety and alcohol use are not signs of weakness. They are signs that someone has been trying to cope without enough support.

When both conditions are treated together, recovery becomes more stable, and more humane.

Healing is not about perfection. It is about learning how to feel safe and steady again.

Help Is Available

If you or someone you love is struggling with anxiety and alcohol use, you are not alone. Integrated, trauma-informed care can help address both conditions with compassion and expertise.

Recovery is possible, with the right support.