_ When alcohol and anxiety are a dangerous mix

During the holidays most of us are thrown headfirst into social situations whether we like it or not. There’s the work holiday party, friend’s parties where everyone is trying to be more dynamic than the next person, and those memorable family gatherings where relatives think it’s okay to squeeze your face just because they haven’t seen you in a year. Some of it may make you nervous, and some may bore you half to death, and you’ll probably get through it all with a smile on your face and a drink in your hand.

Why then do people say that anxiety sufferers should avoid alcohol lest their anxiety increase? That doesn’t seem logical, when alcohol does such a great job of instantly calming your nerves as you pucker up and ask that hot guy in sales for a big, wet kiss?

Well it turns out that although alcohol, in the short term, reduces anxiety, in the long term, alcohol actually makes anxiety worse:

Here’s what you can expect from alcohol…

Short term effects of alcohol
  • Alcohol is a depressant because it acts quickly to depress the central nervous system, giving a feeling of relaxation for a short period of time.
  • Alcohol increases the chemical inhibitory neurotransmitter Gamma-aminobutyric acid (or “GABA”), which has the effect of stopping the anxious feelings being produced.
  • Alcohol’s chemical effect therefore makes it a fast acting “anxiolytic” – i.e. an anxiety reducer.
Long term effects of alcohol
  • Alcohol withdrawal symptoms are experienced as anxiety. This can fuel more alcohol intake, which results in a vicious cycle of anxiety and alcohol consumption. Patients with panic disorder who are alcohol dependent are unable to distinguish panic symptoms, with the exception of tremor, from alcohol withdrawal.
    (Panic attacks and alcohol withdrawal: Can subjects differentiate the symptoms?)
  • Alcohol can impair the functions of hormone-releasing glands and their target tissues. Most significant is the effect of alcohol on blood sugar. Insulin and glucagon are the two main hormones that regulate blood sugar (glucose) from dietary sources, plus the body can also synthesize its own glucose if needed. However alcohol impairs the functions of these two hormones and also impairs the body’s ability to synthesize glucose, all of which results in hypoglycemia. Hypoglycemia causes dizziness, confusion, weakness, nervousness, shaking and numbness. Although the body can both store and synthesize glucose, the brain cannot, and depends entirely on glucose supplied by the blood, and even brief periods of low glucose levels (hypoglycemia) can cause brain damage and trigger anxiety.
    (National Institute on Alcohol Abuse and Alcoholism No. 26 PH 352 October 1994)
  • GABA is the major inhibitory (i.e. calming) neurotransmitter system in the central nervous system. It has been shown that long-term exposure to alcohol reduces the levels and function of the GABA-benzodiazepine (or “GBzR”) receptor in the central nervous system. In other words, long-term consumption actually reduces the anxiolytic function in the brain, making us less able to cope with anxiety in the long run.
    (Reduced levels of the GABA-benzodiazepine receptor in alcohol dependency in the absence of grey matter atrophy)
  • Serotonin Depletion. Alcohol consumption over a long period of time leads to a depletion of serotonin in the brain. As serotonin is a 'happiness' hormone this can lead to depression, and depression is often linked to anxiety. 
    (The Role of Serotonin in Alcohol's Effects on the Brain)
Unless you are in a coma or are a sociopath, everyone has a certain degree of anxiety. Anxiety is normal, but anxiety disorders are not. Yet anxiety disorders are the most common mental illness in the U.S., afflicting 40 million adults. And alcohol is an easily accessible form of self-medication for your anxiety. But it could also end up becoming your only source of relief and your worst enemy.

So, as you toast the new year with that third (or tenth) glass of mulled wine, ask yourself, is this getting get me through another inane conversation with that woman in accounting who insists on showing me photos of her cats, or do I need this just to get through another terrifying day on earth?

Happy, healthy holidays, and safe drinking to everyone….