Alcohol and anxiety: why a drink takes the edge off, and why the anxiety comes back higher

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Alcohol can cause anxiety and make existing anxiety worse, because its calming effect wears off and the anxiety rebounds. Drinkaware says plainly that drinking alcohol can contribute to anxiety and panic attacks, and the NHS advises against using alcohol to relieve anxiety because it can make your mental health worse over time. A glass of wine on a Tuesday evening still works, for an hour or so, and then it stops working.

If you have noticed that you reach for a drink when you feel wound up, and that you feel more wound up the next day, this article is for you. It covers why alcohol calms you down at first, why the anxiety comes back stronger, how the two feed each other over months, how to tell whether drinking has become your way of coping, what to try on the evening you would usually pour one, and who you can talk to. There is no lecture in it and no diagnosis. Nobody here is going to call you anything. The guidance is drawn from the NHS, Drinkaware, Mind and the Mental Health Foundation.

Alcohol is one strand of a bigger picture, and the practical tools in anxiety self-help are the place to go for the rest of it. If what you want is the morning-after version, the dread and the replaying, that is hangxiety, and this page will not repeat it.

Does alcohol cause anxiety?

Alcohol can cause anxiety, both as a rebound the day after drinking and as a longer-term pattern. Drinkaware says alcohol affects people differently, and for some it can trigger or increase anxiety and panic, and that regular drinking can leave people more vulnerable to anxiety disorders. The NHS lists anxiety among the longer-term risks of drinking too much, and names alcohol as one of the things people use to relieve anxiety that tends to worsen mental health instead.

If you already have anxiety, Drinkaware's advice is that drinking may make it worse. In someone already prone to it, a drink settles the nervous system briefly and then hands it back more agitated than it found it.

Why a drink takes the edge off, and why it does not last

A drink calms you because alcohol is a depressant: it slows activity in the brain and nervous system. Drinkaware explains that this is what makes you feel less inhibited and more relaxed at first. The Mental Health Foundation describes the same effect: alcohol acts on the part of the brain that controls inhibition, so you feel relaxed, less anxious and more confident. Both say the same thing about how long it lasts. The relaxation is short-lived and wears off quickly.

Part of the story is a brain chemical called GABA, which has a relaxing effect. Drinkaware says small amounts of alcohol can stimulate it, but heavy drinking can deplete it, which increases tension and panic. In plain terms, the drink borrows calm from later in the evening and from tomorrow.

Sleep is part of what gets borrowed. Drinkaware's sleep guidance says alcohol may help some people drop off at first, but you spend less time in the important REM stage and wake feeling less refreshed. If worry already keeps you awake, anxiety at night explains why the small hours are when it is loudest, and a drink makes those hours worse.

How alcohol and anxiety feed each other

Alcohol and anxiety feed each other through a loop that Drinkaware calls a vicious circle. A drink brings calm. As the alcohol leaves your system, anxiety comes back, and in someone who drinks regularly it can come back as a withdrawal symptom. That anxiety prompts the next drink, and the circle starts again.

Two things make the loop tighten over time, and Drinkaware names both.

• Tolerance. The more you drink, the more alcohol you need for the same effect. The hour of calm gets shorter, or needs a bigger glass.
• Rebound. With regular heavy drinking, the central nervous system adapts to alcohol's suppressing effect. When alcohol levels drop, the brain can tip into fight or flight mode. Drinkaware describes a heightened response that looks a lot like an anxiety disorder, and the NHS lists anxiety among the symptoms of alcohol withdrawal.

The Mental Health Foundation puts the long view simply. Relying on alcohol to cover anxiety can lead to drinking more over time, and that can lead to dependence. It also says alcohol problems and mental ill health are closely linked, partly because people self-medicate difficult feelings. If you recognise yourself in that description, you have found a pattern, and patterns can be changed.

The sharpest version belongs to social anxiety. Drinkaware's hangxiety guidance says people who feel uncomfortable in social situations may be tempted to use alcohol to feel more confident or relaxed, and that once it wears off the anxiety can return to an even greater degree than before. If that is you, how to deal with social anxiety is the longer-term answer, because confidence that comes from a glass has to be topped up every time.

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How do I know if drinking has become my way of coping?

Drinking has become a way of coping when the drink is doing a job your nerves used to do. Drinkaware describes it as relying on alcohol to mask anxiety, or becoming reliant on it to relax, and says that puts you at risk of dependence. The amount matters less than the purpose: a small drink with a job to do is worth noticing.

A few honest questions help here, and none of them is a test.

• What is the drink for? If the answer is usually "to take the edge off", "to get through it" or "to switch my head off", the alcohol is managing anxiety, and anxiety managed that way tends to grow.
• What happens on the evenings you do not drink? Mind suggests keeping a diary to spot patterns in what triggers anxiety and what helps. A week of noting your mood, your drinks and your sleep tells you more than a month of wondering.
• Would you notice if it stopped working? Drinkaware says tolerance builds, so the same glass does less. If you have moved from one to two, or from weekends to weeknights, that is information.

The NHS names three signs that you may need some help with your drinking: you often feel the need to have a drink, other people warn you about how much you are drinking, or you think it is causing you problems. If one of those lands, the next section is still for you, and so is your GP. If you find you need a drink on waking, the NHS lists that among the signs of dependence, and the right next step is a conversation with your GP rather than a plan to cut down alone.

What to try instead on the evening you would usually have a drink

Replacing the evening drink works best when you replace the jobs it was doing. The drink was calming your body, giving your hands something to do, and marking the end of the day. Each of those can be done another way, and the NHS and Mind describe the pieces.

• Settle the body first. The NHS recommends calming breathing exercises for anxiety. Breathe in slowly through your nose and out more slowly through your mouth for a few minutes. Mind also suggests sensory distractions when you feel overwhelmed: holding an ice cube, splashing cold water on your face, or eating something with a strong flavour.
• Move. The NHS lists regular exercise among the things that help with anxiety. A walk after work does some of what the drink did, without the rebound.
• Put the worry somewhere. Mind suggests writing worries down and keeping them in one place, setting aside a specific time to think about them, and listing what you can change and what you cannot. The drink used to switch the thinking off. A notebook parks it instead.
• Keep the ritual, change the contents. The Mental Health Foundation suggests avoiding tempting situations and finding alternative social activities. The NHS tips for cutting down include eating first, alternating alcoholic drinks with water, and having several drink-free days a week. A drink-free day is easier when the evening still has a shape to it.
• Tell someone. The NHS and Mind both recommend talking to someone you trust, and the Mental Health Foundation suggests telling people close to you about your plans. "I am not drinking tonight, I am trying to sort my anxiety out" is a complete sentence.

If you want a therapist's view of your particular loop, Wobble is one way to get it without booking a course of therapy. Wobble therapists work to the Wobble response framework, a structured approach to short, practical support: what they understood from what you sent, practical guidance for your situation, and one or two clear next steps. People use it once, or as a regular check-in. Wobble's Clinical Lead is James Penney, NCPS Accredited Psychotherapeutic Counsellor. Wobble is not an alcohol service and not a crisis service.

Cutting down without going cold turkey

Cutting down gradually is safer than stopping overnight, and Drinkaware recommends it. Drinkaware's advice for anxiety is a four-step plan: track your drinking to spot patterns and triggers, reduce it if you are above the UK low-risk guideline, maintain the lower level for a couple of weeks, and review how you feel. Drinkaware says most people can expect their anxiety to improve in that time, with better sleep, and that the reductions should be gradual and small rather than sudden and large.

The UK low-risk guideline is no more than 14 units a week for men and women, spread over three or more days, with several drink-free days. The NHS adds that there is no safe level, so the guideline is about keeping risk low rather than removing it. Its practical tips for cutting down are the unglamorous ones: decide on a limit before you start, choose a smaller or lower-strength drink, eat first, alternate with water, and take it a day at a time.

If you drink heavily every day, do not stop suddenly without medical advice. The NHS says it can be very dangerous to stop drinking suddenly if your body is dependent on alcohol, and that stopping overnight could be harmful. Speak to your GP or a local alcohol service first, and they will help you do it safely.

When to see your GP, and when it is urgent

See your GP if anxiety is affecting your daily life, whether or not drinking is part of it. The NHS advice is to see a GP if you are struggling to cope, if self-help is not working, or if you would like a referral to talking therapies. Drinkaware adds a specific marker for this topic: if you have cut down or stopped and you still feel anxious after a few weeks, contact your GP surgery, because the anxiety deserves attention on its own terms. In England you can also refer yourself to NHS Talking Therapies without seeing a GP, and you do not need a diagnosed condition to do so, though waits vary widely.

Call 999 or go to A&E if you or someone else is in immediate danger, or if someone who has been drinking heavily has a seizure, severe shaking, confusion or hallucinations, which the NHS lists as signs of severe withdrawal. For urgent mental health support that is not an emergency, call NHS 111 and choose the mental health option. If you are having thoughts of harming yourself, Samaritans on 116 123 will listen at any hour.

Who you can talk to today

Several people will talk to you today about anxiety or drinking, and most of them cost nothing to reach.

• NHS Talking Therapies (England): refer yourself online without seeing a GP, from age 18, or 16 in some areas. No diagnosis needed. Waits vary widely.
• NHS 111, mental health option: urgent support when it is not a 999 emergency.
• Samaritans: call 116 123, any time, from any phone.
• Shout: text 85258 for confidential support by text, around the clock.
• Mind: Infoline 0300 123 3393 for information and finding support near you, and the Support line 0300 102 1234 to talk about how you feel, both 9am to 6pm Monday to Friday in England and Wales.
• Drinkline: 0300 123 1110, weekdays 9am to 8pm and weekends 11am to 4pm, if the worry is the drinking itself.
• Your GP: for anxiety that is sticking around, for help with cutting down safely, and for anything medical.

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Quick summary

Alcohol calms an anxious nervous system for an hour, then hands it back more agitated as it wears off. Tolerance means the calm shrinks, rebound means the anxiety grows, and poor sleep makes both worse. Drinking has become a way of coping when the drink has a job to do, and the honest questions are what it is for, what happens on the nights without it, and whether it still works. On the evening you would usually pour one, settle your body, move, write the worry down, keep the ritual with something else in the glass, and tell someone. Cut down gradually, not overnight, and never stop suddenly if you drink heavily every day. See your GP if the anxiety outlasts the drink. Drinkline and your GP are the places to start if the drinking itself is the worry.

For the wider toolkit, see anxiety self-help. For the morning after, see hangxiety. For the moment-to-moment version, see how to stop feeling anxious.

Sources and further reading

• Drinkaware: Alcohol and anxiety (drinkaware.co.uk)
• Drinkaware: How does alcohol affect mental health? (drinkaware.co.uk)
• Drinkaware: What is hangxiety and how do you deal with hangover anxiety? (drinkaware.co.uk)
• Drinkaware: Alcohol and sleep (drinkaware.co.uk)
• Mental Health Foundation: Alcohol and mental health (mentalhealth.org.uk)
• NHS: Anxiety, fear and panic
• NHS: Alcohol support
• NHS: Alcohol-use disorder
• NHS: The risks of drinking too much
• NHS: Tips on cutting down alcohol
• NHS Talking Therapies self-referral (England)
• Mind: How to manage anxiety and worry
• Mind: Helplines
• Samaritans: 116 123
• Shout: text 85258

This article is for information only and does not replace advice from a qualified medical professional. If anxiety or drinking is affecting your daily life, please speak to your GP or contact NHS 111. If you are in crisis, please call 999 or go to A&E.