Study: People With Anxiety Are More Likely to Experience Symptoms of Alcohol Use Disorder

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  • New research found that individuals with anxiety or depression are likely to experience greater alcohol use disorder symptoms than others who are drinking the same amount.

  • Researchers looked at the “harm paradox”—increased negative consequences individuals may experience when drinking at a certain level—and found that it impacted the majority of individuals with a mental health condition, though individuals with more than one mental illness were at a greater risk.

  • Experts agree that alcohol use and mental illness often do not mix, and encourage patients to seek out professional help if they find themselves falling into unhealthy coping mechanisms.

A new study suggests that individuals with anxiety or depression are likely to experience greater alcohol use disorder (AUD) symptoms than others, even when drinking the same amount.

Many people have experienced the pounding headache, extreme thirst, and nausea that often comes after a night of drinking. But some individuals also feel heightened depression and anxiety after having just a few drinks. In fact, experiencing depression after drinking impacts more than 15% of people, and increased anxiety after drinking affects around 12% of people.

If this sounds like you—or if you have been diagnosed with depression or an anxiety disorder—you may want to take a closer look at your alcohol consumption. Not only could drinking be making your anxiety and depression symptoms worse, but it also could be putting you at a greater risk for AUD.

New research suggests that those who have anxiety or a major depressive disorder experience greater AUD symptoms in comparison to people without those disorders—even when drinking at the same level.

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

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What the Evidence Says

The study, which appeared in the journal Alcohol: Clinical & Experimental Research, included data on almost 26,000 adults from the National Epidemiological Survey on Alcohol-Related Conditions. The team of scientists found that having an anxiety disorder or major depressive disorder predicted more alcohol-related symptoms.

“These symptoms may include physiological effects of alcohol drinking such as changes in sensory perception and heart rate; behavioral effects of drinking such as craving and tolerance; and social effects such as an impact on family and employment [relationships],” Colleen Hanlon, PhD, neurobiologist and vice president of medical affairs for BrainsWay told Health.

The findings are an example of the “harm paradox” effect, which according to Kushner refers to the increased negative consequences people experience from consuming a given level of alcohol (or other substance) that are greater than those experienced by others.

The harm paradox was found to impact the majority of demographics with a mental illness, though it was more pronounced in people with more than one anxiety or depression disorder. Even if someone’s mental health condition was in the past, they likely could be at greater risk for AUD than those without anxiety or depression.

“This study highlights the need for caution when drinking alcohol if you or a loved one has suffered from depression or anxiety, as you are particularly vulnerable to the physiological, behavioral, and social effects of alcohol consumption,” explained Hanlon.

The Relationship Between Alcohol and Mental Health

According to Kushner, it is well known that people with anxiety and mood disorders have an outsized risk of developing alcohol and other substance use problems. Research shows that internalizing disorders—like anxiety disorder or major depressive disorder—commonly co-occur with AUD. As many as 20% to 40% of people with an internalizing disorder have AUD.

“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,” he noted. “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.”

That said, other research has called both of these ideas into question, Kushner added, suggesting that additional forces are driving the AUD-anxiety/mood disorder relationship.

“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,” he pointed out. “That is, a single neurobiological pathway that leads to both disorders.”

This vulnerability implies that having either condition would pose an increased risk of developing the other because having one indicates a neurobiological propensity for the other.

“The relationship [between mood disorders and AUD] is complicated,” John Mendelson, MD, chief medical officer of Ria Health and clinical professor of medicine at the University of California, San Francisco (UCSF) told Health. “Scientists have been trying for a very long time to parse these overlaps to identify the reasons why these conditions are commonly seen in the same individual.”

Related:What Are the Effects of Alcohol Consumption on the Brain?

How to Prevent Alcohol Use Disorder

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.

Be Mindful of Your Habits

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.”

Form Healthy Coping Mechanisms

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.

Get Help When Needed

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.”

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

Related:Why Alcohol Use Has Increased Among Cisgender Women—And How It Has Affected Them

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