Alcohol And Anxiety: Panic Attacks After Drinking | Drinkaware

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Alcohol and anxiety

Drinking alcohol can contribute to anxiety and panic attacks.1

On this page

• What is anxiety?

• Types of anxiety and symptoms

• How alcohol affects anxiety

• Panic attacks

• How to prevent alcohol causing or worsening anxiety 

• Alcohol and depression

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This page explains more about anxiety, why alcohol can trigger it or make it worse, and steps you can take to feel better.

What is anxiety?

Anxiety is what we can feel if we are worried, tense or afraid, particularly about what’s going to happen.2 It can be mild or severe and affect your thoughts, the way you feel, and often has physical symptoms like increasing your heart rate, making you sweat or tremble.3

Most people feel anxious from time to time. It’s a natural human response and usually passes once the situation is over - for example around a job interview. But if you have feelings of anxiety that are constant, overwhelming, or affect your daily life, there are things you can do, and support that is available to help you manage.

Types of anxiety and symptoms

Anxiety can become a health problem if it affects your ability to live your life as fully as you want to.

Several medical categories relating to anxiety are used by doctors – these include generalised anxiety disorder (GAD), social anxiety, panic attacks and phobias.4 One thing they have in common is they cause your body to go into ‘fight or flight’ mode, releasing hormones into your bloodstream to prepare you to react or run away.5

It can cause symptoms like feeling tired, having trouble concentrating or sleeping, headaches or tummy aches - as well as many others.6

And because of the way alcohol interferes with your ‘fight or flight’ response,7 drinking can make you more vulnerable to these anxiety disorders,8,9 and make symptoms worse.10

How alcohol affects anxiety

Alcohol is a depressant.11 It slows down processes in your brain and central nervous system and can initially make you feel less inhibited.12,13 In the short-term, you might feel more relaxed - but these effects wear off quickly.

In fact, if you’re experiencing anxiety, drinking alcohol could be making things worse.

Over time, if you regularly drink heavily, the central nervous system gets used to the suppressing effect of the alcohol, which means your brain is affected if the alcohol level suddenly drops. You can go straight into ‘fight or flight’ mode as the alcohol leaves your system – the same reaction as an anxiety disorder.14

Alcohol and anxiety – the vicious circle

If you suffer from anxiety, it’s important not to be tricked by the temporary feeling of relaxation from drinking alcohol, to avoid being trapped in a vicious circle:

• You drink alcohol
• You initially feel calm as the alcohol affects the brain
• You feel anxious as a symptom of alcohol withdrawal
• You may want to drink again to try to relieve your anxiety

But the last step only starts the process again from the beginning. As the initial calm feeling fades you can feel anxiety as the effects of the alcohol wear off.

The more you drink the greater your tolerance for alcohol - meaning you need to drink more alcohol to get the same feeling. If you rely on alcohol to mask anxiety, you may find you become reliant on it to relax – putting you at risk of alcohol dependence.

Can alcohol cause panic attacks

​​​​Alcohol affects everyone differently, but for some people it can trigger or 20 increase feelings of anxiety and in some cases, panic attacks. While it may feel calming in the moment, alcohol disrupts brain chemistry and can impact your mood, especially as it wears off. This can lead to feelings of panic and if you’re prone to anxiety, alcohol can make symptoms worse.​​​ If you experience sudden, intense anxiety and fear, it might be the symptoms of a panic attack.15 Other symptoms may include a racing heartbeat, or feeling faint, dizzy, lightheaded, or sick.16

A panic attack usually lasts five to 30 minutes. They can be frightening, but they're not dangerous and shouldn’t harm you.

If you suffer from panic attacks, cut right down on your alcohol consumption, if you drink.

Alcohol has an effect on brain chemistry - it can induce panic because of its effects on GABA, a chemical in the brain that normally has a relaxing effect. Small amounts of alcohol can stimulate GABA and cause feelings of relaxation, but heavy drinking can deplete GABA, causing increased tension and feelings of panic.17,18 Panic attacks can occur due to alcohol withdrawal.

How to cope with a hangover panic attack

Hangover related panic attacks can happen as your body recovers and your brain’s chemistry rebalances​​​​​21. You might feel shaky, on edge or overwhelmed even if ​there’s no reason22.​​​ 

​​​To help manage these feelings, try to stay hydrated, eat something nourishing, and take some time to rest. Breathing exercises, going for a walk or speaking to someone you trust can help, but it might be worth thinking about how alcohol affects your mental health and if cutting back can help.​​​​ 

​​​You can also log your symptoms, so you can see if there is a link between when you drink, and any anxiety or panic attacks that occur later on.​​​​

How to prevent alcohol causing or worsening anxiety 

If you feel like you’re struggling with anxiety, try cutting back on the amount of alcohol you drink. Try this four-step guide to get started:

• Step 1 - track

• Step 2 - reduce

• Step 3 - maintain

• Step 4 - review

Step 1 - track

Track how much you’re drinking to help spot patterns so you can avoid triggers – the MyDrinkaware app can help. You can download using the link below.

Step 2 - reduce

If you’re drinking more than the UK low risk drinking guidelines (no more than 14 units a week for both men and women) try to cut down. It’s safer to make gradual, small reductions (not sudden large changes).We have advice on how to take a break from alcohol below, but if you’re worried you are dependent on alcohol talk to your GP surgery or contact an alcohol support service.

Step 3 - maintain

Once you’ve cut down your drinking (or stopped drinking altogether), keep going like this for a couple of weeks. Most people can expect to see an improvement in their anxiety symptoms in this time as the brain’s balance of chemicals and processes start to return to normal and you experience better quality sleep.19

Step 4 - review

If you’re still feeling anxious after a few weeks, contact your GP surgery. Talking therapies like CBT (cognitive behavioural therapy), can help you learn to spot unhelpful patterns of behaviour and help you to develop coping strategies. Your GP should be able to tell you about local services.

Anxiety and depression

Anxiety is different to depression, but they can sometimes go together – feeling anxious and worrying constantly can make you feel low. And depression is affected by alcohol too - find out more on our alcohol and depression webpage.

Alcohol and depression

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External links

The Mind website has more information about different types of anxiety : Anxiety disorders

Find NHS advice on panic attacks: Anxiety, fear and panic

The NHS website, Every Mind Matters, has advice on how to access support and treatment for anxiety in England. This includes options for NHS support, links to charities, helplines and communities, and tips on self-care : NHS Every Mind Matters – support and treatment for anxiety

If you are in Scotland, Wales or Northern Ireland, there is separate advice on getting help with anxiety.

• Scotland – NHS inform
• Wales – NHS mental health and wellbeing
• Northern Ireland – NI Direct, mental health

Specific support is also available if you need help with your drinking.

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Other related content

Here are some other advice and information pages linked to alcohol and mental health.

Advice and information

How to take a break and reset your alcohol tolerance

The more alcohol you regularly drink, the higher your tolerance will be – increasing your risk of becoming dependent. Taking a break can get you back on track.

Alcohol and sleep

Having trouble sleeping? Find out why alcohol makes you tired and how alcohol could be contributing to your sleepless nights.

Further guidance

Alcohol support services

If you are concerned that you or someone you care about has a drinking problem there is help available. Find out the many ways that you can access support.

Alcohol withdrawal

Alcohol withdrawal symptoms can be extremely dangerous. Find out what they are and what you should do if you are experiencing them.

References

[1] Bellos, S., Skapinakis, P., Rai, D., Zitko, P., Araya, R., Lewis, G., Lionis, C. and Mavreas, V. (2013). Cross-cultural patterns of the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety: Secondary analysis of the WHO Collaborative Study on Psychological Problems in General Health Care. https://doi.org/10.35946/arcr.v40.1.03

[2] Mind website. What is anxiety? (February 2021). [Accessed 15 April 2025]. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/about-anxiety/

[3] NHS website, Every mind matters. What is anxiety? [Accessed 15 April 2025]. Available at: https://www.nhs.uk/every-mind-matters/mental-health-issues/anxiety/#what-is-anxiety

[4] Mind website. What are anxiety disorders? (February 2021). [Accessed 15 April 2025]. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/anxiety-disorders/

[5] Mind website. What is anxiety? (February 2021). [Accessed 15 April 2025]. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/about-anxiety/

[6] NHS website, Every mind matters. What is anxiety? [Accessed 15 April 2025]. Available at: https://www.nhs.uk/every-mind-matters/mental-health-issues/anxiety/#what-is-anxiety

[7] Day, E., & Daly, C. (2021). Clinical management of the alcohol withdrawal syndrome. Addiction.

[8] Holmes, A., Fitzgerald, P. J., MacPherson, K. P., DeBrouse, L., Colacicco, G., Flynn, S. M., Masneuf, S., Pleil, K. E., Li, C., Marcinkiewcz, C. A., Kash, T. L., Gunduz-Cinar, O., & Camp, M. (2012). Chronic alcohol remodels prefrontal neurons and disrupts NMDAR-mediated fear extinction encoding. Nature neuroscience, 15(10), 1359–1361. https://doi.org/10.1038/nn.3204

[9] Anker, J. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging the Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol Research: Current Reviews, 40(1), arcr.v40.1.03. https://doi.org/10.35946/arcr.v40.1.03

[10] Gorka, S. M., & Phan, K. L. (2017). Impact of anxiety symptoms and problematic alcohol use on error-related brain activity. International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 118, 32–39. https://doi.org/10.1016/j.ijpsycho.2017.05.011

[11] Abrahao, K. P., Salinas, A. G., & Lovinger, D. M. (2017). Alcohol and the Brain: Neuronal Molecular Targets, Synapses, and Circuits. Neuron, 96(6), 1223–1238.

[12] Gan, G., Guevara, A., Marxen, M., Neumann, M., Jünger, E., Kobiella, A., Mennigen, E., Pilhatsch, M., Schwarz, D., Zimmermann, U.S. and Smolka, M.N., 2014. Alcohol-induced impairment of inhibitory control is linked to attenuated brain responses in right fronto-temporal cortex. Biological psychiatry, 76(9), pp.698-707. Available at: biologicalpsychiatryjournal.com/article/S0006-3223(14)00015-8/abstract. [Accessed 23 February 2017].

[13] Klenowski, P. M. (2018). Emerging role for the medial prefrontal cortex in alcohol-seeking behaviors. Addictive Behaviors, 77, 102–106. https://doi.org/10.1016/j.addbeh.2017.09.024

[14] Day, E., & Daly, C. (2021). Clinical management of the alcohol withdrawal syndrome. Addiction.

[15] NHS website. Panic disorder. [Accessed 15 April 2025]. Available at: https://www.nhs.uk/mental-health/conditions/panic-disorder/

[16] NHS website. Panic disorder. [Accessed 15 April 2025]. Available at: https://www.nhs.uk/mental-health/conditions/panic-disorder/

[17] Cosci, F., Schruers, K. R., Abrams, K., & Griez, E. J. (2007). Alcohol use disorders and panic disorder: a review of the evidence of a direct relationship. The Journal of Clinical Psychiatry, 68(6)

[18] Gimeno, C., Dorado, M. L., Roncero, C., Szerman, N., Vega, P., Balanzá-Martínez, V., & Alvarez, F. J. (2017). Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment. Frontiers in Psychiatry, 8, 173. https://doi.org/10.3389/fpsyt.2017.00173

[19] Driessen, M., Meier, S., Hill, A., Wetterling, T., Lange, W. and Junghanns, K. (2001). The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders. Alcohol and Alcoholism, 36(3), 249-255.

[20] Gimeno, C., Dorado, M. L., Roncero, C., Szerman, N., Vega, P., Balanzá-Martínez, V., & Alvarez, F. J. (2017). Treatment of Comorbid Alcohol Dependence and Anxiety Disorder: Review of the Scientific Evidence and Recommendations for Treatment. Frontiers in Psychiatry, 8, 173. https://doi.org/10.3389/fpsyt.2017.00173

[21] Dharavath, R. N., Pina-Leblanc, C., Tang, V. M., Sloan, M. E., Nikolova, Y. S., Pangarov, P., Ruocco, A. C., Shield, K., Voineskos, D., Blumberger, D. M., Boileau, I., Bozinoff, N., Gerretsen, P., Vieira, E., Melamed, O. C., Sibille, E., Quilty, L. C., & Prevot, T. D. (2023). GABAergic signaling in alcohol use disorder and withdrawal: Pathological involvement and therapeutic potential. Frontiers in Neural Circuits, 17, 1218737. https://doi.org/10.3389/fncir.2023.1218737

[22] Dharavath, R. N., Pina-Leblanc, C., Tang, V. M., Sloan, M. E., Nikolova, Y. S., Pangarov, P., Ruocco, A. C., Shield, K., Voineskos, D., Blumberger, D. M., Boileau, I., Bozinoff, N., Gerretsen, P., Vieira, E., Melamed, O. C., Sibille, E., Quilty, L. C., & Prevot, T. D. (2023). GABAergic signaling in alcohol use disorder and withdrawal: Pathological involvement and therapeutic potential. Frontiers in Neural Circuits, 17, 1218737. https://doi.org/10.3389/fncir.2023.1218737

Last Reviewed: 30th April 2025

Next Review due: 30th April 2028

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