Holiday Drinking and Panic Attacks: What You Need to Know with Clinical Director Tessa Sterling
Alcohol actually works to suppress anxiety temporarily.
If you have ever experienced a panic attack, you will probably agree that it feels like you are having a heart attack. My only panic attack occurred many years ago, when I was in active addiction. I remember it vividly: chest pains, difficulty breathing, numbness in my arms and hands, sweating, palpitations, and tightness over my heart. I was rushed to the hospital by a friend, and was so convincing in my “I’m having a heart attack” performance, that the admissions nurse sent me straight to the emergency department.
After they took my vitals, I was aghast when the attendant asked me to step on the treadmill. I thought, “This is not a good idea – I am having a heart attack.” I remember a nurse telling me she had ‘purse envy,’ and thinking. “I’m having a heart attack. Why is she talking about my purse? I might die!”
Holiday Drinking and Panic Attacks: What You Need to Know
Of course, it ended well, and I am 13 years sober, so I can laugh as I recall another in a long line of alcohol-related ailments and close calls. Now that I work for Sanford Behavioral Health, I understand the connection between alcohol and anxiety. Given the added stress the holidays can bring, and the opportunity to indulge in alcohol around every corner between now and January 1st, it seems prudent to offer a primer on anxiety, panic attacks (an extreme form of anxiety), and heavy drinking.
Let’s start with the vicious cycle of alcohol, anxiety, and panic attacks:
- The holidays are stressful, and anxiety feels overwhelming.
- Alcohol actually works to quell anxiety temporarily.
- However, particularly for regular, heavy drinkers, when alcohol wears off, anxiety rebounds.
- Stress hormones surge, heart rate increases, sleep disruption occurs, and the risk of panic attacks increases.
- Alcohol temporarily calms the spike in anxiety and reinforces the pattern.
- Of note, individuals with an alcohol use disorder have a higher risk of developing an anxiety disorder and vice versa.
The Rebound Effect with Sanford Clinical Director, Tessa Sterling, LMSW
Sanford Behavioral Health Clinical Director Tessa Sterling. LMSW says, “An individual drinks alcohol to manage anxiety, the alcohol causes more anxiety, and the worsening anxiety triggers more drinking, creating a vicious cycle and increased risk of panic attacks.” We went to Tessa for more evidence-based information on the subject.
Tessa, what causes panic attacks?
As alcohol wears off, the brain overcorrects, which causes a spike in anxiety and agitation. In other words, the symptoms return worse than before (the rebound effect). Over time, alcohol reduces natural serotonin and dopamine levels, worsening underlying depression and anxiety. Research shows that even one or two drinks can reduce serotonin levels within 24 hours; reduced serotonin levels trigger low mood and irritability. Consequently, if someone is already depressed or anxious during the holidays, the rebound effect is a double whammy.
Additionally, even after moderate drinking, the body enters a mini-withdrawal as blood alcohol drops, causing:
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- Increased heart rate
- Restlessness
- Sweating
- And a sense of impending doom, which is a hallmark of panic attack symptoms.
For individuals already prone to anxiety, the withdrawal cycle is stronger. Alcohol also impacts the amygdala, the brain’s fear center. The impact on the amygdala lowers inhibition while drinking, but heightens the fear response within 24 hours after drinking. This cycle is why panic attacks often occur the day after a night of heavy drinking (“hangxiety”). A word of caution: if you struggle with anxiety or depression, drinking less (or not at all) during the holidays can help protect your mood and reduce stress.
Thank you, Tessa!
And for those of you who cannot imagine the holidays without alcohol:
Myth Busting – Non-Drinkers Are Not BORING
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