Can alcohol cause panic attacks?

Alcohol use disorder and anxiety frequently co-exist. That means that if you have alcohol use disorder, you’re more likely to also have anxiety, and vice versa. Research has found that panic disorder and alcohol use disorder often show up together. There’s also evidence suggesting a direct relationship between the two. People with both may experience alcohol-induced panic attacks.

Panic attacks are frightening, and it may feel like drinking alcohol can help you to feel calmer temporarily. And while this may be true to a degree, alcohol affects your brain in a way that increases anxiety and panic over time — especially as alcohol metabolizes and leaves your body. 

Panic attacks are scary, but you’re not alone. With the support of a therapist, you can overcome the use of alcohol to manage your anxiety symptoms and learn healthier ways of coping with panic attacks.

How alcohol can trigger a panic attack

Many studies have found that alcohol use disorder and panic disorder tend to appear together. But this doesn’t necessarily mean that alcohol is a direct trigger of panic attacks. Panic attacks have complex causes and usually come out of nowhere.

Alcohol and anxiety, including panic attacks, have a complex and bidirectional relationship. Many people start to become dependent on alcohol because they believe it helps them deal with their panic attacks. 

But alcohol affects different people in different ways. For some, alcohol may have the opposite effect and directly or indirectly lead to a panic attack. Even though alcohol is a depressive and not a stimulant, it can still cause some symptoms that may mimic a panic attack, including heart palpitations and increased sweating. If you’re already at risk for panic attacks, these could make you feel more anxious.

It’s most common for alcohol to cause panic attacks during withdrawal. The more you drink, the more at risk you are of having heightened anxiety while the alcohol is leaving your body. This is because of the way alcohol affects your brain.

Drinking mimics a brain chemical called GABA, which induces feelings of relaxation. This is why some people might feel less panicked while drinking. Once the effects of alcohol wear off, there’s a surge of excitatory chemicals in the brain that compensate for the artificial GABA production. This can lead to intense anxiety as the effects of alcohol wear off.

Some research has also found that increased carbon dioxide (CO2) sensitivity may also contribute to panic attacks in people with alcohol use disorder. Chronic alcohol use may suppress some receptors in the brain, which can lead to a hypersensitivity to CO2 during the withdrawal process. This can cause hyperventilation, which can trigger and worsen panic attacks.

Whether or not alcohol is causing your panic attack, or if you’re drinking to try to cope with a panic attack, it’s important to take it seriously. 

Some signs you’re having a panic attack include:

• A racing or pounding heartbeat that feels out of control
• Shortness of breath or feeling like you can’t get enough air
• Difficulty swallowing
• Dizziness or feeling lightheaded, like you might faint
• A sudden wave of intense fear or a sense of impending doom
• Chest pain or discomfort, which can sometimes be mistaken for a heart attack
• Trembling or shaking that you can’t control
• Feeling disconnected from reality or as if you’re outside of your own body (also called depersonalization)
• Sweating, even if you’re not in a hot environment
• Nausea or stomach discomfort
• Hot flashes or sudden chills running through your body
• Numbness or tingling, especially in your hands, feet, or face
• Fear of losing control or dying, even if there’s no real danger around you

If you notice these symptoms during or after drinking alcohol — especially during withdrawal — it’s possible that alcohol could be triggering your panic attacks.

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Ways to reduce alcohol-related anxiety 

If you experience a panic attack while you’re under the influence of alcohol, stop drinking immediately. Get medical attention if you need it and prepare to cope with additional panic attacks as the alcohol leaves your body.

As you move forward, keep the following tips in mind to cope with alcohol and panic attacks.

Consider quitting alcohol

If you’ve noticed a link between panic attacks and alcohol, it may be a good idea to reduce your drinking or quit altogether. This can be easier said than done — especially if you’ve been drinking for a long time. You may have also come to rely on alcohol as a way to cope with your panic attacks and unknowingly gotten stuck in a vicious cycle.

But with support, you can break this cycle. Peer-led groups (like 12-step groups) and working with a therapist or substance abuse counselor can help you quit as well.

Identify triggers

If alcohol is a panic attack trigger for you, it can be helpful to identify other triggers that lead you to drink alcohol in the first place. For example, is it being around certain people that triggers you to want to drink? Is it being in certain environments where alcohol is readily available? Do you often use alcohol to cope with overly stressful events?

Once you’ve identified your triggers for drinking (and for possible subsequent panic attacks), you can make a proactive plan for how to cope with them.

Learn relaxation strategies

One of the best ways to cope with panic attacks without alcohol is to learn relaxation strategies. When you feel a panic attack coming on, implement techniques like deep breathing or progressive muscle relaxation to relax your nervous system. This physically calms your body and helps the panic attack go away faster. 

You can also proactively practice these techniques to manage stress and reduce the likelihood of a panic attack happening in the first place.

Connect with community

Sometimes, it can help to surround yourself with other people who understand what you’re going through. Although alcohol is often considered a “normal” part of social events, the sober-curious movement is growing. Being sober curious means bringing curiosity and mindfulness to your drinking habits and introducing alternatives — such as mocktails — or abstaining from drinking for periods of time. Find a community of friends you can connect with without needing to drink. 

If you have people in your life you can trust, consider letting them know about your risk of panic attacks and guide them on how they can support you through them.

Support for alcohol use and panic disorders

If these strategies aren’t enough to help you manage alcohol-related panic attacks, you could benefit from professional mental health treatment. If you’ve tried reducing your alcohol use but haven’t been able to, or if panic attacks are disrupting your day-to-day life, it may be time to contact a therapist.

If you live with co-occurring alcohol use and panic attacks, it’s essential to address both in treatment. If you address one and not the other, it’s likely you’ll remain stuck in the cycle. For example, if you try to treat alcohol use disorder without addressing the panic attacks, you may be triggered to use alcohol the next time you have a panic attack.

Some common therapy types that are effective for co-occurring substance use and anxiety disorders (including panic attacks) include:

• Cognitive behavioral therapy (CBT): CBT helps you recognize and change the thought patterns that may contribute to both anxiety and substance use. It also teaches you coping strategies to manage cravings and reduce panic symptoms.
• Dialectical behavior therapy (DBT): Originally developed for suicidal behaviors, DBT has also been found effective for substance use and anxiety. It teaches skills for regulating painful emotions, like distress tolerance and mindfulness.
• Exposure therapy: This type of therapy gradually exposes you to the thoughts or situations that trigger panic attacks in a safe, controlled environment. Over time, it can reduce the fear that you’ll have a panic attack in public.
• Motivational interviewing (MI): MI is a client-centered approach that helps you explore and resolve ambivalence about reducing alcohol use. It focuses on strengthening your intrinsic motivation and commitment to changing behaviors.
• Medication-assisted treatment (MAT): Certain medications can help manage both substance use and panic attacks. This can be important — especially during alcohol withdrawal.

Find care with Rula

Panic attacks are frightening, and many people try to cope with them using alcohol. Unfortunately, this method only keeps you trapped in a cycle and can worsen your panic attacks over time. But there’s hope, and you don’t need to go through this alone.  

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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