Alcohol and Social Anxiety

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Social Anxiety and Alcohol Abuse

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Alcohol and social anxiety tend to go hand-in-hand for some people. Is that true for you?

You might find that you start out having one drink at a social event to “steady your nerves.”

Then before you know it, drinking to manage social anxiety has become a regular thing.

If you’re not careful, suddenly alcohol has become a problem for you separate from your social anxiety.

What is Social Anxiety Disorder?

Social anxiety disorder is a severe form of social anxiety. It affects between 2 and 13 percent of the population and is diagnosed using specific criteria.

It’s the third most common mental disorder behind depression and alcoholism, yet it remains poorly understood.

People with social anxiety disorder have impairments in their lives because of extreme fear and anxiety about social or performance situations.

Social Anxiety and Alcohol Abuse

Of those diagnosed with social anxiety disorder, about 20 percent will also be diagnosed with an alcohol abuse disorder.

In general, when someone has both social anxiety and alcohol abuse problems, the social anxiety comes first. In other words, you drink to manage your anxiety. Over time, it becomes a problem on its own.

Alcohol abuse often leads to its own set of problems, such as relationship issues, job loss or problems with school, and even legal issues.

Signs of Alcohol Dependence

How do you know if your drinking to manage social anxiety has gotten out of control?

Some signs might include the following:

Needing to have a drink first thing in the morning
Needing to drink at every social event
Being unable to stop drinking once you start
Drinking more than five drinks at once
Excessive drinking four or more days a week to excess

Anxiety After Drinking Alcohol

Not only does alcohol abuse cause problems on its own, but it can also make your anxiety worse.

While it might temporarily make you feel less anxious in social situations, alcohol can make you feel more anxious after the effects wear off.

This after-effect anxiety can last several hours to several days, because the alcohol has changed the levels of neurotransmitters in your brain.

Treatment for Alcohol Abuse and Social Anxiety

If you have both social anxiety and alcohol abuse, what’s the best type of treatment?

It’s a tricky situation because you need to address both problems but you need to do it in the right order.

If you’re not yet at the abuse stage but find yourself using alcohol more than you would like, then usual treatments for social anxiety such as talk therapy and medication are advisable.

This type of treatment could help prevent you from developing a secondary alcohol use disorder.

On the other hand, if you are already experiencing significant effects from alcohol abuse, your treatment will need to be handled a little more carefully. Especially when it comes to medication.

Certain anxiety medications can interact with alcohol, so it’s important that your doctor is aware of your level of drinking.

For example, monoamine oxidase inhibitors (MAOIs) interact with the amino acid tyramine found in alcoholic beverages, which can be a dangerous combination.

Benzodiazepines affect the same area of the brain responsible for breathing as does alcohol, and mixing the two can be fatal. They are also habit-forming and not good for someone with a propensity toward addiction.

On the other hand, research has shown that selective serotonin reuptake inhibitors such as paroxetine (Paxil) may reduce the use of alcohol as a coping strategy. For this reason, they are usually the best choice if you have both social anxiety and alcohol abuse issues.

Finally, receiving therapy for social anxiety before trying to join any group programs for alcohol abuse can be helpful. Otherwise, you might be more likely to give up or quit programs like group therapy or Alcoholics Anonymous.

Risk of Relapse

What is the risk of relapse if you have both social anxiety and alcohol abuse issues? It’s a lot higher if you get treatment for one problem but not the other.

In fact, research has shown that people with social anxiety have the highest risk of drinking again after ending treatment for alcohol abuse.

This is because, without appropriate tools and coping strategies, you’ll end resorting to the coping strategy you’ve always used: drinking.

Managing Alcohol Use and Social Anxiety

All this has probably left you thinking, what can I do to manage both my social anxiety and alcohol abuse problem?

The best first step would be to talk to your doctor about local treatment options and diagnosis.

Another option would be to talk to a therapist online through a service such as Betterhelp.

I highly recommend this service for those with social anxiety who find it too hard to see a therapist in person. Readers of this site receive 20% off their first month of therapy.

How about you? Have you struggled to manage your drinking because of social anxiety?

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