“When you have social anxiety, alcohol may seem like a magical cure—suddenly you’re no longer afraid, you’re less inhibited, and you’re the life of the party. But it’s just an illusion because you’re still the same person when you sober up.”
– Dr. Kasey Dean, Nurse Practitioner and Dual Diagnosis Specialist at LVRC
Nausea, upset stomach, and heart palpitations are just three of the physical symptoms of social anxiety disorder; a debilitating mental illness that is more than just “shyness”. People with social anxiety disorder (also called a “social phobia”) feel such an intense fear of certain (or all) social situations that their work, school, and personal relationships suffer as a result. What makes social anxiety disorder particularly difficult to live with is that unlike other specific phobias (say, arachnophobia), social situations are nearly impossible to avoid. While people with a spider phobia may go months or even years without encountering a dreaded eight-legged insect, people with social anxiety disorder are forced to struggle through anxiety-provoking encounters on daily basis. To cope, those with social anxiety disorder often self-medicate, turning to a substance that has been relieving people of their inhibitions and crippling self-consciousness for millennia: Alcohol.
Social Anxiety and Alcohol Abuse: Common Partners in Crime
For people with social anxiety disorder, social situations aren’t only difficult, they’re terrifying. Many cope by keeping human interaction to a minimum.
Using alcohol as a tool for muddling through awkward social situations is not uncommon, even among those without a social phobia. One study that examined 34,000 American adults found that 13 percent of the adults who had drunk alcohol in the past year had done so in order to lessen their anxiety. Unlike the general population, however, those with an anxiety disorder who drink in order to numb their discomfort face a greater risk of becoming alcohol dependent. The same study found that the participants with diagnosed anxiety disorders who self-medicated with alcohol were two to five times more likely to have developed an alcohol use disorder within three years of the study’s completion. All in all, approximately 20 percent of people with a social anxiety disorder will also experience alcohol abuse or dependency. The reason for the correlation between social phobias and alcohol abuse may seem obvious: Drinking reduces anxiety, so people with high levels of anxiety drink in excess in order to feel “normal” in uncomfortable social situations, such as at a party or work function.
Alcohol Makes Anxiety Worse
The irony is, however, that alcohol abuse can actually increase anxiety levels in those with a social phobia, particularly in the hours or days after a drinking binge. This is because alcohol decreases the serotonin levels in the brain and causes a drop in blood sugar, hypersensitivity in the nervous system, and a spiked heart rate. All of these in combination can cause a person to feel depressed, irritable, shaky, and overly sensitive, which can elevate anxiety levels, especially in someone who is already anxious.
What’s the Solution?
Exercise, meditation and exposure therapy can help.
Regardless of whether or not you meet the criteria for an alcohol use disorder, if you have social anxiety and you find yourself leaning heavily on alcohol as a crutch to get you through frightening social situations, you may want to consider finding new and healthier coping techniques. While moderate drinking is not a negative in itself, relying on alcohol for your fearlessness instead of your own inner well of courage robs you of the chance to work through your fears and overcome your phobia. There are healthier ways of coping with social anxiety, such as:
Deep-breathing exercises
Meditation
Exposure therapy
Cognitive-behavioral therapy
Completing exercises in an anxiety workbook
Anti-anxiety medication
If you find yourself trying and failing to quit drinking or using substances, this could mean that you have crossed the line from merely abusing alcohol to becoming physically and emotionally dependent. If this is the case, you will need to seek professional help, as addiction is a serious disease that does not go away on its own.
Signs and Symptoms of an Alcohol Use Disorder:
While there are a number of signs and symptoms of alcohol addiction, the following are four of the most prominent:
Inability to manage or control one’s drinking (once you start, you struggle to stop)
A tendency to drink too much (even when you promise yourself you won’t)
A mental preoccupation with drinking (your thoughts revolve around when you’ll be able to drink again)
Continuing to drink even though your drinking has caused health, work, relationship or legal problems.
How to Get Help:
For those seeking help from a rehab, it’s important to see a therapist or enroll in a rehab facility that specializes in both addiction and anxiety.
Many people are hesitant to seek help for their anxiety because they feel ashamed. They feel as though their anxiety is a result of weakness and that they should be able to solve the problem on their own. But social anxiety disorder, like any mental illness, doesn’t heal itself. You don’t grow out of it; at least not without doing some major work first. If you’re afraid to get help, it can be useful to keep in mind that social anxiety disorder is relatively common. In fact, anxiety disorders are the most common mental illness in the US, affecting some 40 million Americans. Know that you are not alone in your anxiety and that you are not alone in developing maladaptive coping techniques. Given how agonizing a social phobia can feel, it is understandable why you and so many others turn to self-medicating in order to cope. As bad as the consequences of a drinking problem may be, they can often seem preferable to the consequences of living with the stress and paranoia of an anxiety disorder. The best thing you can do for yourself is to make an appointment with a therapist who specializes in co-occurring disorders (also called dual-diagnosis), because you will need to be able to talk to someone who can help you with your anxiety as well as your issues with substance abuse. Your therapist may recommend inpatient or outpatient addiction treatment, and if she or he does, be sure you find a facility that offers both addiction treatment and mental health counseling. The good news is that social anxiety disorder and alcohol dependency are not life sentences. With counseling, education, and practice, you can recover from these mental and emotional handicaps and go on to live a healthy and happy life.
