Alcohol and social anxiety

The short answer

Drinking to cope with social anxiety is very common. People call it “liquid courage”. It can work for a few hours. The trouble is what comes after.

• Young people with social anxiety do not drink more on average. They have more problems with alcohol.
• Social anxiety is linked to a higher risk of alcohol dependence.
• Using alcohol to get through social events works like any other safety behaviour: it stops you learning that you could cope without it.

What the research shows

• Less drinking, more problems. A study combining 70 studies of people aged 13 to 29 found that young people with social anxiety drank slightly less than others overall. But they had slightly more alcohol-related problems. The links were small.
• Higher risk of dependence. In a US survey of more than 43,000 adults, the odds of alcohol dependence were 2.8 times higher in people with social anxiety disorder.
• Harder recovery. In a 12-year US study, alcohol and drug problems made recovery from anxiety less likely.
• Common online too. In a study of 1,102 young people posting about diagnosed social anxiety on a forum, 13% described worrying drug or alcohol use.

Why would people who drink less have more problems? The studies do not fully explain this. A likely reason is why and how people drink: drinking alone before going out, drinking fast to calm nerves, or not being able to face events without it.

What people describe

On forums, people talk about drinking in honest terms. In one thread, someone said they drank only to manage social anxiety, and that it helped about 50% of the time. Others replied with warnings about “hangxiety”: anxiety that comes back stronger the next day, sometimes for several days.

The pattern people describe often goes like this:

1. Dread before the event.
2. A few drinks to calm down.
3. Relief and a looser evening.
4. Worse anxiety the next day, and worry about what you said.
5. A stronger belief that you can’t cope sober.

Why alcohol keeps social anxiety going

A safety behaviour is something you do to feel safer in a feared situation, such as avoiding eye contact or rehearsing. Drinking to get through an event works the same way.

If you drink and the evening goes fine, your mind credits the alcohol, not you. You never find out that you could have coped. Next time, the fear is just as strong, and the need to drink is stronger. In a small study, facing feared situations while dropping safety behaviours lowered anxiety more than facing them with safety behaviours still in place. See what keeps it going.

What you can try

You do not have to stop drinking completely to start changing this. The goal is to stop needing it to be with people.

• Notice your pattern. For two weeks, note when you drink and why. Is it for fun, or to calm fear?
• Arrive sober. Try having your first drink after you have been there for 30 minutes, not before.
• Swap one. At your next event, swap one drink for something else and see what happens.
• Practise sober in smaller settings. Coffee with one friend, a short visit, a class. See exposure on your own.
• Treat the fear. As social anxiety improves, the pull to drink often shrinks. See cognitive therapy for social anxiety.

When to get help

Talk to a doctor if:

• you can’t go to social events without drinking;
• you drink alone before going out;
• you drink more than you meant to, or feel unable to cut down;
• you feel low or anxious for days after drinking.

A doctor can help with both the drinking and the anxiety. Some medicines for anxiety should not be mixed with alcohol, so be honest about how much you drink. See talking to your doctor.

If you are drinking heavily every day, do not stop suddenly without medical advice. Stopping abruptly after heavy daily drinking can be dangerous.

If alcohol, low mood or thoughts of harming yourself feel out of control, please reach out now. See crisis lines.