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Alcohol and Anxiety: Why the Next Day Is Worse

Alcohol reduces anxiety for a few hours and raises it afterwards. That sequence is the whole mechanism, and it is what makes the habit self-sustaining.

5 min read

Pop-art illustration of a person resting their head on their arms on a table, beside two glasses of water.

Key takeaways

  • The relief and the rebound are the same event. Alcohol reduces anxiety while it is present and raises it as it leaves, which is the sequence that makes drinking for anxiety self-reinforcing.
  • A major review described exactly that shape: an initial anxiety-reducing effect followed by an anxiety-increasing one, which then prompts more drinking for the relief.
  • The relationship runs both ways. That review concluded anxiety disorders and alcohol use disorders each appear able to cause the other, rather than one simply being downstream.
  • Sleep is the underrated part. Alcohol consolidates the first half of the night and disrupts the second, and a short, fragmented night raises anxiety on its own.
  • The practical test is a fortnight without it. The rebound is short-lived, so two or three weeks is usually enough to tell whether the drinking was treating the anxiety or producing it.

Alcohol reduces anxiety while it is in your system and raises it as it leaves. Those are not two separate facts about drinking; they are one event with two halves, and the second half is what makes the first half a problem.

Understanding that sequence is what turns a mystifying experience into a predictable one.

The loop, as the research describes it

A major review of the relationship between anxiety disorders and alcohol use disorders described a feed-forward cycle: the initial anxiety-reducing effect of alcohol is followed by an anxiety-increasing one, which then promotes further drinking for the anxiety-reducing effect. [kushner-2000-anxiety-alcohol]

That is a closed loop, and every step of it feels reasonable from inside.

  1. Anxiety is uncomfortable.
  2. A drink reliably reduces it, within minutes.
  3. Some hours later, anxiety returns higher than it started.
  4. The obvious remedy is the thing that worked before.

The review’s broader conclusion is that anxiety disorders and alcohol use disorders each appear able to serve as a cause of the other, which is why “which came first” tends to be a less useful question than people expect. [kushner-2000-anxiety-alcohol]

What anxiety does across the drinking and the day after Illustrative
0 25 50 75 100 Anxiety level 55 Before the first drink 22 During 88 Waking the next day 62 That afternoon 54 Two days later

A schematic of the anxiolytic then anxiogenic sequence described in the review cited. The shape is what the research describes; the values are illustrative.

The bar that causes the trouble is the third. Anxiety on the morning after is higher than the baseline it was meant to treat, which is why the drinking can slowly increase without any decision ever being taken.

Sleep is the part nobody counts

There is a second mechanism, and it is easier to act on.

Research on alcohol and normal sleep found that at all doses it shortens the time taken to fall asleep and consolidates the first half of the night, while increasing disruption in the second half. It also delays the first REM period at all doses and reduces total REM at moderate and high doses. [ebrahim-2013-alcohol-anx]

So a drink genuinely does help you fall asleep, and it degrades the half of the night that was doing the recovery. Wake at three, sleep badly until six, and the next day starts with a sleep debt, which raises anxiety independently of anything alcohol is doing chemically.

Our guide to waking at 3am covers that pattern in more detail, and alcohol is the most commonly missed cause of it.

Why it is hard to see from inside

The relief is immediate and the cost is delayed. Anything with that structure is difficult to evaluate honestly, because the two halves never present themselves together.

The next day gets attributed elsewhere. Morning-after anxiety rarely arrives labelled. It attaches to whatever is available: work, a conversation from the night before, a decision you are worrying about. Believing it is about your life is more compelling than believing it is about a chemical.

And it works. This is the part that gets skipped in advice about drinking. It does what it is being used for, quickly and reliably, which is exactly why the habit is durable.

What is the drink doing?

Tick anything true. This is a reflection prompt rather than a test, and it produces no diagnosis.

0 of 8 ticked

The free anxiety screener uses the GAD-7 and asks about the past two weeks. Worth doing after a stretch without drinking rather than the morning after, or it will measure the rebound rather than your baseline.

What to do

Run the fortnight. Two to three weeks without alcohol is the single most informative thing available, and it answers a question no amount of reading can. Either most of the anxiety lifts, which tells you what was producing it, or it does not, which tells you the thing to treat was never the drinking.

Do not stop abruptly if you drink heavily every day. Withdrawal in that situation can be medically dangerous and needs a doctor rather than a resolution.

Expect the first few days to be worse. The rebound is doing what it does, and the timing invites the conclusion that stopping was a mistake.

Separate the sleep from the chemistry. If the drink is being used to get to sleep, that is a specific problem with a specific treatment, and alcohol is a poor one.

Treat the anxiety directly. Cognitive behavioural therapy is the recommended psychological treatment for generalised anxiety and panic. [nice-cg113-alcohol] If drinking has been managing the anxiety, removing it without putting anything in its place is a harder plan than it needs to be.

Our guides to dealing with anxiety and breathing exercises cover alternatives that work in the moment, and our guide to habit and addiction covers where the line between them actually sits.

When to seek help

See a doctor if you are drinking to manage anxiety most days, if you have tried to cut down and not managed it, if you drink in the morning or feel shaky without a drink, or if anxiety persists on days you have not been drinking.

Do not stop suddenly on your own if you are drinking heavily every day. Ask for advice first, because withdrawal can be dangerous and there is a safe way to do it.

Ask about talking therapy for the anxiety and about local alcohol services separately, since the two are often run by different teams and many alcohol services accept a referral you make yourself.

Go urgently if you have thoughts of harming yourself.

How MyFreud can help

The pattern here is a day apart, which is precisely the gap memory does not bridge: nobody connects Thursday morning to Wednesday evening without a record. MyFreud gives you daily mood tracking that takes seconds, so the relationship between the two becomes something you can look at rather than something you have to believe.

Download MyFreud and start today: App Store or Google Play.

Frequently asked questions

Why do I feel so anxious the day after drinking?

Because the effect reverses. Alcohol dampens anxiety while it is in your system, and as it clears, the balance swings the other way for a period. Add a fragmented second half of the night, dehydration and a cortisol rise timed to the morning, and the result is a few hours of raised anxiety that feels disproportionate to the amount you drank. It is a rebound rather than a revelation about your life, which is worth knowing at the point you are inclined to believe otherwise.

Does alcohol cause anxiety or does anxiety cause drinking?

Both, according to the evidence. A major review of the relationship concluded that anxiety disorders and alcohol use disorders each appear capable of initiating the other, especially where alcohol dependence rather than alcohol misuse alone is involved. That is why the question is less useful than it looks. Whichever came first, the sequence running now is the same: relief for hours, rebound afterwards, and more drinking to address the rebound.

Is a drink to take the edge off actually harmful?

Occasionally, no. The risk is specifically in using it routinely to manage anxiety, because that is the pattern the research identifies as raising the risk of developing a problem. The distinction is not the amount but the function: whether the drink is enjoyment or medication. If skipping it makes an evening feel unmanageable rather than less fun, it has become the second thing.

Will cutting out alcohol reduce my anxiety?

For many people it helps, and a fortnight is usually enough to find out. Because the rebound is short-lived, two to three weeks without drinking separates baseline anxiety from the part the alcohol was producing. Some people find most of it lifts, which answers the question. Others find the underlying anxiety is still there, which is also useful, because it means the thing to treat was never the drinking.

References

  1. 1.Kushner MG, Abrams K, Borchardt C ( 2000). The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. Clinical Psychology Review, 20(2), 149-171. doi:10.1016/S0272-7358(99)00027-6
  2. 2.Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB ( 2013). Alcohol and sleep I: effects on normal sleep. Alcoholism: Clinical and Experimental Research, 37(4), 539-549. doi:10.1111/acer.12006
  3. 3.National Institute for Health and Care Excellence ( 2011). Generalised anxiety disorder and panic disorder in adults: management (CG113). NICE. nice.org.uk .

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