Panic Attacks and Extreme Anxiety After Quitting Drinking Alcohol

When you entered recovery, you may not have been prepared for some of the discomforts that can occur in sobriety. One of these is anxiety, which can take you by surprise. If you are asking, “Why do I get extreme anxiety after quitting alcohol,” you are not alone. Read on to gain a better understanding of this common occurrence.

What to Expect in Alcohol Detox and Withdrawal

First, let’s look at what happens in the brain and body when you are going through detox. The symptoms associated with alcohol detox arise as the brain responds to the absence of the alcohol. This happens because the brain and central nervous system had become used to the daily presence of alcohol. 

When alcohol intake is abruptly halted, over-excitability results, causing withdrawal symptoms. These are the signs of the body attempting to reset itself or to achieve a state of balance again. To get to that point, the body needs to purge the toxins and stabilize, and that takes about a week.

A typical alcohol detox has three distinct stages. The first stage happens in the first day or two and includes symptoms like sweating, irritability, headache, nausea, and vomiting.

The second stage is when symptoms are at their peak discomfort. Symptoms include insomnia, tremors or shaking, confusion, agitation, increased heart rate, increase in blood pressure, and seizures. This is also the stage when an unpredictable event called delirium tremens can occur, which can be very serious.

The final stage of detox is when you see the symptoms begin to subside. However, it is common for post-acute withdrawal syndrome (PAWS) to cause some lingering symptoms. One of these symptoms is anxiety.

What is PAWS?

Post-Acute Withdrawal Syndrome (PAWS) is a cluster of symptoms, both physical and psychological, that persist after the detox has been completed. PAWS is more apt to emerge in those who have a long history of alcoholism. This happens because many of their body systems have been highly impacted due to chronic excess drinking. What results is a prolonged period of certain withdrawal symptoms.

PAWS should be closely watched, as it can pose a threat to recovery. If the symptoms, such as extreme anxiety, become too unbearable it can cause a relapse. Returning to drinking is the only way they know to find relief from the PAWS symptoms. This is one of the reasons why a longer stay in rehab is wise, to have support during PAWS.

Reasons Why You Get Severe Anxiety After Quitting Alcohol

To better understand why you get severe anxiety after you quit drinking, it helps to know the causes of PAWS. Not all will experience PAWS anxiety, but for those who do, here are some of the things that trigger it:

• Changes in brain chemistry. Alcohol dependency and addiction cause significant changes to occur in the brain anatomy and brain chemistry. The flood of dopamine following alcohol use causes the brain to stop making its own supply of dopamine and endorphins.
• Stress response. Both the central nervous system and the peripheral nervous system are impacted by alcohol use disorder. Activation of the sympathetic nervous system is heightened, which triggers the fight or flight response. PAWS sometimes triggers a chronic stress response, making it hard in early recovery to manage even normal amounts of stress.
• Loss of coping tool. Getting sober means you no longer have access to the coping tool—alcohol—that had been used to manage anxiety. For some people, the use of alcohol to cope with stress and anxiety is the reason they developed alcoholism. Once sober, the pre-existing anxiety can reemerge.

How to Manage Anxiety in Early Recovery

Many of the tools that can be highly effective in reducing anxiety in recovery were introduced in treatment. These can be accessed in an outpatient program as part of a continuing care strategy:

• CBT. When alcohol was used as a means of self-medicating anxiety, CBT can help identify unhealthy thoughts and behavior patterns. The CBT therapist helps you control anxiety by shifting these thought distortions toward positive affirming thoughts.
• Group therapy. Lots of people in recovery experience anxiety. Sharing your personal struggles with others who can relate, it helps build confidence. A skilled therapist will guide the group with exercises to practice that help manage the anxiety or stress response.
• Daily exercise. One of the most effective ways to manage anxiety in recovery is to make physical activity part of your routine. Exercise is a natural stress reducer. This is due to the chemicals that are produced when you exert yourself in physical activity.
• Holistic therapies. Holistic methods play a central role in managing anxiety. These are activities that cause the body and mind to relax and calm down. These include deep breathing techniques, yoga, meditation, journaling, and massage.

The Importance of Continuing Care in Recovery

Continuing care is essential in early recovery, whether you suffer from extreme anxiety or not. These are the actions you take to help buttress your sobriety, even when dealing with stress or anxiety. They include:

1. Building a strong support network. There are going to be things that occur that may threaten your recovery. To help weather these, it is crucial to have a strong support base. Ask someone to be your sponsor, attend 12-step meetings often, and have a trusted friend you can talk to.
2. Sober living. Not everyone is headed home to a safe, supportive environment. Sober living provides an alcohol-free living space that is also shared with others who are committed to sobriety.
3. Outpatient therapy. If you are struggling with PAWS anxiety, or pre-existing anxiety, a therapist can be very helpful. A weekly session gives you a supportive place to discuss your anxiety, and also learn techniques to manage it.

Elevate Wellness Center Treatment for Alcohol Use Disorder 

Elevate Wellness Center is a residential treatment program that treats alcohol use disorder and co-occurring anxiety disorder. If you are asking, “Why do I get extreme anxiety after quitting alcohol?” we can help you. Please reach out to our team at (855) 778-8668.