Month: November 2020

If you feel anxious after cutting out alcohol, that’s incredibly common, and even to be expected. Before we dive into the scientific reasons behind why anxiety is common in early sobriety, know that your anxiety can be addressed and managed without alcohol, and that you’re not alone. 

In summary, there are two key reasons you may be feeling especially anxious when you stop drinking: 

1. You might have already had baseline anxiety. You may have been using alcohol to manage existing anxiety because you didn’t have the tools in your toolkit to address it in healthier ways. 
2. Your brain is in recovery mode. Long-term alcohol use affects your brain’s ability to regulate emotions without it, and when you stop drinking, it takes time for your brain to re-learn how to function without alcohol.
   

Using Alcohol To Cope with Anxiety

Alcohol is an anxiolytic, or an anxiety (anxio-) stopper (-lytic). And it’s effective. While it’s not a healthy coping mechanism, alcohol does soothe anxiety in the short term. However, your mind and body ultimately pay the price. As Monument’s medical advisor James Besante, MD, shares, “Many times people are self-medicating to treat baseline anxiety with alcohol. For some people that’s the best tool they have in their toolbelt. I never fault my patients for using alcohol to treat anxiety because anxiety can be debilitating.” 

However, to live your healthiest and fullest life, Dr. Besante recommends finding alternate coping mechanisms. When getting sober, you might have to confront the reasons you started drinking. Anxiety in early recovery is often baseline anxiety that existed before developing unhealthy drinking habits and getting sober. When removing alcohol as our coping mechanism, it’s important to get a new anxiety-management tool in the toolbelt to replace it.

While it will be uncomfortable, sitting with those anxious feelings is a big part of growth in your journey. And with time and support, they can be managed.

Why Does Quitting Alcohol Make You Anxious?

In addition to the presence of baseline anxiety, there’s a physiological reason why quitting drinking can make you anxious at first. Here’s a helpful analogy: imagine the central nervous system as a highway. It’s constantly racing with electric signals that pass through our brain and throughout our body to do every function we need to survive. We also have a special neurotransmitter system that functions as ‘brakes’ to help slow down racing signals. Our body naturally balances our need to send these signals with the need to regulate them.

When we drink alcohol, we add more brakes to our highway. We feel more sedated, and have a harder time accomplishing tasks. With long-term alcohol use, our brain realizes that we’re turning the brakes up with alcohol, and starts turning down its natural brakes to stay in balance.  Over time, we lose our natural brakes and ability to moderate racing signals without drinking. This is a sign of physiological dependence on alcohol. 

When we stop drinking, we are left without any breaks — natural or alcohol-induced. So it is very common to feel those racing thoughts at full speed: restlessness, anxiety, panic, and more. That’s where the more intensified anxiety comes from. 

How Long Does Anxiety Last After You Quit Drinking?

The good news is, our brain can restore its natural brakes. For many, anxiety levels can improve within three weeks without drinking. For those experiencing post-acute withdrawal syndrome (or ‘PAWS’), it may take more time. This is because PAWS symptoms often include longer-lasting anxiety and irritability as the brain recovers from the negative effects of alcohol. You can check out the alcohol recovery timeline to learn more about acute and post-acute withdrawal symptoms. Regardless of your timeline, relief is within reach. Alcohol’s depressive qualities intensify anxiety and depression, and removing it from your life is shown to improve your mental wellbeing.  

If anxiety symptoms persist after several months sober, you may have an underlying anxiety condition. Working with a therapist is a great way to address co-occurring anxiety and develop healthier coping mechanisms. With time and support, anxiety can be mitigated.  

How to Manage Anxiety When You Stop Drinking

There are many tools you can use to help manage anxiety in early sobriety and beyond. These same tools can also be beneficial in managing alcohol cravings and persevering through setbacks. 

Practice mindfulness and meditation

Mindfulness describes the process of grounding yourself in the present moment and staying focused on what’s really true. Mindfulness can help you clarify your goals, reroute negative thoughts, and feel more at peace. Incorporating mindfulness into your day can also help reduce acute anxiety and prevent anxiety spikes in the future. Meditation is a popular mindfulness practice that helps you become aware of your thoughts and surroundings by sitting still and observing what occurs. Trying guided meditation is a great way to get started with mindfulness. 

Here are a few other ways you can practice mindfulness:

Reach out to a therapist

Working with a therapist is one of the best things you can do to manage anxiety. Therapy can help you identify your triggers, restructure negative thought patterns, and learn new coping skills through methods like motivational interviewing and cognitive behavior therapy (CBT). In therapy with Monument, you get matched with a therapist specialized in using these tools to help people change their relationship with alcohol and minimize anxiety simultaneously.

Explore stress-relieving activities

Finding hobbies and fun alcohol-free activities can be a great way to release anxious energy. These activities may involve other people, or can be self-care practices you do alone, such as taking a bath, practicing yoga, or reading. Even taking a light walk when you notice anxious thoughts can make a huge difference. The key is to find a calming activity that can help break the cycle of anxiety. 

Seek peer support

Trying to tackle anxiety alone can be … anxiety-inducing! Sharing our experience with trusted friends and family can help lessen the weight of anxious thoughts and strip them of their power. Talking with others who have similar experiences after quitting alcohol can also be a powerful resource. At Monument, you can join moderated alcohol support groups and get encouragement and tips from others. Many of these groups are focused specifically on managing anxiety while in recovery. 

Can Quitting Drinking Help My Anxiety?

While quitting alcohol can lead to increased anxiety in the short-term, it’s one of the best things you can do to help minimize anxiety in the long-term. When you stop drinking, you can say goodbye to hangxiety and shame about what you may have said or done when under the influence. Plus, without the influence of alcohol, you’re able to take actions as your truest self, which leads to an increased sense of confidence and self-worth. If you struggle with underlying anxiety, removing alcohol can help you focus on developing healthier and more effective strategies for coping. Overall, quitting or cutting back on drinking can have a tremendous positive impact on your mental health. 

The early days of sobriety can be very challenging, but you can get through them. With time and support, it will get easier. Your body will heal, and you will build healthier coping habits that diminish the importance of alcohol in your life. Join Monument today to get connected with an expert Care Team and encouraging community who will support you along your journey.

If you believe you might be experiencing acute alcohol withdrawal, please contact your healthcare  provider immediately and visit https://findtreatment.gov/ to find a location to get supervised detox near you. If this is a medical emergency, call 911.

Sources:

1. University of Pennsylvania. “Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, https://pubmed.ncbi.nlm.nih.gov/19634954/.” Accessed Nov 18, 2020. 
2. Brown University. “Cognitive-behavioral treatment with adult alcohol and illicit drug users: a meta-analysis of randomized controlled trials, https://pubmed.ncbi.nlm.nih.gov/19515291/.” Accessed Nov 18, 2020. 

If the thought of practicing gratitude feels perplexing, you are certainly not alone. Many of us grew up with traditions and customs focused on gratitude, especially during holiday celebrations. But what is gratitude? Is it an emotion? A habit? A virtue? Gratitude can be difficult to define, and even harder to commit to practicing regularly.

Cultural expectations may pressure us to be grateful for what we have, which can feel disingenuous at times. As a result, I tend to be cautious of those who preach gratitude. But despite my misgivings, I have found that taking time to actively reflect on what I am thankful for on a regular basis has been beneficial for my mental health and increased my capacity to endure challenges.

My gripes with gratitude

There is no shortage of wellness teachers telling us we could easily change our lives if our thoughts were just more positive! Our culture tends to reward the expression of happy emotions while penalizing the expression of anger, sadness, fear, and beyond. This idea is called toxic positivity and can be found in every facet of our lives, from work culture to social media to our relationship with drinking.

Gratitude can also be weaponized by those seeking to preserve the status quo. For example, if we bring a problem up at work, our boss might shame us for being ungrateful, dismiss us as being too negative, or tell us “it could be worse.” In cases such as these, portraying gratitude as a moral virtue can lead to feelings of inadequacy on our part, while allowing the other party to dismiss our concerns and avoid scrutiny.

Problems arise when we deny our true human experiences by minimizing the pain we are feeling. Forcing an outlook that “all is well” (when it may not be) can contribute to the negativity we were trying to avoid in the first place. This may be especially difficult when working toward changing your relationship with alcohol. Processing new and difficult emotions may not come easily if we limit our permissible emotions to happiness and gratitude. Personally, when I find the time to reflect, I try to honor anger, sadness, jealousy, or any other emotion that arises. Welcoming the entire spectrum of emotions often leaves me in a better place than if I had tried to suppress those feelings to focus only on the positive.

With these thoughts in mind, I believe we can still build a practice of gratitude that is attainable, nurturing, and suited to our individual needs.

My gratitude practice

I began playing around with the idea of practicing gratitude when I realized my habit of ruminating was clouding my memories. The day I spent outdoors in the sun was remembered as the day I got hangry and fought with my partner on the way home. The night spent catching up with friends was remembered by the moment I spilled my drink across the table. The otherwise rewarding day at work was remembered by the one patient who was angry I was running late and left in the middle of the visit.

I was hopeful that a gratitude practice would help me remember my reality more accurately, with less of a focus on the negative. Additionally, I knew that ruminating was a hallmark of depression and anxiety. So, I began writing down a few lines at the end of each day (or at least whenever I had the time and energy to do so), trying to include both negative and positive things that had happened during that day. Over time I started to see changes in my thinking. The day was less likely to be thrown off by one or two inevitably negative moments. I began to feel more appreciative of the things most important to me, and better able to recognize when they were showing up in my life.

Despite my skepticism that gratitude is a panacea for all of life’s problems, I do believe that gratitude has been a useful tool in my collection of self-care practices. It has helped me guard myself against feelings of inadequacy, of not being enough, and of not having enough (even amidst the stream of materialistic messages inundating us constantly).

Benefits of and strategies for a gratitude practice

Studies have shown that practicing gratitude in its different forms can reduce stress, decrease depressive symptoms, and help us do better academically and professionally. Other studies have shown it may boost our immune system and improve pain and sleep scores. Practicing gratitude may even change the activity of the brain long-term. One study where individuals wrote gratitude letters showed that three months later, participants had greater neural modulation in the medial prefrontal cortex.

Many quick and simple ways of practicing gratitude have been studied, the most common being:

• Journaling about things for which to be grateful
• Thinking about someone for whom you are grateful
• Writing or sending a letter to someone for whom you are grateful
• Meditating on gratitude
• Writing down three things for which you were grateful at the end of the week
• Practicing saying “thank you” in a sincere way
• Writing thank-you notes

Most of these interventions can be done in a few minutes a day or a couple of times a week. I hope this inspires you to try or revisit a gratitude habit! And, if you’re sick of hearing about gratitude, I think that’s okay too. 🙂