3 Substances you may not realise are making your anxiety worse
When clients first come to me for therapy, they often report being overwhelmed by anxiety despite their efforts to manage it. Anxiety is stopping them from doing things they really want to do and they are trying their best to manage it through methods like self-care and mindfulness but they are still consumed by anxiety and panic.
However, there are often subtle yet significant factors exacerbating their anxiety that they are not aware of. Three of the most common culprits are alcohol, caffeine, and recreational drugs such as cannabis and cocaine. It might surprise you, but alcohol and caffeine are both psychoactive drugs and can impact your anxiety levels even with moderate use.
Anxiety/ stress response journal
To help identify anxiety patterns, I’ll often suggest clients keep an anxiety or stress response journal for two weeks. This doesn’t have to be fancy or complicated, it is just a note of times you noticed your anxiety or stress levels increasing. Just make a note of the time of day, what was happening and your symptoms. For example
Time
8.30a.m.
Event
Running late to get the kids to school and to get to work.
Symptoms
Heart racing, sweating, anger
If you like, you could also keep track of what you’re consuming e.g. meals, alcohol, caffeine, other drugs and how much sleep you got. But in my experience it's not completely necessary as you will usually know your routine yourself and see the patterns emerge.
Alcohol
The one thing that consistently shows up in these journals is that clients notice more anxiety symptoms in the days after drinking alcohol. It's very common to see a pattern along the lines of:
Saturday
Met up with friends, felt a bit awkward so had a few drinks to be able to be more social.
Sunday
No hangover, but felt on edge all day. Had a drink with dinner to relax.
Monday
Working, felt awful all morning, eventually had a panic attack before a meeting, skipped it and left early. Anxious about my manager's reaction to me missing the meeting.
The rest of the week they may not drink at all, and usually will still feel anxious but their anxiety is not as high as it was on Monday.
They aren’t drinking excessively (maybe 1-4 drinks on a weekend evening) and it usually hasn’t even registered with them that there is a link between alcohol and their anxiety symptoms. However, when we look at the diary we can see there is a spike in anxiety in the days after drinking alcohol.
While alcohol makes us feel more relaxed and uninhibited, as it leaves our system it can have the opposite effect, making us more anxious. Sometimes we call this ‘the fear’ or ‘hangxiety’ but what I’ve seen is that you don’t need to have had enough to drink to cause a hangover for alcohol to increase your anxiety levels. Even a couple of drinks can have a detrimental effect.
Stopping drinking for a few weeks, alongside regular therapy sessions and their other self-care practices e.g. yoga/ mindfulness will often be enough to reduce anxiety to a much more manageable level.
While there is a link between long-term alcohol abuse and anxiety, that is a different problem. This is a more short-term issue and usually people can begin to drink moderately again once they have learned more ways to manage their anxiety.
Recreational drugs
Other recreational drugs, such as cannabis and cocaine are not as commonly or openly consumed in Ireland as alcohol but they are increasingly popular. In my experience, clients are often more aware of the possibility of a link between their anxiety and drugs other than alcohol.
However, this really depends on how normalised these drugs are in your social circle. If using cannabis is an everyday occurrence, clients may not realise how much it is impacting on their anxiety.
The pattern will be very similar to alcohol, using the drug to reduce anxiety in the short term and then noticing higher anxiety due to the withdrawal effect in the following days.
Again, this is different to an addiction and people may be able to temporarily cut back using these drugs until their anxiety is better managed through therapy, self-care etc.
Caffeine
Coffee, tea, soft drinks can all contain caffeine and most people consume at least one of these every day. These drinks are the most likely to be missed in anxiety tracking because they are so normalised my clients don’t even think to write them down.
However, the side effects of caffeine consumption are extremely similar to the symptoms of anxiety - heart racing, palms sweating, difficulty sleeping. What can happen is if you are prone to anxiety, you confuse the side effects of caffeine with anxiety symptoms thus becoming more anxious and the vicious cycle continues!
From working with anxious clients, I’ve noticed caffeine tolerance varies hugely, varying between one cup of tea causing panic attacks to reducing anxiety slightly by cutting back to two espressos a day.
Again, cutting back or cutting out caffeine can really help clients manage their anxiety and it's something I often recommend people try out to see if it helps reduce anxiety symptoms.
Anxiety and therapy
In my experience, none of these things will be enough on their own to cause anxiety and cutting out these substances won’t completely get rid of your anxiety. However, cutting out or cutting back can reduce anxiety to the point that you feel more able to engage in therapy.
When dealing with anxiety this is so important, I always say there is no point trying to do deep work as to the causes of anxiety if you are so anxious that you’re not even able to leave the house to get to your therapy session. We have to try and manage your anxiety symptoms first before addressing the causes.
That’s why I initially focus on making change to reduce anxiety somewhat, so that we can then explore root causes of anxiety and work on reducing it further in the long-term.
If you’re experiencing anxiety, panic attacks or stress and want to see if psychotherapy could help, please do get in touch for a consultation call.
