What is alcohol induced anxiety disorder?
Most people realize that alcohol may lower anxiety at low doses, but do not realize that heavy alcohol consumption may induce prominent anxiety symptoms. Alcohol induced anxiety symptoms frequently include generalized anxiety symptoms, phobias and panic attacks. However, to establish this diagnosis, clinicians attempt to rule out general medical conditions or mental disorders that can mimic this disorder.
Alcohol induced anxiety disorders can possibly develop during intoxication or withdrawal from alcohol. The duration and intensity however, is typically worse than the anxiety observed during the normal or primary course of these conditions. A sign of alcohol induced anxiety is that there is usually the onset of drinking prior to the anxiety syndrome as well as improvement and remission from anxiety during periods of abstinence. You can monitor the course of the symptoms for a period of time after alcohol cessation to determine the nature of the disorder. A substantial improvement of anxiety will be observed during this period, usually suggesting a direct relationship of anxiety to alcohol. Full remission of symptoms are frequently not observed until at least three to four weeks after abstinence.
Alcohol Induced Sleep Disorder:
Heavy alcohol use is frequently associated with sleep disturbances. At intoxicating blood-alcohol levels and especially when the blood-alcohol levels are declining, sedation and sleepiness may be observed. Intoxication from alcohol induces an increase in non-rapid eye movement sleep (NREM), while decreasing rapid eye movement (REM) sleep. Subsequently, there is an increase in wakefulness, restless sleep, nightmares and vivid dreams related to a reduction in non-rapid eye movement sleep and a rebound in rapid eye movement sleep density. Often times during alcohol withdrawal, sleep is intermittent and fragmented with an increase in rapid eye movement (REM) sleep. After withdrawal, individuals frequently complain of sleep difficulties and often experience superficial and fragmented sleep for a significant period of time, often for months or years at a time.
Primary sleep disorders can be distinguished from alcohol induced sleep disorders in that the onset of drinking precedes the sleep disturbance and remission may occur during a course of sustained abstinence. Alcohol induced sleep disorders can occur during the course of a typical alcohol intoxication or period of withdrawal. The duration and severity of the sleep disturbance may exceed however, those typically observed during these conditions. Because of the fact that protracted alcohol induced symptoms are frequent among alcoholics, onset of alcohol induced sleep disorder may occur up to four weeks after initiation of alcohol abstinence. A history of a previous sleep disorder and/or persistence of sleep disturbances for more than four weeks following intoxication or acute withdrawal are highly suggestive of a primary sleep disorder. Proper diagnosis is frequently complicated by the fact that heavy alcohol consumption can co-occur and increase other mental disorders that present with sleep disturbances. Drinking alcohol is also known to intensify other sleep problems such as narcolepsy or breathing related sleep disorders.
Can alcohol induce sexual dysfunction?
While alcohol in small doses appears to enhance sexual receptivity in women and often increases arousal to erotic stimuli in men, consistent heavy consumption may cause significant sexual impairment. Alcohol-induced sexual dysfunction is usually characterized by impaired desire, impaired arousal, impaired orgasm, or sexual pain. This dysfunction frequently results in marked distress and/or interpersonal conflicts. These impairments frequently begin during alcohol intoxication, although the duration of symptoms may exceed the current course of alcohol intoxication. Symptoms often subside after a period of three to four weeks of alcohol abstinence. If symptoms persist beyond this period of time, it may suggest a primary sexual dysfunction or a sexual dysfunction due to the medical complications of alcoholism. The onset of recurrent sexual dysfunction prior to the onset of alcohol abuse also may suggest a primary sexual disorder. Finally, other substances, particularly those prescribed for treatment of alcohol withdrawal such as benzodiazepines or barbiturates should also be ruled out as a primary cause of the sexual dysfunction.
By Paul Susic Ph.D. Licensed Psychologist (Health and Geriatric Psychologist)
Inspired by DSM-IV-TR Mental Disorders: Diagnosis, Etiology and Treatment by Michael B. First and Allan Tasman