When a panic attack hits, you just want it to stop. And drugs or alcohol may seem like an easy way to quiet this internal alarm. But as time goes on, substance use can actually make anxiety and panic attacks worse.
Why Drugs and Alcohol Make Panic Attacks Worse
Substances such as alcohol and benzodiazepines temporarily slow down your nervous system, which can calm anxiety for a few hours.
Key Takeaway
What It Means
Substances can worsen panic attacks over time
Although alcohol and certain drugs may temporarily reduce anxiety, they often trigger rebound anxiety that increases the frequency and intensity of panic attacks.
Panic attacks are temporary
Most panic attacks peak within about 10 minutes and gradually subside, even though they may feel overwhelming while they are happening.
Breathing and grounding techniques work
Slow breathing, grounding exercises, and staying present help calm the nervous system without relying on substances.
Avoid escaping the panic
Remaining in the situation when it's safe teaches your brain that panic is uncomfortable but not dangerous, reducing future fear.
Long-term recovery requires treatment
Therapy, healthy lifestyle changes, and dual diagnosis treatment can address both panic attacks and substance use for lasting recovery.
Yet, as the substance wears off, your nervous system rebounds, often swinging into a state that’s more anxious than before. Your sleep may also get disrupted, your body’s stress response gets more sensitive, and the very alarm you were trying to silence starts going off more loudly and frequently.
As time goes on, a cycle emerges; panic leads to using, using leads to rebound anxiety, and rebound anxiety leads to more panic. But with the right support, this cycle can be broken.
How to Calm a Panic Attack in the Moment
While substance use tends to numb anxious thoughts and feelings, the following techniques work to calm your nervous system directly:
Slow your breathing: Panic speeds up your breath, and fast breathing feeds panic. Try breathing in gently for a count of four, then out slowly for a count of six. Long, slow exhales send a direct signal to your body that you’re safe.
Ground yourself with your senses: Look around and name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This pulls your attention into the present moment and the environment around you.
Name what’s happening: Say to yourself: “This is a panic attack. It’s uncomfortable, but it isn’t dangerous, and it will pass.” Panic thrives on the fear that something terrible is happening. Naming it takes away some of its power.
Try not to fight it or flee: Running from a panic attack teaches your brain that it really was dangerous, which makes the next one more likely. If you can, stay where you are and let the wave move through you. Riding it out teaches your brain the opposite lesson.
Cool down physically: Splash cold water on your face, hold something cold in your hands, or step outside for fresh air. Cold sensations can help reset your nervous system.
Topic
Key Information
Why Drugs and Alcohol Make Panic Attacks Worse
Alcohol and benzodiazepines may temporarily calm the nervous system, but as they wear off, the body often experiences rebound anxiety. This rebound can increase stress sensitivity, disrupt sleep, and make panic attacks occur more frequently.
The Panic Cycle
Panic leads to substance use, substance use leads to rebound anxiety, and rebound anxiety increases the likelihood of future panic attacks. With proper treatment and support, this cycle can be broken.
Slow Your Breathing
Breathe in gently for four seconds and exhale slowly for six seconds. Longer exhales help signal safety to your nervous system and reduce panic symptoms.
Ground Yourself
Use the 5-4-3-2-1 grounding technique by identifying five things you see, four you can touch, three you hear, two you smell, and one you taste to bring attention back to the present.
Name What's Happening
Remind yourself, “This is a panic attack. It's uncomfortable, but it isn't dangerous, and it will pass.” Labeling the experience can reduce fear and lessen its intensity.
Avoid Fighting or Escaping
If possible, remain where you are and allow the panic attack to pass naturally. Staying teaches your brain that the situation is not actually dangerous.
Cool Your Body
Splash cold water on your face, hold something cold, or step outside for fresh air. Cooling sensations may help calm your nervous system.
How Long Panic Attacks Last
Most panic attacks peak within about 10 minutes. Although they may feel overwhelming, they are temporary and will pass.
Cognitive Behavioral Therapy (CBT)
CBT is the most well-researched therapy for panic attacks. It helps challenge catastrophic thinking and gradually reduces fear of avoided situations.
Healthy Lifestyle Habits
Regular exercise, quality sleep, and limiting caffeine and nicotine may reduce overall anxiety and lower the risk of panic attacks.
Practice Relaxation Regularly
Consistent practice of slow breathing, meditation, and progressive muscle relaxation makes these techniques easier to use during a panic attack.
Build a Support System
Talk with trusted friends or family about how they can help during a panic attack, and consider joining a support group for additional encouragement.
Dual Diagnosis Treatment
When panic attacks and substance use occur together, treating both conditions simultaneously through dual diagnosis care can improve long-term recovery outcomes.
Panic attacks typically peak within about ten minutes. It may feel endless in the moment, but your body simply cannot sustain that level of alarm for long. It is temporary, and it will pass.
Long-Term Ways to Reduce Panic Attacks
Reducing panic attacks in the long-term usually requires working with a professional, as well as adjusting certain lifestyle habits. Strategies that may help include:
Therapy, especially cognitive behavioral therapy (CBT):CBT is the most well-researched approach for panic. It helps you untangle the catastrophic thoughts that fuel attacks and slowly rebuild confidence in situations you’ve been avoiding.
Building daily habits that support your nervous system: This may involve regular exercise, consistent sleep, and limiting caffeine and nicotine, which may help reduce your baseline anxiety.
Practicing relaxation and grounding techniques: Try slow breathing, meditation, and muscle relaxation. These are better to practice regularly. Then, in the midst of a panic attack, they can be easier to implement.
Building your support system: Tell those you trust what may help you during a panic attack. It may also be beneficial to turn to a support group, which may help you feel less alone.
If panic and substance use, however, have become tangled together, treating only one of them usually isn’t enough. At Freedom Recovery Centers (FRC), this is why we incorporate dual diagnosis treatment as part of our rehab process. Recovery and relief from panic attacks are possible. When you’re ready, our team is here to answer your call at 804-635-3746.
Frequently Asked Question
Answer
Can alcohol make panic attacks worse?
Yes. While alcohol may temporarily reduce anxiety, it often causes rebound anxiety as it leaves your system, increasing the likelihood of future panic attacks.
Why do panic attacks return after using drugs or alcohol?
Many substances temporarily suppress the nervous system. As their effects wear off, the nervous system can become more reactive, leading to increased anxiety and panic symptoms.
How long does a panic attack usually last?
Most panic attacks reach their peak within about 10 minutes and gradually improve, although some lingering symptoms may persist afterward.
What should I do during a panic attack?
Focus on slow breathing, grounding yourself with your senses, reminding yourself that the panic will pass, and avoiding the urge to flee if you're in a safe place.
Is cognitive behavioral therapy (CBT) effective for panic attacks?
Yes. CBT is considered one of the most effective, evidence-based treatments for panic disorder because it helps change fearful thought patterns and avoidance behaviors.
Can lifestyle changes reduce panic attacks?
Yes. Regular exercise, consistent sleep, reducing caffeine and nicotine, and practicing relaxation techniques may lower overall anxiety and decrease panic attacks.
What is dual diagnosis treatment?
Dual diagnosis treatment addresses both substance use disorders and mental health conditions, such as panic disorder, at the same time to improve recovery outcomes.
When should I seek professional help for panic attacks?
If panic attacks become frequent, interfere with daily life, or are linked to alcohol or drug use, seeking professional evaluation and treatment is recommended.
Reviewed
Medically and professionally reviewed by Freedom Recovery Center
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