Hope in a Bottle: The Link Between Alcohol and Social Anxiety

Liquid courage. Survival juice. Awesome water. For the socially anxious among us, alcohol has many names and, surprisingly, just as many functions. If social anxiety and alcohol updated their relationship status, it would definitely be “It’s Complicated.”

It’s not just a way to feel less inhibited (Hey, whiskey says I can dance!) or less awkward (Must. Grip. Beer bottle. For dear life). While the science of the complex relationship between social anxiety and alcohol is still emerging, at least four types of socially anxious drinkers have been theorized:

The Pre-Gamer

Nia, 50, is an administrative assistant with a wide smile. She can handle pretty much anything as “office manager Nia,” but if she has to show up somewhere, like a party or a fundraiser, as “just plain Nia,” she needs a drink or two to steady her nerves. “It’s cliché,” she says, rolling her eyes at herself, “but it really does take the edge off.” Nia wouldn’t be caught dead with an actual flask, but she’s been known to fill an empty water bottle with a couple of shots of vodka and stow it in her purse. When she gets to an event, she’ll park her car, slug it down, and wait a few minutes. “It works right when I need it,” she says, “arrival and settling in.”

The After-Drinker

Mateo is a 41-year-old pulmonary researcher, who loves running experiments in the lab but dreads giving presentations, going to conferences, and networking—all inescapable parts of his job. He always feels awkward at events and tries his best, as he says, “to act like a normal human being.” Afterwards, he can’t help but replay interactions in his head, focusing on jokes that fell flat or the things he wishes he had said or done differently. “I dwell,” he simply says. Mateo doesn’t drink much or at all at events, but when he gets home, he’ll open beer after beer, trying to drown out his own ruminating. “Basically, I drink when I’m kicking myself,” he says.

The Supersized Social Drinker

David is 35 and manages a local distribution center. He’s not much of a drinker, except on the rare occasions when his friends manage to drag him out. Inevitably, he ends up drinking way more than he knows is good for him. “My friends say I’m a unicorn: I’m both a lightweight and a party animal,” he says. “I probably wouldn’t have a social life at all if not for Jack and Cokes. I know that’s lame, but if there’s no booze, I don’t go. If I can’t drink, I can’t be social.”

But not everyone with social anxiety uses alcohol to manage feeling judged. Sometimes, our social anxiety makes us so afraid we’ll be judged that we don’t trust ourselves to drink at all.

The Almost-Abstainer

Karla is a 25-year-old student going for her master’s degree in education. Typically, she doesn’t drink any alcohol. “I wouldn’t want to do anything stupid,” she says. “I’m just afraid I’d end up all staggerific.” At parties or weddings, she says, “I’ll walk around with a drink, but it’s mostly a prop.” If she’s feeling really safe or really daring, “I might sip it, but I can make one drink last for hours. I used to not drink at all—I didn’t touch a drop until I was 22 and almost done with college.” And now? “I still only drink light stuff—wine spritzers, stuff like that. I don’t like the idea of losing control and saying or doing something I’ll regret.”

A 2013 meta-analysis found that individuals with higher social anxiety consume less overall alcohol than folks who don’t get as anxious. But the socially anxious drinkers still have higher levels of hazardous drinking and more of what the researchers called “alcohol-related negative consequences,” like missing work, getting injured, or having unwanted sexual experiences. It’s counterintuitive, but it makes sense: socially anxious souls often avoid social situations, like parties or get-togethers, and therefore drink less in general. But when they’re forced to go, like David, they may drink relatively more in an attempt to “self-medicate.” Since they have lower tolerance and less practice pacing themselves, they reach hazardous levels of inebriation (and regrettable decisions) more quickly.

If you’re one of the seven in 10 Americans who’ve had a drink in the past year, to paraphrase the great philosopher Homer Simpson, alcohol could be not only the solution to but the cause of your social anxiety problems.

Why both? On the one hand, alcohol “works,” at least in the short term. A 2015 study found that for every drink, social anxiety declines by 4%. It’s an easy way to magically feel more fabulous. Two glasses of pinot for an 8% reduction of feeling like a fool? Sign me up.

But over the long term, it can be a different story. First, while drinking may take away social anxiety, over time, many people may start to drink in response to social anxiety. Indeed, a 2008 study found that in individuals with both social anxiety and a problem with alcohol, the social anxiety almost always comes first.

Second, folks with social anxiety are more likely to drink alone to drown out negative emotion, like Mateo ruminating into his beer after a conference.

Finally, we learn to associate alcohol and confidence, like Nia did. We listen when vodka over-promises: “I alone can make you a good conversationalist!”

Any way you slice it, capital-S Social Anxiety Disorder more than quadruples the risk of developing an alcohol use disorder.

With results like that, why do we keep looking for hope in the bottle? A hallmark of social anxiety is a perceived gap between standards and ability: we simultaneously expect sky-high social skills from ourselves (There must never be silence in conversation, or I must always have something interesting to say) and think we are too hopelessly awkward, weird, or inept ever to reach those standards. Alcohol artificially closes the gap. We become less inhibited and miraculously wonderful at conversation, but we don’t realize we had those skills all along and were just too inhibited to use them. Alcohol steals the credit and becomes like Dumbo’s magic feather: take it away, and we think we can’t fly.

A solution? Tackle the root of the problem: a good therapist can work with the social anxiety and help you realize that all that mind-reading, monitoring, and social recalibration you do actually means you already have excellent social skills and that you just need some practice without the training wheels of booze. Therapy can help you tone down your sky-high standards, tame that critical inner voice, and help you practice tuning in to conversation rather than letting your internal dialogue drown it out.

If face-to-face therapy isn’t your speed, don’t despair. Established online options include Joyable to tackle social anxiety or Headspace to amp up your mindfulness. Or go old-school with a book (like the Shyness and Social Anxiety Workbook or Managing Social Anxiety) that will help you tackle your fears.

In short, instead of giving all the credit to liquid courage, you can nurture your own courage. And that’s better than any awesome water.

Ellen Hendriksen, PhD, is the host of the Savvy Psychologist podcast.