Could That Panic Attack Be From What You’re Using? The Truth About Substance-Induced Anxiety

Have you ever felt your heart race, hands tremble, or breath shorten after drinking alcohol or using a drug? You might have thought it was just a bad reaction—but in some cases, it could be something more serious. This intense fear or anxiety linked to substance use is known as substance-induced anxiety disorder.

Substance-induced anxiety happens when certain drugs, alcohol, or medications change the way your brain works. This can lead to panic attacks, extreme worry, and other anxiety symptoms. These feelings can start while using the substance or during withdrawal. For some people, the anxiety goes away after the drug leaves the body. But for others, it can stick around and cause long-term distress.

This condition is not the same as having an anxiety disorder that developed on its own. The key difference lies in when and why the symptoms started. Understanding this link between substances and anxiety is important. It helps people get the right diagnosis and treatment—and gives them hope that things can get better.

So how exactly do drugs or alcohol hijack your peace of mind? And what can you do if this is happening to you or someone you care about? Let's take a closer look.

What Is Substance-Induced Anxiety Disorder?

According to studies, substance-induced anxiety disorder is a type of anxiety that starts because of drug or alcohol use—or when someone suddenly stops using them. It isn’t the same as having a regular anxiety disorder. The key difference is that the anxiety shows up only during or after using a substance, and not from an ongoing mental health condition.

For example, a person may feel panicked or extremely nervous after taking too much of a stimulant like cocaine or during alcohol withdrawal. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this condition must be clearly linked to the substance and not better explained by another disorder.

These symptoms can feel just as intense as any other anxiety disorder. But the good news is, they often improve after the substance wears off or once the withdrawal phase ends. Still, some people may need medical help, especially if the anxiety becomes overwhelming or lasts longer than expected.

Recognizing the timing and cause of the anxiety is key. This helps doctors know whether it’s truly substance-induced—and how to treat it the right way.

How It Happens: Causes and Risk Factors

Substance-induced anxiety starts when drugs or alcohol interfere with the brain’s natural chemistry. These changes can create intense feelings of fear, panic, or worry. Sometimes it happens while the substance is still in the body. Other times, it shows up during withdrawal.

Several factors can raise the risk of this condition:

• Genetics – A family history of anxiety or substance use can make someone more likely to develop this disorder.
• Trauma or stress – Past trauma, high-stress environments, or ongoing life challenges can increase vulnerability.
• Pre-existing mental health issues – People already diagnosed with depression, anxiety, or PTSD may be more likely to develop substance-induced anxiety.
• Type of substance used – Stimulants, alcohol, opioids, and certain medications each affect the brain differently and may trigger anxiety.
• Frequency and amount of use – Heavier or more frequent substance use leads to greater risk of anxiety symptoms.
• Sudden withdrawal – Stopping a drug or alcohol too quickly can shock the brain and trigger panic or fear.

Knowing these risk factors can help doctors and individuals spot early warning signs—and take steps to prevent long-term harm.

Substances Commonly Involved

Not all substances cause anxiety in the same way. Some trigger it while you’re high, while others bring it on during withdrawal. Understanding which substances are most likely to lead to anxiety or panic can help you recognize the source of your symptoms.

Here are some of the most common ones:

• Alcohol – Although alcohol may feel calming at first, it can cause anxiety once it wears off. People going through alcohol withdrawal often report panic, fear, and restlessness.
• Stimulants – Drugs like cocaine and meth can make your heart race and create feelings of paranoia, which can lead to full-blown panic attacks.
• Opioids – These painkillers can bring short-term relief, but anxiety often shows up during withdrawal.
• Benzodiazepines – These drugs are made to treat anxiety, but when taken in large doses or suddenly stopped, they can cause more anxiety than they prevent.
• Caffeine – High doses of caffeine can make some people feel jittery, nervous, or panicked.
• Hallucinogens and cannabis – These substances may cause strange thoughts, depersonalization, and fear, especially in people who are sensitive to them.

Different drugs affect different people in different ways. But if you notice anxiety getting worse after using or stopping a substance, it might be more than just a coincidence. It could be a sign of something deeper going on.

Symptoms to Watch For

Substance-induced anxiety can feel just like any other anxiety disorder—but the key is that it happens during or after substance use. These symptoms can be intense and frightening, especially if you’re not expecting them.

Here are some common anxiety symptoms to look out for:

• Feeling restless or on edge
• Trouble focusing or thinking clearly
• Muscle tension or tightness
• Irritability or mood swings
• Trouble falling or staying asleep

Panic attacks may also happen, bringing even more severe symptoms like:

• Rapid or pounding heartbeat
• Shortness of breath or choking feeling
• Sweating or trembling
• Chest pain or dizziness
• Nausea or stomach pain
• Numbness or tingling
• Feeling detached from your body or surroundings
• Fear of losing control or dying

These symptoms might last just a few minutes, or they may continue for hours. If they start right after using a substance—or when trying to stop—it’s a strong sign that the anxiety is substance-induced. You don’t have to face these feelings alone. Getting the right support can make all the difference.

How Long Do Symptoms Last?

The length of substance-induced anxiety symptoms can vary from person to person. In many cases, the anxiety goes away after the substance leaves the body or once withdrawal is over. But for others, it may last longer and need medical care.

Several things can affect how long the symptoms stick around:

• Type of substance used – Some drugs cause short-term anxiety, while others may lead to weeks of symptoms.
• How much and how often – People who use large amounts or use regularly may have more intense and longer-lasting symptoms.
• Withdrawal effects – Anxiety often peaks during withdrawal, then fades as the brain returns to balance.
• Your overall health – A person’s mental and physical health can affect how fast they recover.
• Other mental health conditions – If someone has anxiety or depression before using substances, symptoms might continue even after the drug is gone.

According to studies., if anxiety symptoms last more than a month after stopping the substance, doctors may consider another mental health cause. In those cases, further evaluation is needed to find the best treatment path.

Diagnosis

Getting the right diagnosis is an important first step toward feeling better. Substance-induced anxiety disorder can look like other mental health problems, so doctors need to ask careful questions and look at your full health picture.

To diagnose this condition, a doctor may:

• Ask about your substance use – This includes legal drugs like alcohol, prescribed medications, or illegal substances.
• Look at when the anxiety started – If the symptoms began during drug use or shortly after stopping, it may point to a substance-induced cause.
• Review your medical and mental health history – This helps rule out other anxiety disorders that aren’t caused by substances.
• Use diagnostic tools – Doctors often follow the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) to check if the symptoms match the criteria.
• Do a psychological or cognitive assessment – This helps them understand how your thinking, mood, and memory are affected.

Accurate diagnosis is key. It helps guide the right kind of treatment and makes sure you’re not treated for the wrong issue. If you or someone you know is showing signs of anxiety after using substances, don’t wait. A healthcare provider can help figure out what’s really going on.

Treatment Options

Treating substance-induced anxiety means helping the person manage both the anxiety and the substance use at the same time. This is called a dual diagnosis approach. It gives the best chance for healing and long-term recovery.

Here are common treatments that may be used together:

• Medical detox – Helps safely remove the substance from the body and manage withdrawal symptoms under medical supervision.
• Cognitive Behavioral Therapy (CBT) – Teaches people how to change negative thought patterns that feed anxiety and substance use.
• Dialectical Behavior Therapy (DBT) – Focuses on managing strong emotions and building healthy coping skills.
• Individual counseling and group therapy – Provides support, guidance, and connection with others going through similar struggles.
• Medication – Some people may benefit from short-term medications for anxiety, depression, or sleep, prescribed by a doctor.
• Inpatient or outpatient rehab programs – Offers structured care, depending on how serious the symptoms are.

According to Substance Abuse and Mental Health Services Administration (SAMHSA), millions of people in the U.S. have both mental health and substance use disorders. That’s why it's important to treat both conditions at once—not one before the other. Healing takes time, but with the right plan and support, recovery is possible.

Recovery and Coping

Recovering from substance-induced anxiety is more than just stopping the drug or alcohol. It also means learning how to handle stress, build healthy habits, and stay connected to people who care. With the right tools, many people can take back control of their lives.

Here are some helpful coping strategies:

• Create a daily routine – A regular sleep schedule, healthy meals, and physical activity can bring structure and reduce anxiety.
• Practice mindfulness – Deep breathing, meditation, or gentle yoga can calm the mind and improve focus.
• Avoid triggers – Stay away from places, people, or situations that may tempt you to use again.
• Join a support group – Talking with others who’ve faced the same struggle can give hope and encouragement.
• Set small goals – Celebrate progress, even if it’s just one step at a time. Each success builds confidence.
• Stay connected – Spend time with family or friends who support your recovery and understand your journey.

You don’t have to recover alone. Building a life beyond anxiety and substance use is possible—and there are people ready to help you get there.

Conclusion

Substance-induced anxiety disorder can feel scary—but it’s not hopeless. When drugs or alcohol change how your brain works, they can create intense fear, panic, and emotional pain. But these symptoms are not your fault, and they don’t have to last forever.

The key is to recognize what’s really going on. If the anxiety started during or after substance use, it may be part of a larger pattern that needs treatment. With the right diagnosis and support, many people recover fully and build stronger, healthier lives.

If you or someone you love is struggling, don’t wait. Reach out to a healthcare provider or treatment center. You deserve peace of mind—and help is available.