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Despite finding that rates of alcohol abuse or dependence were relatively high in both samples, the researchers saw no evidence that preexisting depressive or anxiety disorders occurred at higher rates among those subjects who later developed alcoholism. Food and Drug Adminstration (FDA) for the management of generalized anxiety disorder. Similar to other serotonergic-based medications, buspirone has a desirable safety profile but a relatively delayed onset of anxiolytic effects. Previous trials have evaluated buspirone among patients with comorbid generalized anxiety disorder (or anxiety symptoms) and AUDs. The majority of these studies have found Drug rehabilitation reductions in both anxiety and alcohol outcome measures, including cravings (Bruno 1989; Tollefson et al. 1991) and drinking measures (Kranzler et al. 1994). However, one study found no effect of buspirone on either anxiety or alcohol use (Malcolm et al. 1992).
- As consumption increases even more, these symptoms also are likely to intensify.
- Identifying and addressing personal triggers allows for better preparation and management.
- If you rely on alcohol to mask anxiety, you may find you become reliant on it to relax – putting you at risk of alcohol dependence.
- One study highlighted that caffeine can also raise your blood pressure, cause stomach problems, and lead to dehydration.
- Pre-existing anxiety disorders, such as generalized anxiety disorder (GAD) or panic disorder, increase the risk of heightened anxiety after alcohol consumption.
- One potential explanation for these findings is that the reasons for using alcohol may differ by gender.
Anxiety during pregnancy: Is it normal?
- Anxiety sensitivity also has been linked to the incidence of both anxiety and substance use disorders (DeHaas et al. 2001; DeMartini and Carey 2011; Schmidt et al. 2007).
- In this case, it is uncertain whether the longer term treatment of alcoholism requires additional aggressive therapies aimed at treating underlying depressive or anxiety disorders.
- Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for anxiety and depression.
- Individuals with alcohol use disorder (AUD) or a history of alcohol dependence are also more likely to experience anxiety during withdrawal.
- If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.
- Some of the ways of managing hangxiety are the same as the strategies for combating a hangover, but there are also additional things you can keep in mind to specifically tackle your anxiety feelings.
Specifically, whereas socially phobic men benefitted equally well from either cognitive–behavioral therapy https://ecosoberhouse.com/ (CBT) or 12-step facilitation (TSF), women with social phobia fared less well if they were assigned to TSF. To shed light on the potential role of social anxiety in addiction treatment, Book and colleagues (2009) compared participants in an intensive outpatient program with high and low social anxiety on attitudes toward treatment activities. Members of the group with high social anxiety, who predominantly were female (71 percent), overall showed less treatment participation than did members of the comparison group. For example, they were less likely to speak up in group therapy, attend a 12-step meeting, or seek sponsorship within a 12-step group.
What is anxiety?
Instead, so-called third variables are posited to account for their joint presence. The potential relevance of such factors was demonstrated in a 21-year longitudinal study of young people (Goodwin et al. 2004), in which early presence of anxiety disorders seemed to predict the later development of alcohol dependence. However, when the investigators controlled for other variables, such as prior other drug dependence and depression, the presence of anxiety disorders no longer was a significant predictor. The results of this study suggest that the link between anxiety and AUDs was not direct but instead may have been a consequence of those other variables studied.
Social embarrassment
To borrow terminology from the respective CBT approaches for anxiety and AUDs, the link between anxiety and drinking for comorbid clients may mean that in effect an exposure exercise also becomes a high-risk situation for alcohol relapse. Relapse to avoidance strategies (e.g., reliance on checking behaviors in obsessive-compulsive disorder or avoidance of social gatherings in social anxiety disorder) in the process of exposure is undesirable even for people suffering only from an anxiety disorder. For people who use alcohol as an avoidance strategy, however, a relapse can be especially costly. Moreover, use of alcohol to avoid anxiety during an exposure exercise also can interfere with the corrective learning process required for extinction of the anxiety response. Indeed, research findings suggest that exposure-based methods can lead to worse alcohol outcomes for comorbid individuals and that alcohol use during exposure may hinder extinction (e.g., Randall et al. 2001).
- If your treatment plan includes medication, your psychiatrist will prescribe and manage it.
- In this followup study, although the sons of alcoholics were three times more likely to develop alcohol abuse or dependence, they showed no higher rates of major depressive disorders or major anxiety disorders during the followup period.
- However, these results are inconsistent, and other factors may be involved.
- As a typical depressant, alcohol affects the brain in many ways, and it is likely that high doses will cause feelings of sadness (i.e., depression) during intoxication that evolve into feelings of nervousness (i.e., anxiety) during the subsequent hangover and withdrawal.
- Alcohol disrupts sleep patterns, leading to insomnia or fragmented sleep, which can worsen anxiety.
Increased Heart Rate
Two critical elements of CBT skills training also may be especially difficult for patients with comorbid social anxiety disorder, including drink-refusal skills and enhancing one’s social support network. In essence, clients need to show assertiveness to engage in the parallel process of ending relationships and habits that are high risk for relapse while also proactively initiating alcohol and panic attacks contacts and improving relationships with others who will support recovery efforts. Therefore, clients in CBT who also have social anxiety may particularly benefit from additional practice with assertiveness, perhaps including adjunctive social-skills training. Not all people struggling with alcohol problems meet diagnostic criteria for anxiety disorders.
Patients typically experience symptom relief within 4 to 6 weeks, with continued improvement over time. Most patients notice a reduction in anxiety within 2 to 4 weeks, with continued improvement over time. If the symptoms of a hangover or hangxiety are severe—or if you are having shaking, tremors, a fever, changes in consciousness, or seizures—get prompt medical attention.
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**Steroid withdrawal** (also called *glucocorticoid withdrawal* or
*steroid tapering*) refers to the process of
gradually reducing a dose of systemic corticosteroids after they have been taken for an extended period.
The goal is to allow the body’s own adrenal glands to recover their
natural cortisol production while preventing a sudden drop in steroids that can lead to
illness.
—
## 1. Why a taper is needed
| Problem | What happens if you stop abruptly |
|———|———————————–|
| **Adrenal suppression** – long‑term steroid use signals
the hypothalamic–pituitary–adrenal (HPA) axis
to slow or stop its own cortisol output | Severe low‑cortisol state → fatigue, dizziness, nausea, low blood pressure, and potentially adrenal crisis |
| **Underlying disease flare** (e.g., asthma, arthritis) |
Symptoms can worsen rapidly |
—
## 2. How a taper is planned
1. **Determine the daily dose** you are currently taking (or the cumulative dose if you have been tapering).
*Example:* You take 20 mg of prednisone daily.
2. **Choose a step‑down schedule** that reduces the dose
by a small amount each week or every few days, depending on how your
body reacts.
– **Small reductions:** 5 mg per week for moderate doses.
– **Very low doses (<10 mg/day):** reduce by 2–3 mg at a time.
3. **Use lower‑strength tablets** or split the tablet if available to achieve the desired reduction.
*Example:* If you only have 5 mg tablets, take one for 15 days and then stop for 7 days to simulate a 10 mg reduction per week.
4. **Monitor symptoms:** If you feel new aches, fatigue, or mood changes, slow down the tapering (e.g., reduce by a smaller amount or pause for a few days).
5. **Keep a daily log** of pain levels and any side effects to help track progress.
### Sample Taper Schedule
| Week | Pain Score (1–10) | Take 2×5 mg tablets/day | Next week |
|——|——————-|————————–|———–|
| 1 | 7 | 2×5 mg (10 mg total) | 0.8 kg |
| 2 | 6–7 | 2×5 mg (10 mg) | 0.8 kg |
| 3 | 5–6 | 1×5 mg (5 mg) | 0.8 kg |
| 4 | 4–5 | 1×5 mg (5 mg) | 0.7 kg |
**Weight Management Plan**
– **Target Weight Loss:** 0.3 kg per week
– **Calorie Deficit:** ~300 kcal/day
**Meal Structure:**
| Time | Meal | Food Items |
|————|————-|————————————————–|
| Breakfast | High protein | Greek yogurt, berries, chia seeds |
| Snack | Protein | Almonds or a protein shake |
| Lunch | Balanced | Grilled chicken, quinoa, mixed greens |
| Snack | Light | Hummus with carrot sticks |
| Dinner | Low-carb | Salmon, broccoli, cauliflower mash |
**Exercise Plan:**
– **Strength Training:** 3 sessions/week (upper/lower split)
– **Cardio:** 2 sessions of HIIT or steady-state cardio
– **Flexibility:** Stretching and foam rolling post-workout
—
### 5. What If Scenarios
| Scenario | Expected Effect on Body Composition |
|———-|————————————-|
| **1. Cut to 4% body fat** | Muscle mass may drop by ~2–3 kg; overall lean body mass could decline due to higher energy deficit and potential loss of glycogen and water. |
| **2. Increase training volume (double workouts)** | Greater muscle hypertrophy if nutrition supports it, but risk of overreaching and increased catabolism unless caloric intake is adjusted upward. |
| **3. Reduce carbohydrate intake to <50 g/d** | Glycogen stores deplete, potentially improving fat oxidation; may cause decreased training performance and increased fatigue. |
| **4. Add intermittent fasting (16/8)** | May improve insulin sensitivity and promote fat loss; minimal effect on muscle mass if protein intake remains adequate and total calories are maintained. |
—
### 3. Practical Recommendations
| Goal | Action Plan | Timeline |
|——|————-|———-|
| **Maintain Muscle Mass** | • Consume ≥1.5 g/kg body weight protein (≈90 g).
• Distribute protein across 4–5 meals; include whey/casein post‑workout.
• Keep total calories at maintenance (~2,200 kcal). | Continuous |
| **Promote Fat Loss** | • Reduce daily caloric intake by ~300 kcal (≈1,900 kcal) while keeping protein high.
• Increase training volume or intensity slightly (e.g., add 10–15 min of HIIT). | 4–6 weeks |
| **Optimize Recovery** | • Prioritize sleep ≥7 h/night.
• Use active recovery sessions; incorporate foam‑rolling, mobility drills. | Continuous |
| **Monitor Progress** | • Weekly weigh‑in and body composition scan (DXA or BIA).
• Adjust calories by +50–100 kcal if weight loss stalls for 2 weeks. | Ongoing |
—
### Quick Reference Table
| Parameter | Goal | Rationale |
|———–|——|———–|
| **Body fat** | ↓10‑15% (from ~25% to ~20%) | Improves metabolic health, enhances muscle definition |
| **Lean mass** | ↑5–10 kg | Supports basal metabolism, aids strength gains |
| **Strength** | ≥2× body weight in squat/bench | Demonstrates functional power and muscular balance |
| **VO₂max** | 35‑45 ml/kg/min | Maintains cardiovascular fitness, reduces injury risk |
| **Recovery** | ≤1.5 hrs sleep per day | Optimal hormonal milieu for growth & repair |
—
### 📊 Summary Table
| Metric | Target Value | Rationale |
|——–|————–|———–|
| Body Fat % | 8‑12% | Muscle definition, health |
| Lean Mass | +10 kg | Metabolic boost, strength |
| Strength (Squat/Bench) | ≥1.5× body weight | Functional power |
| VO₂max | 35‑45 ml/kg/min | Cardio fitness |
| Sleep | ≤1.5 hrs/day | Hormonal recovery |
—
### 🚀 Final Takeaway
– **Aim for a lean, muscular physique**: Target **8–12% body fat** and add **10+ kg of muscle**.
– **Prioritize strength training** (≥1.5× body weight in squat/bench).
– **Maintain cardio fitness** with a VO₂max around **35–45 ml/kg/min**.
– **Optimize recovery**: Keep sleep under 1.5 hours per day.
Follow these guidelines, and you'll be on track to achieve peak physical performance!
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