Alcohol Induced Anxiety Disorder:

Although alcohol is known to lower anxiety at low doses, heavy alcohol consumption is believed to induce prominent anxiety symptoms. Alcohol induced anxiety symptoms usually include generalized anxiety symptoms, panic attacks, and phobias. In order to establish this diagnosis however, clinicians usually rule out general medical conditions or mental disorders that can mimic this disorder. Alcohol induced anxiety disorders may develop during intoxication or withdrawal from alcohol, although the duration and intensity is typically worse than the anxiety normally observed during the course of these conditions. The onset of drinking prior to the anxiety syndrome as well as improvement and remission from anxiety during periods of abstinence frequently suggest alcohol induced anxiety disorder. Monitoring the course of the symptoms for a period of time after alcohol cessation can be useful in determining their nature. A substantial improvement of anxiety will be observed during this period, usually suggesting a direct relationship of anxiety to alcohol. In many cases, full remission of symptoms are not observed until at least three to four weeks after abstinence.

Alcohol Induced Sleep Disorder:

Heavy alcohol consumption is frequently associated with disturbances of sleep. At intoxicating blood-alcohol levels and especially when the blood-alcohol levels are declining, sedation and sleepiness may be observed. Alcohol intoxication induces an increase in non-rapid eye movement sleep (NREM), whereas rapid eye movement (REM) sleep density decreases. Subsequently, there is an increase in wakefulness, restless sleep, nightmares or other vivid dreams related to a reduction in non-rapid eye movement sleep and a rebound in rapid eye movement sleep density. Frequently during alcohol withdrawal, sleep is discontinuous and fragmented with an increase in rapid eye movement (REM) sleep. After withdrawal, individuals may complain of sleep difficulties and frequently experience superficial fragmented sleep for a significant period of time, sometimes for months or years at a time.

Alcohol induced sleep disorders can be distinguished from primary sleep disorders in that the onset of drinking precedes the sleep disturbance and by remission of the symptoms during the course of sustained abstinence. Alcohol induced sleep disorders can occur during the course of a typical alcohol intoxication or withdrawal episode. Duration and severity of the sleep disturbances however may exceed 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. However, a history of previous primary 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 can also intensify other sleep problems such as narcolepsy or breathing related sleep disorders.

Alcohol Induced Sexual Dysfunction:

Although alcohol in small doses appears to enhance sexual receptivity in women and increase arousal to erotic stimuli in men, heavy continued drinking may cause significant sexual impairment. Alcohol-induced sexual dysfunction is usually characterized by impaired desire, impaired arousal, impaired orgasm, or sexual pain. It is also frequently associated with marked distress and/or interpersonal conflicts. Usually these impairments begin during alcohol intoxication, although the duration of symptoms may exceed the uncomplicated course of alcohol intoxication. Symptoms usually 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 disorder. Also, other substances, particularly those prescribed for treatment of alcohol withdrawal such as benzodiazepines or barbiturates should also be ruled out as a cause of the sexual dysfunction.