You can't control anxiety. You can learn to manage it.

What anxiety actually is

Anxiety is your body's fear and threat response, a feeling of nervousness, worry or unease that can show up as a racing heart, restlessness, muscle tension, trouble sleeping or trouble concentrating. Some anxiety is a completely normal part of being human, it's what your body does before a hard conversation or a big deadline.

It becomes an anxiety disorder when it doesn't go away and starts interfering with daily life, something roughly a third of adults experience at some point, according to the US National Institute of Mental Health. Here in South Africa, the national SASH study, the largest population survey of its kind, found anxiety disorders are the single most common category of mental health condition in the country, ahead of mood disorders and substance-use disorders.

Source: American Psychiatric Association ↗ · NIMH, Generalized Anxiety Disorder ↗ · SASH Study, South African Medical Journal ↗

What actually causes it

There's rarely one clean cause, research points to a mix of genetics, brain chemistry and environment layering on top of each other. Family history plays a real role. So does the balance of chemicals like GABA and glutamate in your brain, the same two that alcohol directly interferes with, which is part of why the two are so tangled together. Stressful or unstable environments, and traumatic events specifically, are also well established risk factors.

Source: NIMH, Anxiety Disorders ↗ · American Psychiatric Association ↗

Why alcohol makes it worse, not better

A drink can genuinely quiet anxiety in the moment, that part isn't imagined. Alcohol floods your brain with GABA, the same calming chemical your body makes naturally, which is exactly why it feels like relief. The cost shows up later. As the alcohol wears off, your brain swings hard the other way: GABA drops and glutamate, your brain's stimulating chemical, surges past where it started. This rebound has an actual clinical name, hangxiety, and it typically starts 6 to 12 hours after your last drink and peaks around 24 to 48 hours later.

People who already live with anxiety tend to feel this rebound harder, their systems are more sensitive to the swing. With regular drinking, the brain adjusts its baseline to expect this cycle, lowering natural GABA activity and raising glutamate over time, so anxiety gradually becomes the norm rather than something alcohol only briefly interrupts. This is one of the most common ways the cycle starts: 20 to 40% of people being treated for an anxiety disorder also have alcohol use disorder, two conditions actively feeding each other.

Source: Henry Ford Health, Hangxiety ↗ · Cleveland Clinic, Hangxiety ↗ · NIAAA, Alcohol & Co-occurring Mental Health Conditions ↗

How to manage it, not control it

Anxiety isn't something you switch off, and treating it like a problem to defeat can make it feel bigger. Managing it means having real tools ready for when it shows up. A few are backed by consistent evidence.

• Extended exhale breathing. In for about 4 seconds, out for about 6, with your shoulders relaxed. Longer exhales directly calm your nervous system.
• The 5-4-3-2-1 grounding technique. Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, 1 you can taste. It pulls your attention out of your head and into the room you're actually in.
• Movement. Physical activity releases endorphins and is one of the most consistently evidenced ways to lower everyday anxiety, it doesn't need to be intense to count.
• Protecting sleep. Anxiety and poor sleep feed each other in both directions, so sleep is one of the most underrated tools available, not a side issue.
• Reducing or cutting alcohol. Given the rebound cycle above, this is itself one of the most direct ways to lower baseline anxiety over time, not an unrelated lifestyle change.
• Talking to someone. Therapy, especially cognitive behavioural therapy, has strong evidence behind it for anxiety specifically, and it doesn't take a crisis to be worth trying.

These are tools, not a cure, and what works varies from person to person. Most need a few weeks of consistent practice before the difference is really felt, so it's worth giving something longer than one try.

Source: UnityPoint Health ↗ · LifeStance Health, Grounding Techniques ↗ · Lightfully Behavioral Health ↗

When to reach out

If anxiety is stopping you from getting through your day, or it's showing up as panic attacks, that's worth talking to someone properly, not pushing through alone. Reaching out isn't a last resort, it's just the next tool.