Post-Acute Alcohol Withdrawal: Why Recovery Symptoms Can Continue After Alcohol Withdrawal

Posted on by Stephen Brumwell

What To Know

  • Acute alcohol withdrawal and longer-term recovery are different phases.
  • Cravings, disturbed sleep, anxiety, irritability, reduced pleasure and difficulty concentrating can continue after the initial withdrawal period.
  • Symptoms and timelines vary considerably. Not everyone experiences PAWS, and there is no single pattern that applies to everyone.
  • PAWS is a useful descriptive term, but it is not a formal diagnosis with one agreed symptom list or timeline.
  • Continuing support after detox can make recovery safer and more manageable.

Important: Alcohol withdrawal can cause seizures, hallucinations, severe confusion and other life-threatening complications. If you drink heavily, drink every day, have experienced withdrawal before or are unsure about your risk, seek medical advice before stopping suddenly.

Alcohol recovery can be a challenging journey, and some of the most discouraging symptoms can continue after the acute withdrawal period has ended.

You may have stopped drinking, made it through the first difficult days and expected to feel steadily better. Instead, you may still be dealing with poor sleep, anxiety, irritability, cravings, low motivation or brain fog.

This does not necessarily mean that recovery is going badly. It usually means you are in the longer-lasting symptoms often described as post-acute withdrawal symptoms, post-acute withdrawal syndrome (PAWS) or protracted alcohol withdrawal.

In this article, we’ll dive into what PAWS is, the common symptoms of alcohol withdrawal and how we can best navigate it.

What Is Post-Acute Alcohol Withdrawal?

Acute alcohol withdrawal usually begins within hours after alcohol intake is stopped or substantially reduced. Symptoms can include sweating, tremor, nausea, anxiety, insomnia, a rapid heart rate and, is some more severe chronic cases, we can have seizures or delirium.

Post-acute alcohol withdrawal refers to symptoms that continue after this acute phase has settled.

The American Society of Addiction Medicine uses protracted withdrawal to describe symptoms such as anxiety, irritability and sleep disturbance that persist beyond the expected acute withdrawal period.

The term PAWS remains debated because it is not listed as a separate diagnosis in the DSM-5-TR or ICD-11. There is also no test that can confirm that a symptom is caused by PAWS.

Regardless, i’ll refer to it as PAWS, as essentially, it all ends up meaning the same thing.

Why Can Symptoms Continue After Alcohol Withdrawal?

Alcohol affects several systems involved in calmness, alertness, reward, sleep and stress. When we consume alcohol on a habitual basis, our brain adapts to alcohol becoming a need in our body.

As explained in Alcohol Withdrawal: The Seesaw Effect of Glutamate and GABA, alcohol strengthens inhibitory or slowing signals while suppressing excitatory signals. It’s purely a compensatory effect.

When we remove alcohol, the result is an overactive nervous system, which results in some of those more stimulatory symptoms such as anxiety, sleeplessness, etc.

The most dangerous parts of alcohol withdrawal pass within days, but then the bodies re-calibration or adaptation to no alcohol is where the other difficult symptoms arise.

Our stress signaling, reward processing, sleep architecture and cognitive function continue to change across the following weeks and even months.

Outside of brain chemistry, these symptoms are also impacted by our nutritional health, physical health, and other substances, living conditions and available support.

Common Symptoms During Longer-Term Recovery

Cravings That Gradually Diminish

Let’s set one thing straight first, Intense cravings are common during early abstinence.

Everyone encounters them in sobriety, but it’s often not a straight line when they come and go.

A craving can return suddenly when you are stressed, tired, around alcohol or reminded of an old drinking routine. Even an unexpected opportunity to drink can bring the urge back into focus.

A systematic review of protracted alcohol withdrawal found that craving generally declined across the first weeks and months, although individual experiences and treatment settings varied.

Alcohol cravings isn’t that we’re failing at all. It’s really just an older association to our previous bodies hardwiring. I discuss this further in Cravings 101: Understanding the Fundamentals of Why We Crave.

Impaired Stress Management

Irritability, increased sensitivity and difficulty managing stress are common complaints during extended abstinence.

Once normal ordinary demand sometimes feel more intense. The busy day after a poor nights sleep comes at us stronger than expected. This can be frustrating, particularly when you’re still in the earlier stages of quitting, you thought you’d feel calmer and have it all together, right?

Don’t worry, I did too, but actually stress is a common relapse trigger.

Learning how to recognise rising tension, reduce unnecessary pressure and ask for support is the important part.

The HPA Axis and Stress Sensitivity

The hypothalamic-pituitary-adrenal axis, usually shortened to the HPA axis, is one of the systems that coordinates the body’s response to stress.

Long-term alcohol use and repeated withdrawal can alter this stress-response system. Research reviewed in the PAWS literature suggests that stress signaling may remain disrupted during abstinence, which may contribute to negative mood, heightened stress sensitivity and difficulty coping in some people.

It doesn’t mean everyone is going to have a blunted HPA Axis, and it’s often also impacted by many other factors – Sleep, inflammation, workload and burnout.

The practical takeaway is that if your capacity for stress feels lower than usual, it’s actually useful information.

You have quit drinking alcohol, celebrate this as an achievement in itself and just reduce avoidable pressure where possible. Plan your stress free moments and build that stress management resilience back.

The HPA Axis can also be well supported by nutrients and herbal medicine, so please book a consultation and let me help be part of that stress management support!

Loss of Interest or Lowered Pleasure (Anhedonia)

Anhedonia means a reduced ability to feel interest, pleasure or reward.

Things you normally enjoy? They feel flat, you have difficulty getting motivated and staying motivated by ordinary daily activities.

This is particularly unsettling at any stage of recovery. Alcohol repeatedly activates reward pathways, and the brain can become less responsive to everyday rewards you may expect to give you that pleasure sensation. But it’s all normal during the recovery process.

The pleasure and motivation will return in time, assuming we’re supporting all the foundations of our health (sleep, diet, stress). Of course, persistent anhedonia can also coincide with depression and other health conditions. Do seek professional support if it is severe, worsening, accompanied by hopelessness or making it difficult to function.

Sleep Disturbance

Sleep can remain unsettled after the acute withdrawal period. You may struggle to fall asleep, wake repeatedly, experience vivid dreams or sleep for a long time without feeling refreshed.

Poor sleep also worsens irritability, anxiety, fatigue, cravings. It can be a hinging point where it escalates our stress and pushes us to the point of relapse.

It’s often caused by many factors, our neurochemicals re-balancing, our HPA Axis not functioning as it should. This is often why tailored support from a Naturopath is so beneficial, we can support all of this gently.

Putting into place regular sleep and wake times, morning light, and less stimulation at night can gently support our sleeps natural rhythm. More practical guidance is available in Sleep Hygiene: How To Reset Your Sleep and Circadian Rhythm.

Brain Fog and Cognitive Recovery

Brain fog can include difficulty concentrating, remembering information, planning, changing tasks or making decisions.

You’ve probably experienced it during that hangover stage, that brain “foggy” ness. It’s all part of the picture of our body re-balancing and re-calibrating.

This process can also take time. A 2024 systematic review found that many aspects of attention, executive function, perception and memory recovered over approximately six to twelve months of abstinence. Some abilities improved earlier, while a few showed more variable or slower recovery.

Fatigue

Fatigue is often related to the accumulation of the afforementioned symptoms. It’s tiring, our sleep is disrupted, our nervous system is working hard to regulate stress and a new everyday routine without alcohol.

It makes a lot of sense for us to be tired. You may also be doing it with kids or parenting, even worse (don’t worry, i’ve done it).

Alcohol can also be associated with nutritional deficiencies and a wide range of physical health problems. So some of this fatigue can come from long-term nutrient depletion.

Fatigue should not automatically be labelled as PAWS, particularly when it is severe or persistent.

How Long Does Post-Acute Withdrawal Last?

There is no reliable answer that applies to everyone, it’s a very individual process.

Some models describe it lasting three to six months or longer, but symptoms tend to not always follow the same timeline.

We may have eased cravings in the first month, while sleep, mood and other cognitive changes taking a little longer.

The duration and intensity is also impacted by:

  • How much and how long a person was drinking for.
  • Whether they have experienced repeated withdrawals or attempts to quit.
  • Other drug use or withdrawal.
  • Sleep and nutritional status.
  • Physical and mental health conditions.
  • Medications and treatment.
  • Current stress, safety and social support.

Symptoms may also appear to come in waves. A person may feel noticeably better, have several difficult days and then improve again. This can reflect stress, sleep loss, triggers or normal day-to-day function, which can also be an aggravating factor too.

Not All Of Your Symptoms Are Related

When we quit alcohol, it’s easy to bucket every uncomfortable symptom we have under the PAWS label.

Anxiety, depression, insomnia, fatigue, these may have been present before the drinking became severe. The can also be indicators of chronic health issues impacted by nutritional deficiency, hormone disruption, or other medical related conditions.

This isn’t me trying to minimise your sober journey, but a recommendation to organise a clinical review with a health professional when your symptoms are:

  • Severe, worsening or unexpected.
  • Persisting without improvement long-term.
  • Interfering with work, relationships or basic daily tasks.
  • Making it difficult to remain alcohol-free.
  • Accompanied by persistent low mood, panic or hopelessness.

During your journey, it’s always good to get support as well. This helps provide guidance and also ressurrance.

Long Term Recovery Support Tips

Useful longer-term support may include:

  • Ongoing support. To make it easier and ensure sufficient support, always seek help from your GP and other related health professionals. A Naturopath can also provide gentle support to really soften the impact of your symptoms too, while treating the root cause of something else.
  • Medication where appropriate. Some medications, such as Antabuse, may help for some people to maintain abstinence. This needs to be discussed with your GP.
  • A regular sleep rhythm. Keep wake time as consistent as possible, get morning light and reduce late-night stimulation.
  • Regular meals. Include adequate protein and a range of nutrient-dense foods. Nutritional deficiencies should be assessed and treated appropriately as well.
  • Gradual exercise. Walking, resistance training or another manageable form of movement can support sleep, mood and physical health. Build this habit gradually if you haven’t before so you’re not outrunning fatigue with intense training.
  • Stress regulation. Breathing exercises, quiet time, realistic workloads, time outdoors and structured relaxation can help lower the total stress load.
  • A plan for triggers. Identify the people, places, emotions and situations that increase risk. Recognising your triggers makes it easier to act before a craving becomes overwhelming.
  • Connection and accountability. Linking it back to the first point, support is important. Peer support, trusted friends, family, recovery groups and professional care can reduce isolation and make difficult periods easier to manage.

When To Get Professional Help

Speak with a GP or alcohol and other drug professional if symptoms are persistent, worsening, difficult to manage or increasing the risk of returning to alcohol.

Seek urgent medical care for seizures, hallucinations, severe confusion, chest pain, collapse, extreme agitation or a return of severe withdrawal symptoms. Call 000 if there is an immediate danger.

For free and confidential alcohol and other drug information in Australia, call the National Alcohol and Other Drug Hotline on 1800 250 015. The service directs callers to the relevant service in their state or territory.

If you are feeling overwhelmed, unsafe or unable to cope, contact Lifeline on 13 11 14. If life is in immediate danger, call 000.

The Bottom Line

Finishing alcohol withdrawal is an important step, but it is not always the point at which sleep, mood, stress tolerance and motivation immediately return to normal.

The process is not a straight line, so be patient with the process, and seek support always on the difficult days. Your body and brain are adjusting, so also be kind to yourself.

With time, appropriate care and support, your persistent symptoms will become less. It’s all a journey and a fulfilling life in recovery is achieveable!

If you need further support managing your symptoms or just after some gentle guidance, reach out for a free discovery call.

Frequently Asked Questions

Is post-acute withdrawal syndrome a recognised diagnosis?

PAWS is widely used as a descriptive term, but it is not a separate formal diagnosis in the DSM-5-TR or ICD-11. Researchers and clinicians may instead use terms such as protracted alcohol withdrawal or persistent symptoms during abstinence.

What are the most common symptoms after alcohol withdrawal?

Commonly reported symptoms include cravings, disturbed sleep, anxiety, irritability, reduced pleasure or motivation, fatigue and difficulty concentrating. These symptoms can have other causes, so persistent or severe problems should be assessed.

How long can symptoms continue after quitting alcohol?

There is no fixed PAWS timeline. Some symptoms improve over weeks, while sleep, mood or cognitive changes may continue for months. Drinking history, repeated withdrawals, health, other substances, stress and treatment can all influence recovery.

Why do the symptoms seem to come in waves?

Symptoms can become more noticeable after stress, poor sleep, conflict, skipped meals or exposure to drinking cues. Normal day-to-day variation can also make recovery feel uneven. A symptom wave does not necessarily mean that recovery has reversed.

Does having cravings mean recovery is failing?

No. Cravings are a common part of recovery and can return when an old cue or association is activated. The useful response is to identify the trigger, use your plan and seek support if cravings are becoming harder to manage.

Can the brain recover after long-term alcohol use?

Research indicates that meaningful recovery in many cognitive functions is possible with sustained abstinence. A systematic review found that many aspects of attention, memory and executive function recovered within six to twelve months, although recovery varied between individuals and cognitive abilities.

References

This article provides general information and is not a substitute for individual medical advice, diagnosis or treatment.

Herbal Highlight: Passionflower. Traditional Uses, Modern Evidence and Safety

Posted on by Stephen Brumwell

What To Know

  • Passionflower (Passiflora incarnata) is a calming nervous-system herb traditionally used for a racing mind, nervous tension, restlessness and difficulty sleeping.
  • Clinical studies have reported reductions in anxiety and perceived stress, along with improvements in sleep quality and total sleep time.
  • Its personality is gentle but purposeful: it may help someone feel more settled without necessarily producing heavy sedation.
  • Tea, liquid extracts, tablets and capsules can differ considerably in strength and preparation, so they are not dose-for-dose equivalents.
  • Passionflower may add to the effects of sedating medicines or supplements and should be avoided during pregnancy.

What Is Passionflower?

Passionflower is a fast-growing perennial vine with large, intricate white and violet flowers. The medicinal species is Passiflora incarnata, a plant native to the south-eastern United States and now cultivated in many parts of the world, including Australia. It is different from Passiflora edulis, the species most commonly grown for the passionfruit we eat.

Herbal preparations use the aerial parts of the plant: the leaves, stems and flowers above the ground. The name itself has a rather dramatic history. Spanish missionaries saw symbols of the Passion of Christ in the flower’s unusual structure, which is how the plant became known as Passionflower.

Its use as a medicine goes back much further. Indigenous peoples of the Americas used Passionflower as a calming and sleep-supporting plant. It was later taken into European herbal medicine, where it became an established remedy for nervousness, restlessness, mild mental stress and insomnia (Miroddi et al., 2013).

The Personality of Passionflower

Herbalists often understand a plant not only by a list of conditions, but by the pattern of the person in front of them. Passionflower fits the person who is tired but still mentally alert, whose thoughts continue long after the day has finished, or who feels as though their nervous system is always hovering in the “on” position.

I always like to say that Passionflower is the perfect herb for someone that struggles with a racing mind, or finds it difficult to switch off. It’s gentle and significantly therapeutic at the same time.

Passionflower doesn’t knock out us, but helps quiet the mental noise and ease the nervous tension that is preventing our rest in the first place.

That distinction is important. Passionflower is not necessarily about knocking someone out. Its value is in helping quieten the mental noise and ease the nervous tension that may be preventing rest in the first place.

Inside Passionflower

Passionflower contains a complex mixture of plant compounds, particularly flavonoids such as vitexin, isovitexin, orientin and apigenin. As with many herbs, its effects are unlikely to come from one compound acting alone.

Laboratory research suggests that certain Passionflower extracts may influence gamma-aminobutyric acid, better known as GABA. GABA is one of the brain’s main inhibitory chemical messengers. In simple terms, it helps reduce excessive nervous-system activity and supports the shift from alertness towards calm.

This provides a possible explanation for Passionflower’s traditional use when worry, physical restlessness and poor sleep occur together. The exact activity depends on the species, plant material and extraction method, which is one reason different Passionflower products can feel quite different in practice!

Indicated Uses of Passionflower

Passionflower is most useful when nervous tension, mental overactivity and poor sleep are part of the same picture. The European Medicines Agency recognises its traditional use for mild mental stress and to aid sleep, and clinical research helps show what those benefits may look like in everyday life.

Racing thoughts and difficulty switching off

This is the classic Passionflower picture

The body may be tired, but the mind is still reviewing conversations, planning tomorrow or moving rapidly from one thought to the next. You mind literally struggles to shut off, it’s still stuck in the office at work.

Passionflower may help soften that feeling of mental overactivity so the nervous system can begin to settle. It can be particularly relevant in the evening, although practitioners may also use it during the day when constant thinking and internal tension are making it difficult to relax or focus.

Mild anxiety and nervous tension

Passionflower may help reduce the sense of worry, apprehension and nervous tension that accompanies mild anxiety. A 2020 systematic review examined nine clinical trials, with most reporting lower anxiety levels after Passionflower was used.

One small four-week trial compared Passionflower extract with oxazepam in 36 adults with generalised anxiety disorder. Both groups experienced improved anxiety symptoms by the end of the study. Oxazepam acted more quickly, while the Passionflower group reported fewer problems with impaired work performance (Akhondzadeh et al., 2001).

For more on why anxiety can affect both the mind and body, see Anxiety Explained: What Happens in the Body and What Can Influence It.

Stress, restlessness and feeling constantly “on”

Stress is not always experienced as a clear anxious thought. Sometimes it appears as an inability to sit still, a sense of internal agitation, physical tension or the feeling that the day’s momentum never quite stops.

In a 2024 randomised placebo-controlled trial involving 65 adults with stress and insomnia, a standardised Passionflower extract reduced perceived stress, improved general psychological wellbeing and increased total sleep time over 30 days (Harit et al., 2024).

This means passionflower is very applicable when it comes to daytime stress carrying over into our evening routine. It can help us manage that stress better, and improve our bedtime sleep recovery!

Difficulty falling asleep and shortened sleep

Passionflower is commonly used when poor sleep begins with an active mind. It helps address our nervous tension and mental activity that may be keeping us awake.

In a double-blind placebo-controlled study of 41 healthy adults, one week of Passionflower tea improved participants’ ratings of sleep quality (Ngan & Conduit, 2011). Another randomised trial involving 110 adults with insomnia found that two weeks of Passionflower extract increased objectively measured total sleep time by approximately 23 minutes compared with almost no change in the placebo group (Lee et al., 2020).

The 2024 stress and insomnia trial also found an increase in total sleep time, reinforcing Passionflower’s fit for people whose sleep is being disrupted by stress and difficulty winding down.

Sleep is a tricky one though, and Passionflower is not the all-in-one fix for our sleep. We also must consider light exposure, routine, caffeine, alcohol, pain and underlying health issues too. Read more in Sleep Hygiene.

Short-term situational anxiety

Passionflower is also really good for that short-term situational anxiety. I remember many times where I knocked back some Passionflower before a big exam. just to dial down the noise.

In a study of 60 outpatient surgery patients, a single dose taken before the procedure lowered anxiety without increasing sedation or impairing psychomotor recovery (Movafegh et al., 2008).

A second randomised study involving 60 people undergoing spinal anaesthesia found that Passionflower prevented the usual rise in anxiety without changing psychomotor function, sedation or cardiovascular measurements (Aslanargun et al., 2012).

The takeaway here is that Passionflower promotes calm in the moment without leaving a person groggy or heavily sedated.

Forms and Dosing

Passionflower is available as herbal tea, dried herb, liquid extract, tablets and capsules. Tea can be a gentle way to include it in an evening routine, while liquid extracts and standardised tablets or capsules may provide a more concentrated preparation.

The form matters because the amount of herb, extraction method and concentration can vary widely. A dose used in a study cannot automatically be converted into an equivalent number of cups of tea, millilitres of liquid or capsules.

I won’t delve much into the specifics of dosing, because if you’re looking at liquid extracts or standardised tablets, it is very important to discuss this with a Herbalist or Naturopath.

Passionflower Safety and Interactions

Passionflower is generally considered reasonably well tolerated for short-term oral use, but possible side effects include drowsiness, dizziness and confusion.

I know we said Passionflower isn’t exactly sedating, but it does technically carry sedative properties. Use extra caution with medicines or supplements that cause sedation, including sleep medicines, benzodiazepines and some antihistamines. I would also avoid driving until you know how Passionflower effects you.

When using Passionflower during pregnancy, like with most supplements or herbal medicines, it should not be self-prescribed without seeking professional advice first. Passionflower is generally considered quite safe, but guidance is always recommended. Some herbs definitely should not be used in pregnancy or lactation, so caution is always key.

The Bottom Line

What I like most about Passionflower is that it has a very recognisable place. It suits the person who feels tired but wired, whose mind keeps racing and whose nervous system needs some help finding its way back towards calm.

Its long traditional use is now supported by studies reporting reduced anxiety and perceived stress, better subjective sleep quality and increased total sleep time. It is a good example of a herb that can be gentle without being insignificant.

The species, dose and the individuals situation does matter, and it’s a relatively low risk herb when considering other factors, but professional guidance is always recommended.

Please note: Persistent or worsening anxiety or insomnia still deserves proper assessment. If you have been battling with a chronic condition for some time, reach out to a health professional to see where they can help.

Frequently Asked Questions

What is passionflower traditionally used for?

Passiflora incarnata has traditionally been used for mild mental stress, nervous tension, restlessness and difficulty sleeping.

Does passionflower help anxiety?

Clinical trials have found that passionflower extract can reduce anxiety symptoms, including generalised anxiety and short-term anxiety before medical procedures. Persistent anxiety should still be assessed by an appropriate health professional.

What does Passionflower feel like?

People often use Passionflower to feel less mentally wound up and more able to settle. It may quieten racing thoughts and ease nervous tension without necessarily causing heavy sedation, although individual responses and products vary.

Can Passionflower make you sleepy?

Yes. Drowsiness is possible and can be stronger when Passionflower is combined with medicines, alcohol or other supplements that cause sedation.

References

Akhondzadeh, S., Naghavi, H. R., Vazirian, M., Shayeganpour, A., Rashidi, H., & Khani, M. (2001). Passionflower in the treatment of generalized anxiety: A pilot double-blind randomized controlled trial with oxazepam. Journal of Clinical Pharmacy and Therapeutics, 26(5), 363–367. https://doi.org/10.1046/j.1365-2710.2001.00367.x

Aslanargun, P., Cuvas, O., Dikmen, B., Aslan, E., & Yuksel, M. U. (2012). Passiflora incarnata Linneaus as an anxiolytic before spinal anesthesia. Journal of Anesthesia, 26(1), 39–44. https://doi.org/10.1007/s00540-011-1265-6

European Medicines Agency. (2016). Passiflorae herba — herbal medicinal product. https://www.ema.europa.eu/en/medicines/herbal/passiflorae-herba

Harit, M. K., Mundhe, N., Tamoli, S., Pawar, V., Bhapkar, V., Kolhe, G., Mahadik, S., Kulkarni, A., & Agarwal, A. (2024). Randomized, double-blind, placebo-controlled, clinical study of Passiflora incarnata in participants with stress and sleep problems. Cureus, 16(3), e56530. https://doi.org/10.7759/cureus.56530

Lee, J., Jung, H.-Y., Lee, S. I., Choi, J. H., & Kim, S.-G. (2020). Effects of Passiflora incarnata Linnaeus on polysomnographic sleep parameters in subjects with insomnia disorder: A double-blind randomized placebo-controlled study. International Clinical Psychopharmacology, 35(1), 29–35. https://doi.org/10.1097/YIC.0000000000000291

Movafegh, A., Alizadeh, R., Hajimohamadi, F., Esfehani, F., & Nejatfar, M. (2008). Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: A double-blind, placebo-controlled study. Anesthesia & Analgesia, 106(6), 1728–1732. https://doi.org/10.1213/ane.0b013e318172c3f9

Miroddi, M., Calapai, G., Navarra, M., Minciullo, P. L., & Gangemi, S. (2013). Passiflora incarnata L.: Ethnopharmacology, clinical application, safety and evaluation of clinical trials. Journal of Ethnopharmacology, 150(3), 791–804. https://doi.org/10.1016/j.jep.2013.09.047

Miyasaka, L. S., Atallah, Á. N., & Soares, B. G. O. (2007). Passiflora for anxiety disorder. Cochrane Database of Systematic Reviews, (1), CD004518. https://pubmed.ncbi.nlm.nih.gov/17253512/

Ngan, A., & Conduit, R. (2011). A double-blind, placebo-controlled investigation of the effects of Passiflora incarnata (passionflower) herbal tea on subjective sleep quality. Phytotherapy Research, 25(8), 1153–1159. https://doi.org/10.1002/ptr.3400

National Center for Complementary and Integrative Health. (2025). Passionflower: Usefulness and safety. https://www.nccih.nih.gov/health/passionflower

Szopa, A., Ekiert, H., Ekiert, R., Jafernik, K., Kocjan, J., Kołodziejczyk-Czepas, J., Szewczyk, A., Złotek, U., & Zengin, G. (2020). Passiflora incarnata L.: A systematic review of its phytochemistry, pharmacology and clinical applications. Nutrients, 12(12), 3894. https://doi.org/10.3390/nu12123894

Anxiety Explained: What Happens in the Body and What Can Influence It

Posted on by Stephen Brumwell

Article Snapshot

  • Anxiety is a normal response to a real or possible threat.
  • The response can affect thoughts, heart rate, breathing, muscle tension, digestion, sleep and concentration.
  • Anxiety becomes more concerning when it persists, feels out of proportion or interferes with work, relationships, sleep or ordinary activities.
  • There is rarely one universal cause. Biology, learning, stress, health, hormones, sleep, substances and life circumstances can interact.
  • Caffeine, alcohol, inconsistent sleep and inadequate recovery can amplify symptoms in some people.
  • Regular meals, appropriate movement, slower breathing, sleep support and social connection may help lower the overall load, but they do not replace mental-health care when it is needed.
  • Psychological therapy and medication are evidence-based options. Treatment should be matched to the person, the type of anxiety and its severity

Anxiety is a hard thing. It’s often very misunderstood, and it affects us both mentally and physically.

We have racing thoughts, all consuming worry, and often a continued sense that something is wrong. At this same time, our heart races up, our chest tightens, stomach turns, and our sleep can often be impacted too.

Anxiety involves real changes in the body, across our nervous system, hormones, breathing, digestion and more.

In this article, we’ll explain how anxiety is part of the body’s normal protection system. We’ll unpack what happens underneath anxiety, what influences it, and where chronic nervous system activation causes difficulty switching off or going out our day to day lives.

What Is Anxiety?

Anxiety is the body’s automatic response to a real or anticipated threat, and in the right context, it’s useful!

It sharpens our attention, increases energy and prepares us for the possible threat.

But… There’s a difference between occasional anxiety, and an anxiety disorder (or condition).

Normal anxiety usually has an identifiable trigger and settles when the situation passes. An anxiety condition is more likely when the fear or worry is persistent, difficult to control, out of proportion to the situation or strong enough to interfere with daily life (Healthdirect Australia, 2024).

Anxiety conditions, on the other hand, take different forms. They range from generalised anxiety disorder (GAD), panic disorder, social anxiety, specific phobias and agoraphobia. Obsessive-compulsive disorder and post-traumatic stress disorder are now classified separately in diagnostic systems, although anxiety can be a major symptom too.

In this day and age, Anxiety is fairly common too. The Australian Institute of Health and Welfare reported that approximately 17% of Australians aged 16–85 experienced an anxiety disorder during a recent 12-month period (AIHW, 2025).

We must ask though, why is it common? Because chronic anxiety affects our sleep, appetite, digestion, concentration, and bleeds into our relationships, work and our ability to function day-to-day.

What Happens in the Body During Anxiety?

I always like to describe anxiety as an alarm system, or an alert that something big or possibly scary is coming (and it’s normal).

Your brain continuously assesses the environment, your memories and sensations from inside the body. When it detects possible danger, it can activate systems designed to help you respond.

The sympathetic nervous system

The sympathetic branch of the autonomic nervous system prepares the body for action. Adrenaline and noradrenaline help increase alertness, heart rate and blood flow to working muscles.

We experience a range of common and probably familiar symptoms including:

  • a racing or pounding heart
  • quicker or shallower breathing
  • sweating or feeling hot
  • trembling
  • tense shoulders, jaw or abdomen
  • dry mouth
  • nausea, urgency or “butterflies”
  • dizziness or tingling
  • difficulty sitting still.

These sensations can feel frightening, but they are often the body attempting to protect you (as more of a primal, natural response).

The stress-hormone system

The hypothalamic-pituitary-adrenal axis, usually shortened to the HPA axis, helps coordinate the longer stress response. It involves signaling between the brain and adrenal glands, including the release of cortisol.

Cortisol is not simply a “bad stress hormone”. It helps mobilise energy, regulate inflammation and support adaptation. Problems are more likely when stress is prolonged, recovery is inadequate or the alarm system keeps activating when no immediate action is required. Anxiety biology involves several interacting systems rather than a single chemical imbalance (Szuhany & Simon, 2022).

The anxiety feedback loop

Once the sympathetic nervous system and stress-hormone response are active, our attention becomes more sensitive to possible danger. This is useful if we need to respond to a genuine threat, but less helpful when the threat is an exam, a big speech or something uncertain that we cannot immediately resolve.

It can create a feedback loop:

  1. We notice the impending threat and begin anticipating what could go wrong.
  2. The alarm response increases, making the threat and related body sensations feel more important.
  3. Our attention keeps returning to the threat, while positive or reassuring information becomes harder to absorb.
  4. The continued focus reinforces the sense that danger is present, and anxiety escalates.

You might find when these feedback loop happens over and over, the anxiety feels bigger. Sometimes, we feel it in our gut, or the feelings can often feel paralysing.

This is because although cortisol plays a large part of this response, our interpretation, body sensations, breathing and our relationship with anxiety also need to be considered.

What happens when the stress response stays active?

A short stress response is adaptive. It helps us mobilise energy and respond to a challenge, this is the type of anxiety we want.

The downside appears when the alarm is activated repeatedly, the perceived threat does not resolve or there is not enough time for recovery.

The chronic work stress, worry, or copious amounts of cortisol spiking caffeine. These are all examples of things that keep us in the anxiety loop.

Over time, this can contribute to lighter or disrupted sleep, muscle tension, digestive changes, irritability, fatigue and difficulty concentrating. Those effects can then make us feel less resilient and more sensitive to the next stressor, creating another loop between anxiety and inadequate recovery.

The parasympathetic nervous system helps bring the body back towards rest, digestion and recovery. This system is the opposite of our sympathetic nervous system. We need more activation of the parasympathetic to pull us out of the anxiety loop, and there are many neurotransmitters that play a role with this switch too (such as GABA, which is essentially lowers Glutamate, which lowers cortisol).

I won’t delve too much into the nitty-gritty of neurotransmitters here. For a deeper explanation or understanding, see Substance Abuse and Neurotransmitters.

The Physical Feeling of Anxiety

The stress response temporarily changes priorities across the body.

Digestion may slow or become more active. Breathing patterns can change blood carbon-dioxide levels, contributing to light-headedness or tingling.

We can get tense muscles, and our sleep can often be lighter (because our body is literally on alert).

We can sometimes have a rabbit increase in appetite, or it can disappear all together, the physical symptoms can really range from person-to-person.

A lot of examples include:

  • chest tightness or palpitations
  • reflux, nausea, bloating, diarrhoea or constipation
  • headaches or jaw tension
  • fatigue combined with difficulty resting
  • poor concentration or brain fog
  • insomnia or unrefreshing sleep
  • feeling detached, unreal or overwhelmed

Things That Make Anxiety Worse

Anxiety is often the result of several factors adding together. Yes it’s the original alarm system feedback loop, it begins with this.

But then we have a range of other lifestyle, dietary and biochemical factors that make anxiety worse.

Again, these can differ from person-to-person, just like the physical symptoms do.

Sleep and circadian rhythm

Anxiety can make it difficult to fall asleep, and keeps us out of that deep, restorative sleep we need.

In return, this sleep deprivation impairs of brain’s emotional regulation, resulting in even worse anxiety symptoms. The relationship with anxiety and sleep literally runs both directions like a viscous cycle (Royant-Parola, 2026).

A consistent wake time, morning light, a darker evening environment and enough opportunity for sleep can be useful foundations. Read more in Sleep Hygiene and Morning Sun and Circadian Rhythm.

Caffeine, alcohol and other substances

Caffeine increases alertness, but it can also increase shakiness, heart rate and anxious feelings. A meta-analysis found that caffeine increased anxiety in healthy participants, with a larger effect at higher doses (Liu et al., 2024).

Sensitivity varies, and yes, coffee is good for you, but we always need to look at dose, timing and your reoccurring symptoms and anxiety level.

Coffee has a wealth of benefits, but if your intake is incredibly high, it’s likely doing more harm than good for your quality of life.

Alcohol also may feel calming in the short term but can disrupt sleep and contribute to rebound anxiety as its effects wear off. Cannabis, stimulants, nicotine, some medications and withdrawal from alcohol or sedatives can also influence symptoms.

Never stop prescribed medication suddenly without professional guidance.

Food intake and nutritional status

Our food intake, particularly the frequency and how balanced our meals are, can have negative impact on our anxiety.

Examples include skipping breakfast, or consuming too much highly processed foods, that are practically void of nutrients and spike your blood sugar.

But no, it does not mean every anxious person has blood sugar issues, although, it can be part of the picture.

Nutrients also, such as iron, vitamin B12, folate, vitamin D, magnesium and zinc are important in maintaining normal nervous system function. Deficiency can exacerbate anxiety symptoms, and contribute to fatigue, restlessness, poor concentration or reduced resilience to stress.

Magnesium is often promoted as an anxiety solution. Particularly because it supports nervous system signaling, and promotes release of GABA, a neurotransmitter that activates our parasympathetic nervous system. Read more on the broader evidence and roles of Magnesium here: Magnesium: Why This Mineral Matters.

Gut symptoms and the gut-brain axis

The gut and brain communicate through neural, hormonal, immune and metabolic pathways. Stress can change digestion, while ongoing gastrointestinal symptoms can increase vigilance and distress.

Similar to sleep, this is another directional relationship where anxiety and stress impacts our gut, and then the state of our gut feeds back and worsen anxiety symptoms (Verma et al., 2024).

Some gut symptoms include altered bowel habits, reflux, and even persistent pain. Of course, ongoing symptoms always require assessment to rule out other diseases, such as coeliac disease, dairy intolerances or other serious health conditions.

Please note: Severe food restriction or narrowed diet to treat anxiety is not recommended, always seek guidance by a trained health professional, such as a Nutritionist or Naturopath.

Hormonal patterns

Some people notice predictable changes around the menstrual cycle, pregnancy, postpartum period or perimenopause. A systematic review found that symptoms can fluctuate across the menstrual cycle in several anxiety-related conditions (Green & Graham, 2022).

Fluctuations in oestrogen and progesterone can influence brain chemicals involved in mood and calming, including serotonin and GABA. For some people, the sharper hormonal shifts in the days before a period can temporarily increase anxiety, irritability, stress sensitivity and sleep disruption.

Hormone disruption can be a big deal. If we are experiencing Increased anxiety, stress resilience and sleep disruption, that is a trifecta of contributors that worsen the experience.

It’s often recommend to track cycle timing across 2-3 cycles to understand potential hormonal impacts. If you want to understand your hormones more, a 24-hour urinary test is most recommended to really understand what is happening undereath. A snapshot blood test can often be unreliable.

For more context on changing hormones, sleep and mood, see Unpacking Perimenopause.

Physical health and medications

Thyroid conditions, heart-rhythm problems, anaemia, respiratory illness, chronic pain and other health conditions, these can all amplify or produce anxiety-like symptoms. Some medicines or supplements may also contribute.

This does not mean your condition is the main driver of your anxiety, it’s likely a combination of contributors, so don’t worry.

This is why your GP or relevant health professional should always be considering the wider, more holistic picture. This is also particularly relevant when symptoms are new, severe, or rapidly changing.

Movement and recovery

Physical activity can support mood, sleep and stress regulation. A large overview of systematic reviews found that physical-activity interventions can improve symptoms of anxiety and psychological distress across adult populations (Singh et al., 2023).

This is actually a big win for physical activity, but, more is not always better here!

Someone who is exhausted, under-fuelled or highly sensitised to a racing heart may respond better to walking, resistance training, yoga or shorter sessions than another intense workout.

If you are on a 7 day workout bender trying to lose the weight, while severely undereating and juggling life in between, this is likely contributing to your anxiety picture.

Workload, uncertainty and digital input

Chronic stress = chronic cortisol activation = chronic fuel for your anxiety.

Months of deadlines, financial pressure, conflict, distressing news and constant notifications can repeatedly activate many of the same stress systems used during a physical threat.

Notice what happens after late-night work, doomscrolling, and also throwing the days stressors into the mix. You may also be repeatly checking symptoms or consuming large chunks of health content to find the cure to your anxiety.

The answer isn’t in the health content, it’s actually in the workload and stress your body is taking on.

I’m not saying to avoid all online information, but decide when it’s useful, and when it isn’t.

Humans were not evolved to know it all, so it’s okay to have uncertainty.

Relationships and emotional safety

Supportive relationships can buffer physiological stress. Being able to speak honestly, share practical load and feel safe with another person can change how manageable a situation feels.

On the other hand, anxiety can increase when emotions are suppressed, or the relationships in your home or work life just don’t feel safe or supportive.

Of course, we must always have a food first approach, but there is a point where this cannot solve the environmental or emotional driver.

If your home or work life puts you in serious danger, Call 000 or Lifeline 24-hour crisis support on 13 11 14

Tips to Reduce the Anxiety Load

That was all probably a lot to unpack if you read it all. The most important takeaway is that while everything appears connected, tying to fix it all will create more pressure.

Below are more pattern-like tracking tips to gradually resolve some of the anxiety you may be facing.

Track When Anxiety Happens

For one or two weeks, note:

  • when anxiety appears
  • what you were doing or thinking beforehand
  • your sleep quality that previous night
  • caffeine, alcohol and medication timing
  • were you eaitng well or was there long gaps?
  • menstrual-cycle (if relevant)
  • digestive symptoms (and any food intake around it)
  • stressful events (social, work, home)
  • did anything make your anxiety better?

This list isn’t exhaustive, but some good areas to keep in the back of your mind.

Reduce one avoidable load

Did you find a pattern or notice something you can realistically change?

Great, pick one and stick to it for the next 2 weeks.

This could be dropping one coffee, eating more consistently, or having a hard line when it comes to work finish time to support healthy work life balance.

The key is to find something simple and make it easily actionable. I recommend reading Atomic Habits by James Clear if you want good tactical ways to incorporate habit simplicity.

Work with your body, not against it

Stress is actually inevitable, but the key is how we work with it.

Slower, comfortable breathing may help reduce physiological arousal. A meta-analysis found respiratory interventions can reduce anxiety, although the methods and quality of studies vary (Leyro et al., 2021).

Try a gentle exhale-focused pattern without forcing a very deep breath. If breathwork makes you more uncomfortable, stop and use another grounding strategy, such as feeling your feet on the floor, naming objects in the room or walking slowly.

The key here is activating that parasympathetic nervous system to pull us out of that fight-or-flight, high anxiety state.

Box breathing is also a good tactic, which involves 4 slow breaths in, hold for 4, 4 slow breaths out, hold for 4. Repeat this 6-8 times a session, 2 times a day (or when needed).

Cover the foundations (as best as you can)

Sleep, regular meals, daylight, appropriate movement, time outdoors and meaningful contact with other people.

I won’t unpack too much here, but these are your foundations for health and really essential to supporting healthy quality of life.

Again, maybe you can pick one, but really, they’re kind of non-negotiable if you want to reduce your anxiety long-term.

Get the right kind of help

Psychological therapies, including cognitive behavioural therapy and graded exposure, are established treatments for anxiety. Medication may also be appropriate for some people.

Treatment should be discussed with a GP or mental-health professional and matched to your symptoms, preferences and health history if you decide to go down the medication route (Healthdirect Australia, 2024; Szuhany & Simon, 2022).

Nutrition and naturopathic care can sit alongside mental-health treatment as well.

If you are struggling to tick off the foundations, or just stuck, this type of care can really help. Naturopathic care involves supporting your diet, sleep, stimulant use, check deficiencies and other health factors.

When to Seek Professional Help

Speak with a GP or mental-health professional when anxiety:

  • is persistent or getting worse
  • causes panic attacks
  • interferes with sleep, work, study or relationships
  • leads you to avoid important activities
  • causes increasing reliance on alcohol, sedatives or other substances
  • comes with significant depression, hopelessness or difficulty coping
  • begins suddenly or with concerning physical symptoms
  • you have episodes of suicidal thoughts

Call 000 if you or someone else is in immediate danger. If you are feeling overwhelmed or having difficulty staying safe, Lifeline provides 24-hour crisis support on 13 11 14 (Lifeline Australia, n.d.)..

Frequently Asked Questions

What is the difference between stress and anxiety?

Stress is commonly linked to an identifiable demand, such as a deadline, conflict or illness. Anxiety can continue after the immediate stressor has passed or may focus on a possible future threat. They overlap, and ongoing stress can increase anxiety.

Can anxiety cause physical symptoms?

Yes. Anxiety can affect heart rate, breathing, muscles, digestion, sleep, temperature, concentration and balance. New or severe symptoms should still be medically assessed rather than automatically attributed to anxiety.

Can caffeine make anxiety worse?

Yes, particularly at higher doses or in sensitive people. Consider the total amount from coffee, tea, energy drinks, pre-workout products and some medicines. Reduce gradually if intake is high.

Is anxiety caused by a nutrient deficiency?

Usually not by one nutrient alone. Iron, vitamin B12, folate, vitamin D, magnesium and zinc support normal physiology, and deficiency can overlap with anxiety-like symptoms. Assessment should consider food intake, health history and appropriate testing.

Can gut problems cause anxiety?

The gut and brain communicate in both directions. Digestive symptoms may increase distress, and anxiety can change gut motility and sensitivity. This relationship is real but complex; it should not be reduced to one microbe or a universal probiotic.

When does anxiety become a disorder?

Anxiety may meet the threshold for a disorder when it is persistent, difficult to control, out of proportion to the situation and causes distress or interferes with daily functioning. A qualified health professional can assess this properly.

References

Australian Institute of Health and Welfare. (2025, May 20). Prevalence and impact of mental illness. https://www.aihw.gov.au/mental-health/overview/prevalence-and-impact-of-mental-illness

Green, S. A., & Graham, B. M. (2022). Symptom fluctuation over the menstrual cycle in anxiety disorders, PTSD, and OCD: A systematic review. Archives of Women’s Mental Health, 25(1), 71–85. https://doi.org/10.1007/s00737-021-01187-4

Healthdirect Australia. (2024, September). Anxiety. https://www.healthdirect.gov.au/anxiety

Leyro, T. M., Versella, M. V., Yang, M.-J., Brinkman, H. R., Hoyt, D. L., & Lehrer, P. (2021). Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression. Clinical Psychology Review, 84, 101980. https://doi.org/10.1016/j.cpr.2021.101980

Lifeline Australia. (n.d.). Lifeline crisis support. https://www.lifeline.org.au/get-help/national-services/lifeline-crisis-support

Liu, C., Wang, L., Zhang, C., Hu, Z., Tang, J., Xue, J., & Lu, W. (2024). Caffeine intake and anxiety: A meta-analysis. Frontiers in Psychology, 15, 1270246. https://doi.org/10.3389/fpsyg.2024.1270246

Royant-Parola, S. (2026). Sleep disturbances in anxiety disorders: State of the art and management. L’Encéphale, 52(3S), S46–S50. https://doi.org/10.1016/j.encep.2026.02.011

Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E. M., & Maher, C. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. British Journal of Sports Medicine, 57(18), 1203–1209. https://doi.org/10.1136/bjsports-2022-106195

Szuhany, K. L., & Simon, N. M. (2022). Anxiety disorders: A review. JAMA, 328(24), 2431–2445. https://doi.org/10.1001/jama.2022.22744

Verma, A., Inslicht, S. S., & Bhargava, A. (2024). Gut-brain axis: Role of microbiome, metabolomics, hormones, and stress in mental health disorders. Cells, 13(17), 1436. https://doi.org/10.3390/cells13171436

Top 6 Safe and Effective Performance-Enhancing Supplements for Alcohol Addiction Recovery: A Quick Reference Guide

Posted on by Stephen Brumwell

Article Snapshot

  • The six supplements covered in this guide are N-acetylcysteine (NAC), L-theanine, B vitamins, protein powder, magnesium and zinc.
  • Supplements do not treat alcohol dependence, prevent relapse or make alcohol withdrawal safe.
  • Thiamine, or vitamin B1, is medically important during alcohol withdrawal. The appropriate dose and form depend on nutritional status and clinical risk.
  • Nutrient deficiencies should be assessed rather than assumed. More is not always better, particularly with minerals.
  • Introduce one supplement at a time and check for interactions with medicines or health conditions.

When it comes to alcohol recovery, have you considered whether carefully chosen supplements could support the process?

Recovery can place substantial demands on the body. Long-term heavy drinking may displace nutritious food, reduce nutrient absorption, increase losses of certain nutrients and make consistent eating difficult. Early recovery may also involve disrupted sleep, anxiety, low appetite, fatigue and reduced physical capacity.

That is where supplements can sometimes play a supporting role. They may help correct a genuine deficiency, make adequate nutrition more achievable or assist with a clearly defined wellbeing goal.

However, supplements are not a cure for alcohol addiction. They should sit alongside appropriate medical care, counselling, peer support and prescribed treatment where needed.

This quick-reference guide focuses on the same six foundational options: NAC, L-theanine, B vitamins, protein powder, magnesium and zinc.

Supplements Are Not Alcohol Withdrawal Treatment

Alcohol withdrawal can be medically serious. Supplements cannot prevent withdrawal seizures, delirium tremens or other complications of suddenly stopping heavy, sustained alcohol use.

If you drink heavily or daily, have experienced withdrawal before, or are unsure whether you are physically dependent, speak with a GP, addiction medicine clinician or alcohol and other drug service before stopping. In an emergency in Australia, call 000.

The Australian Guidelines for the Treatment of Alcohol Problems specifically recommend thiamine for people undergoing alcohol withdrawal. The dose and route depend on nutritional status and clinical risk. Someone who is malnourished or showing signs of Wernicke’s encephalopathy may require injectable treatment rather than an over-the-counter tablet.

For a closer look at nutrition after long-term drinking, read Alcohol and Nutrition: Does Chronic Drinking Cause Nutrient Deficiency?.

1. N-Acetylcysteine (NAC)

N-acetylcysteine, usually shortened to NAC, provides cysteine that the body can use to produce glutathione, an important part of the body’s antioxidant defence system.

Alcohol metabolism can increase the production of reactive oxygen species and disrupt antioxidant balance. In a controlled rat study, Ozaras et al. (2003) found that NAC co-administration reduced several markers of alcohol-induced oxidative stress and liver injury. This supports the biological rationale for NAC, but it is preclinical evidence and cannot establish the same protective effect in people.

That distinction matters because human alcohol-recovery outcomes remain mixed. A 2026 systematic review of placebo-controlled trials found that NAC was generally well tolerated, but did not consistently improve the primary symptoms of alcohol use disorder or co-occurring post-traumatic stress disorder.

This means NAC may be considered as a supportive supplement in an individual plan, but it should not be presented as a reliable way to stop cravings, manage withdrawal or prevent relapse.

Optimal dose: Between 1,000 – 2,400 mg/daily.

Important limit: NAC is not a substitute for evidence-based alcohol treatment.

2. L-Theanine

L-theanine is an amino acid found naturally in tea. It is commonly marketed for calm focus because it may influence stress responses without acting like a strong sedative.

Evidence suggests the effect is modest and context-dependent. In a small randomised, placebo-controlled crossover trial of healthy adults, Hidese et al. (2019) found improvements in verbal fluency and executive-function measures after four weeks of L-theanine. A larger 2026 systematic review and meta-analysis also found a short-term attention benefit, while effects on stress and anxiety were less consistent.

This is relevant because focus and concentration can feel impaired during early sobriety, but neither study tested L-theanine as a treatment for alcohol recovery. It may help some people feel calmer or more focused, but it has not been established as a treatment for alcohol withdrawal, alcohol cravings, anxiety disorders or depression.

Research commonly uses approximately 200 milligrams, although study designs and populations vary. Start conservatively and discuss it with a health professional if you take prescription medicines, have low blood pressure, are pregnant or breastfeeding, or have a mental health condition requiring treatment.

Optimal dose: Between 200 – 400 mg/daily.

Important limit: Do not use L-theanine to delay appropriate care for severe anxiety, depression, insomnia or withdrawal symptoms.

3. B Vitamins

B vitamins help the body release energy from food and support the nervous system, blood-cell formation and many other essential processes.

Chronic alcohol consumption can affect the intake, absorption, storage and metabolism of several B vitamins. An updated review by Sandoval et al. (2022) describes how low levels of vitamins B1, B2, B6, B9 and B12 may occur through a combination of inadequate intake, reduced intestinal absorption, altered metabolism and decreased hepatic storage. The review also notes that evidence for broad vitamin supplementation strategies remains incomplete.

The most medically important B vitamin in alcohol withdrawal is thiamine, or vitamin B1. Thiamine deficiency can lead to Wernicke’s encephalopathy, a serious neurological condition. Warning signs can include confusion, poor coordination, unusual eye movements or vision changes. This requires urgent medical attention.

The Australian Guidelines for the Treatment of Alcohol Problems recommend thiamine for people undergoing alcohol withdrawal. The form, dose and duration depend on nutritional status and clinical risk. Oral thiamine may be suitable in some circumstances, while people with poor nutrition or suspected Wernicke’s encephalopathy may need intramuscular or intravenous treatment.

A general B-complex product may help when dietary intake has been poor, but it should not be treated as a replacement for properly assessed thiamine care. High-dose B-vitamin products can also cause problems when used unnecessarily or for long periods.

Important limit: Do not rely on a standard B-complex supplement to make alcohol withdrawal safe.

4. Protein Powder

Protein powder is essentially a convenient food product. It can help when appetite is low, time is limited or eating a full meal feels difficult.

This may be useful in recovery because prolonged heavy drinking can contribute to irregular meals, weight loss and loss of muscle mass. Adequate protein supports the maintenance and rebuilding of body tissue, and regular meals may also make daily energy and appetite feel more stable.

A systematic review and meta-analysis by Morton et al. (2018) found that protein supplementation produced modest additional gains in muscle mass and strength during resistance training, particularly when it helped participants reach an adequate total intake. The benefit is not unique to whey. Dairy, soy, pea and mixed proteins can all be useful depending on tolerance, preference and the rest of the diet.

For active adults, approximately 1.2 to 1.6 grams of protein per kilogram of body weight per day is a common general range. This is context rather than a personalised prescription.

Someone with kidney disease, significant liver disease, a medically restricted diet, swallowing difficulties or unexplained weight loss should seek individual advice before deliberately increasing protein.

Optimal intake: Between 1.2 – 1.6 grams of protein per kilogram of body weight per day.

Important limit: Protein powder does not directly treat alcohol cravings or repair the effects of alcohol use.

For practical guidance, see Protein Intake for Exercise, Protein Sources Guide and Whey Protein Explained.

5. Magnesium

Magnesium is involved in normal nerve and muscle function, energy production, blood-pressure regulation and hundreds of enzyme reactions.

People with alcohol dependence can be at greater risk of low magnesium because of poor dietary intake, gastrointestinal problems, increased urinary losses and co-existing health issues. The Pavuluri et al. (2022) case-control study also found significantly lower mean serum magnesium in its alcohol-dependence group than in controls. This makes magnesium worth assessing, particularly when food intake has been limited, while recognising that one observational study cannot establish cause or prove a benefit from supplementation.

However, symptoms such as anxiety, insomnia, fatigue or muscle cramps are not specific to magnesium deficiency. They can have many causes, including alcohol withdrawal itself. Feeling anxious after stopping alcohol does not automatically mean that a high-dose magnesium supplement is the answer (but it can help).

Optimal dose: Between 400 – 600 mg/daily.

Important limit: Magnesium does not prevent the dangerous complications of alcohol withdrawal.

For more detail, read Magnesium: Why This Mineral Matters for Energy, Stress, Sleep and the Nervous System.

6. Zinc

Zinc supports normal immune-cell development and signalling, wound healing, DNA synthesis, growth and many enzyme reactions. A review by Maywald and Rink (2022) describes zinc as essential to normal immune defence and explains how deficiency can impair immune responses. This does not mean that extra zinc will boost immunity when zinc status is already adequate.

Low zinc status may be more common in alcohol dependence. In a case-control study of 100 people with alcohol dependence syndrome and 100 controls, Pavuluri et al. (2022) found significantly lower mean serum zinc and magnesium levels in the alcohol-dependence group. Because this was an observational study from one hospital, it shows an association rather than proving that alcohol caused the difference or that supplementation improves recovery.

If zinc intake or status is low, improving food quality or using a carefully chosen supplement may help restore adequate levels. That is different from assuming that more zinc will automatically accelerate recovery, enhance performance or prevent infection.

Excessive zinc can cause nausea, vomiting and stomach discomfort. Long-term high intake may interfere with copper absorption and contribute to copper deficiency. Antibiotics and some other medicines can also interact with zinc supplements (so use with caution long term!).

Optimal dose: Daily intake is approximately 11 mg (males) and 8 mg (females).

Important limit: Avoid combining multiple products containing zinc without checking the total amount.

For more detail, read Zinc: Why It Matters for Immunity, Recovery and Overall Health.

The Takeaway

The six supplements in this guide each have a different potential role.

NAC supports glutathione production, although its alcohol-specific clinical evidence remains inconsistent. L-theanine may provide modest support for attention or stress in some people. B vitamins matter when intake or status is low, with thiamine requiring particular medical attention during alcohol withdrawal. Protein powder can make adequate nutrition easier. Magnesium and zinc may be useful when intake is inadequate or deficiency is present.

None of these supplements replaces treatment for alcohol dependence. None makes withdrawal safe. None can compensate for inadequate food, poor sleep or a lack of professional support.

Always address your foundations first and ensure they are rock solid. This means, rebuild a consistent diet, manage your stress well, and look after your sleep. Once these are established, you can begin to look at supplements as additional supporting tools for recovery.

Frequently Asked Questions

Can these six supplements treat alcohol addiction?

No. NAC, L-theanine, B vitamins, protein powder, magnesium and zinc may support specific nutritional or wellbeing needs, but they do not replace counselling, medical care, peer support or prescribed treatment for alcohol use disorder.

Which supplement is most important during alcohol withdrawal?

Thiamine, or vitamin B1, receives specific attention in Australian alcohol treatment guidance because deficiency can cause serious neurological harm. The appropriate form and dose depend on nutritional status and clinical risk, so it should be discussed with a healthcare professional.

Can NAC reduce alcohol cravings?

NAC has been studied for alcohol use disorder, but current findings are inconsistent. It should not be described as a proven craving treatment or used instead of established care.

Can L-theanine help with anxiety in early recovery?

L-theanine may modestly affect stress or attention in some people, but evidence for anxiety is inconsistent and it has not been established as a treatment for alcohol withdrawal or an anxiety disorder.

Do I need protein powder?

Not necessarily. Protein powder is useful when it helps you reach an adequate protein intake, but ordinary foods can meet the same need.

Should I take magnesium and zinc together?

They may be used together in appropriate amounts, but the total intake from every product should be checked. More is not better, and high doses can cause side effects or nutrient imbalances.

References

  • Ahmed, M. A. E., Amin, M., Abdalla, Y. E., Abdelghani, A., Eid, N., Samy, A., Kassar, O., Alsaadany, K. R., & Mansour, M. E. M. (2026). N-acetylcysteine for patients with alcohol use disorder, post-traumatic stress disorder, and their co-occurrence: A systematic review of placebo-controlled randomized trials. BMC Psychiatry, 26, 384. https://doi.org/10.1186/s12888-026-08124-8
  • Gerolymos, C., Saddier, E., Boyer, L., & Fond, G. (2026). Cognitive and affective effects of L-theanine: A systematic review and meta-analysis of 31 randomized trials. Molecular Psychiatry. Advance online publication. https://doi.org/10.1038/s41380-026-03727-9
  • Haber, P. S., & Lintzeris, N. (2021). Thiamine and other supplements. Guidelines for the Treatment of Alcohol Problems. https://alcoholtreatmentguidelines.com.au/chapter-8-alcohol-withdrawal/thiamine-and-other-supplements
  • Hidese, S., Ogawa, S., Ota, M., Ishida, I., Yasukawa, Z., Ozeki, M., & Kunugi, H. (2019). Effects of L-theanine administration on stress-related symptoms and cognitive functions in healthy adults: A randomized controlled trial. Nutrients, 11(10), 2362. https://doi.org/10.3390/nu11102362
  • Maywald, M., & Rink, L. (2022). Zinc in human health and infectious diseases. Biomolecules, 12(12), 1748. https://doi.org/10.3390/biom12121748
  • Morton, R. W., Murphy, K. T., McKellar, S. R., Schoenfeld, B. J., Henselmans, M., Helms, E., Aragon, A. A., Devries, M. C., Banfield, L., Krieger, J. W., & Phillips, S. M. (2018). A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. British Journal of Sports Medicine, 52(6), 376–384. https://doi.org/10.1136/bjsports-2017-097608
  • National Institutes of Health, Office of Dietary Supplements. (n.d.). Magnesium: Fact sheet for health professionals. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
  • National Institutes of Health, Office of Dietary Supplements. (2025). Zinc: Fact sheet for health professionals. https://ods.od.nih.gov/factsheets/zinc-healthprofessional/
  • Ozaras, R., Tahan, V., Aydin, S., Uzun, H., Kaya, S., & Senturk, H. (2003). N-acetylcysteine attenuates alcohol-induced oxidative stress in the rat. World Journal of Gastroenterology, 9(1), 125–128. https://doi.org/10.3748/wjg.v9.i1.125
  • Pavuluri, P., Jangili, S., Ryakam, L., Vadakedath, S., Tummalacharla, S. C., Kondu, D., & Kandi, V. (2022). The activities of zinc and magnesium among alcohol dependence syndrome patients: A case-control study from a tertiary care teaching hospital in South India. Cureus, 14(4), e24502. https://doi.org/10.7759/cureus.24502
  • Sandoval, C., Farías, J., Zamorano, M., & Herrera, C. (2022). Vitamin supplements as a nutritional strategy against chronic alcohol consumption? An updated review. Antioxidants, 11(3), 564. https://doi.org/10.3390/antiox11030564

Addictive Personality: Is It Real, and Can Those Traits Be Channeled for Good?

Posted on by Stephen Brumwell

Article Snapshot

  • “Addictive personality” is not a formal diagnosis. There is no single personality type that causes addiction.
  • Personality can still influence risk. Traits such as impulsivity, sensation seeking, reward sensitivity and all-or-nothing behaviour may make certain rewards harder to moderate for some people.
  • Being intense, ambitious or highly focused is not the same as addiction. Loss of control and continuing despite meaningful harm are much more important warning signs.
  • Some of the energy once directed towards alcohol or another addictive behaviour can sometimes be redirected into exercise, learning, creative work, business or other purposeful goals.
  • The aim is not to simply swap one compulsion for another. Healthy redirection still needs boundaries, self-awareness and the ability to stop.
  • A more useful question than “Do I have an addictive personality?” may be: Which patterns increase my risk, and which parts of my personality can I use constructively?

I’ve heard the phrase “I’ve got an addictive personality” more times than I can count.

I’ve probably used it myself.

Usually, what people mean is something along the lines of: if I get into something, I really get into it. Maybe it’s alcohol, exercise, work, gaming, food, shopping, business ideas or a hobby that somehow goes from casual interest to full-blown obsession in three days.

I can relate to that all-or-nothing mentality.

When I wrote about this years ago on my older blog, Clarity Sober, I looked at the idea that some of the traits associated with addiction can also show up in highly driven, ambitious and entrepreneurial people. I still think there is something useful in that conversation, but I would frame it differently now.

The idea of a single “addictive personality” is much too simple.

There isn’t one personality type that causes addiction, and the term itself isn’t a formal diagnosis. Addiction is influenced by a mix of biology, genetics, environment, mental health, learning, social factors and behaviour. Personality can be part of that picture, but it is only one part (National Institute on Drug Abuse).

So perhaps the better question isn’t “Do I have an addictive personality?”

Maybe it’s “What patterns do I have that make certain behaviours harder to control, and can some of those same traits be used more constructively?”

Is an Addictive Personality Actually Real?

Not really, at least not in the way the phrase is commonly used.

There is no recognised diagnosis called an addictive personality, and researchers haven’t identified one universal set of personality traits shared by everyone who develops an addiction.

That makes sense when you think about how different people with substance-use problems can be.

One person may be highly impulsive and constantly chasing stimulation. Another may be anxious, cautious and using alcohol to switch off. Someone else may be dealing with trauma, chronic pain, loneliness, depression or a social environment where heavy drinking has simply become normal.

They can arrive at a similar problem through very different pathways.

I think through general discussion, using the term “addictive personality” is okay, but jus know, addiction can be far more complicated than that.

Your Personality and Addiction

Saying there is no single addictive personality doesn’t mean personality has nothing to do with addiction.

Certain traits have been studied in relation to substance use and risky behaviour, particularly impulsivity and sensation seeking. Longitudinal research has found that differences in these traits can relate to different patterns of substance use across adolescence and early adulthood (Quinn & Harden, 2013).

Again, that does not mean someone who is impulsive or adventurous will develop an addiction.

It simply means some traits may influence how strongly a person is drawn toward reward, novelty or immediate gratification.

A few patterns people often describe when they talk about having an “addictive personality” include:

  • getting intensely interested in things very quickly
  • struggling with moderation once something feels rewarding
  • chasing novelty, excitement or stimulation
  • making decisions before fully considering the consequences
  • becoming highly focused on goals or activities
  • feeling restless or bored when there isn’t enough stimulation
  • using certain behaviours as a way to escape uncomfortable emotions
  • tending toward an all-or-nothing mindset

None of those automatically equal addiction, but if you’re ticking all of these boxes, the risks of developing an addiction could be higher.

The All-or-Nothing Personality

There are people who casually decide to take up running, and kind of stop there, right?

Then there are people who buy the shoes, download Strava, research heart-rate zones, sign up for a half marathon and somehow own a Garmin by Thursday. All-or-Nothing.

I fit very much into this category, it’s really a double-edged sword. It keeps you accountable and successful, but also makes you teter on the edge of burnout.

You probably if you fall into this category. This same person might throw themselves into the below categories.

  • Extreme fitness
  • over work
  • Entrepreneurial business
  • Music
  • Academic study
  • creative projects
  • Deep nutrition tracking
  • A new hobby
  • Personal development

This intensity though, can sometimes produce genuinely impress results (and often, build great businesses).

The problem is not necessarily that you care deeply about something or become highly motivated.

The more useful question is “Can you do all these, and choose when to stop when you say you will?”

Passion Is Not the Same as Addiction

I think we need to be careful about pathologising everything people enjoy intensely.

Working long hours during an important business launch isn’t automatically a work addiction.

Loving exercise doesn’t mean you’re addicted to exercise.

Gaming regularly doesn’t automatically mean you have a gaming disorder.

Being incredibly enthusiastic about a hobby is often completely normal.

With addiction, one of the important warning signs is that control starts to deteriorate and the behaviour continues despite meaningful harm or consequences.

It’s all about the warning signs, or what I like to call, the Hallmarks of Addiction, more here: Hallmarks of Addiction: Red Flags That a Habit Has Become Hard to Control.

Can Those Same Traits Be Redirected?

This is the part of the original idea that I still find genuinely interesting.

When someone gives up alcohol or another addictive behaviour, they often don’t suddenly become a completely different person.

They don’t suddenly become bored or unmotivated.

They often still have the intensity, but it’s redirected into challenges, novelty, competition, or highly driven achievements.

Of course, this doesn’t mean the recovery challenges, the cravings or the sobriety milestones disappear. This highly driven energy also doesn’t happen immediately.

Recovery can often create a strange gap. We use to spend some much mental energy around drinking, obtaining alcohol, recovering from alcohol or thinking about when the next drink was coming.

We must learn fill the gap, and redirect the energy in a productive way.

This could be finally establishing a health exercise routine, diving into study for personal development or growth, or even leaning into some new creative work.

There is nothing wrong with becoming deeply invested in something positive that isn’t alcohol

The important part is keeping enough awareness that you don’t simply replace one uncontrolled compulsion with another.

Channel It, Don’t Just Swap It

If someone stops drinking but then starts exercising compulsively, spending uncontrollably or working until their relationships and health fall apart, we probably haven’t solved the underlying problem.

We’ve just changed the behaviour, we’ve swapped it but kept the same issue. Healthy redirection still needs it’s own boundaries.

If you still have that intensity, and you’re channeling it into some new tasks, ask yourself:

  • Is this helping me or harming me?
  • Am I choosing this, or do I feel compelled to do it?
  • Can I take a day off without becoming distressed?
  • Is this activity improving my life overall?
  • Are my relationships, sleep and health still intact?
  • Am I avoiding something emotionally by keeping myself constantly busy?

What About Entrepreneurship and Leadership?

My original article leaned heavily into the connection between addictive personality traits, leadership and entrepreneurship.

There are certainly traits that can be useful in entrepreneurship, including achievement motivation, creativity, persistence and a willingness to tolerate uncertainty or risk. Research on entrepreneurial intentions has also examined characteristics such as risk-taking propensity and achievement motivation (Sun et al., 2020).

And yes, there can be some surface-level overlap with traits people informally associate with an “addictive personality.”

I’ve mentioned them probably already, but that’s traits such as being highly driven, competitive, willing to take tasks, or become highly motivated by achievement and reward.

These maybe “addictive personality” traits don’t create successful entrepreneurs though.

A successful entrepreneur with good leadership qualities also requires good judgement, patience, consistency and healthy emotional regulation.

The same intensity that once went into destructive behaviour may potentially become useful when it is paired with self-awareness, structure and control.

Don’t Romanticise Addiction

The final part I want to discuss is the trap of romanticising addiction.

It’s not a superpower, in fact, being able to control the addiction and stop it for good, that’s the superpower.

Addiction can damage health, relationships, careers, finances and families. For some people, it can be life-threatening.

Maybe you are naturally ambitious, maybe your personality is intense, and maybe you are competitive, curious, and highly driven.

Despite your success, do not use addiction as your motivational angle for your success, because if you do, that double-edged sword will come back to bite you.

The Takeaway

You probably don’t have an “addictive personality.”

You have a personality.

Within that are strengths, vulnerabilities, habits, experiences and behavioural patterns that may influence your risk of addiction.

Some of those patterns may need serious attention.

Others may be parts of you that can be redirected rather than eliminated.

For me, that’s a much more useful way to think about the topic than deciding someone is simply born with the personality of an addict.

Recovery and personal growth aren’t always about becoming a completely different person.

Sometimes they’re about learning to point the same engine in a better direction.

If you’re interested in the behavioural side of addiction and recovery, you may also like to read the following articles

Frequently Asked Questions (FAQs)

Is an addictive personality a real diagnosis?

No. “Addictive personality” is not a formal diagnosis, and there is no single personality profile that explains why someone develops an addiction. Addiction is influenced by a combination of biological, psychological, environmental, social and behavioural factors. Personality may contribute to risk, but it is only one part of the picture.

What personality traits are linked with addiction?

Research has commonly looked at traits such as impulsivity and sensation seeking, along with differences in reward seeking and decision-making. These traits may influence risk for some people, but having them does not mean someone will develop an addiction.

Does being obsessive or all-or-nothing mean I have an addiction?

Not necessarily. You can be highly focused, competitive or deeply interested in something without being addicted to it. A more important question is whether you are losing control and continuing despite meaningful harm. I cover this distinction further in Hallmarks of Addiction.

Can addictive tendencies be channelled into positive habits?

Sometimes. People in recovery may find it helpful to direct time, energy and intensity into exercise, study, creative work, business, volunteering or structured goals. The important part is maintaining boundaries so a positive activity does not simply become another uncontrolled compulsion.

Can you replace one addiction with another?

It can happen. Stopping alcohol or another addictive behaviour does not automatically resolve the patterns underneath it. If exercise, work, shopping, gaming or another activity starts becoming difficult to control or causes harm, it is worth looking at the behaviour rather than assuming it is healthy simply because the original addiction has stopped. For more on how reward and urges can operate, see Cravings 101.

References

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