Q Coffee seems to worsen my anxiety, and I need alcohol to be around people. Is this related to social phobia?
A Caffeine directly worsens anxiety responses, and the habit of using alcohol to cope with anxiety is very dangerous as it can develop into alcohol dependence. Both are among the first factors to address in managing social phobia.
Detailed Answer
Caffeine stimulates the sympathetic nervous system, raising heart rate and heightening anxiety sensitivity, so reducing or eliminating coffee, energy drinks, and strong tea is a basic management step for those with social phobia. Conversely, alcohol may feel like it temporarily reduces anxiety, but repeated use builds tolerance and creates a dependency pattern where one cannot meet people without drinking. This is why the co-occurrence of alcohol use disorder in social phobia patients reaches 20–40%. If you are getting through social situations by drinking, you must inform a professional about this pattern.
Korean Medicine Clinic Perspective
In Korean medicine, alcohol may feel like it temporarily promotes Liver circulation, but in the long term it generates Liver Heat (간열), further worsening Liver Qi Stagnation. At Dongjedang, we discuss specific strategies for managing caffeine and alcohol intake alongside treatment to resolve Liver Qi Stagnation.
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