There’s a Physiological Reason You Feel Anxious After a Night of Drinking
After a night of drinking a little too much, you may experience the pounding headache, the unbearable nausea, and/or an aversion to bright lights. But sometimes when you overdo it on the adult bevs you are also overcome by a feeling of uneasiness and anxiousness, or your mind’s flooded with panicky thoughts.
The term for a hangover with a side of anxiety has now been dubbed “hangxiety.” While hangover anxiety isn’t necessarily a new concept, it could be that society’s finally started buzzing about the phenomenon because we’re more open about mental health in general (which is a good thing!).
Research shows that it’s a real thing that people are experiencing. A 2019 study published in Personality and Individual Differences found that hangover anxiety after a day of drinking was most prevalent in highly shy people, or people with deal with social anxiety.
We talked to psychology and alcohol experts to get the lowdown on the anxiety that often comes with a nasty hangover—here’s everything you need to know about how to move past hangover anxiety to get on with your day.
There’s a physiological reason you might feel anxious after a night of drinking.
Although we don’t tend to think of it this way, a hangover is basically a form of withdrawal from alcohol. “What goes up must come down—alcohol makes you feel good—and it tends to reduce tension. But when the alcohol wears off, the brain and the body have a ‘rebound’ process,” explains George Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This one- to two- day “withdrawal” period is often coupled with the typical acute hangover symptoms (fatigue, headache, dry mouth, nausea), as well as anxiety and even depression in some cases.
This typically doesn’t happen after one glass of pinot grigio, by the way; this is more likely to be the case after a night of taking a few shots, or maybe finishing off a full bottle of wine. “If you are a heavy drinker, over time, your central nervous system adjusts to having alcohol around all the time. Your body works hard to keep your brain in a more awake state, but when the alcohol level suddenly drops, your brain stays in this keyed-up state,” says Sanam Hafeez, Psy.D., a New York City-based licensed clinical neuropsychologist. Your brain continuing to be hyped up is what makes you feel the effects of anxiety, Hafeez points out.
Hormonal fluctuations from drinking may also play a role in hangxiety. When you’re drinking, the alcohol releases mood-boosting hormones known as endorphins. But then the next morning, you’re coming down from those endorphins, so that’s why you might feel low, Hafeez explains. Also, when your brain is working hard to return the body to its usual state after heavy drinking, the neuropeptide CRF (which triggers the stress-hormone cortisol) spikes, leaving you feeling more panicky than usual, says Koob.
But there are psychological reasons for feeling anxiety post-drinking, too.
“For some drinkers, the hangover anxiety is almost as predictable as the pounding headache and queasy stomach,” says Hafeez. The heart-racing, sweaty-palmed, antsy-stomach feeling is often related to worrying about the consequences of a blackout, or of being in a state of mind where there are holes in your memory and fears about things you said or did.
Thoughts of, What did I say to my boss?, or, Did I approach the person I like? come flooding into your mind, and the anxiety surrounding what you said or did to embarrass yourself might be the culprit. Other times, Hafeez says, the hangxiety might not be related to anything specific, and might just be an overall feeling of uneasiness.
Sometimes, because people tend to use alcohol as a social lubricant, the anxiety comes creeping back in as soon as the alcohol starts to wear off. “Anxiety and depression are often related to alcohol abuse, because the person has more anxiety when they’re not drinking rather than drinking,” Koob notes.
In other cases, someone may still have anxiety when they are drinking, but according to Hafeez, just two drinks is enough to relax the brain—at least temporarily, anyway.
Just because you’re feeling the hangxiety hardcore doesn’t necessarily mean you have an anxiety disorder.
The more you drink, generally the more likely you are to experience the anxiety-like effect of alcohol. Hafeez adds that if you already deal with anxiety, you’ll likely feel the effects of hangover anxiety even more than people who do not have an anxiety disorder. Koob adds that whether or not you feel hangover anxiety may also depend on whether you have a family history of anxiety.
There’s no direct proof that drinking in excess and getting hungover directly causes anxiety issues. However, Koob points out, drinking to cope with social phobias (and the resulting withdrawal from that drinking) can be intertwined with an anxiety disorder, so it’s not always easy to spot when your post-drinking anxiety is a sign of a larger emotional/mental issue.
Avoiding hangover anxiety is about more than just drinking less.
The obvious answer to avoiding hangovers (and, therefore, hangover anxiety) in the first place is to drink less, which is easier said than done for some people. What’s super important is awareness of your personal tolerance—not only regarding how much is your limit, but what kinds of alcohol tend to send you over the edge or leave you feeling worse emotionally.
This may mean, for some people, you avoid mixing drinks and stick to one thing all night, or you avoid hard liquor, Hafeez suggests. You also want to tune into how you’re pacing yourself when you drink, and consume water with your alcoholic beverages to stay in control.
Along with self-regulation, try to practice mindfulness as you drink. Have a convo with yourself in which you predict how you will feel the next day, both physically and emotionally, and go from there. Chances are you don’t want to feel wired, grouchy, or sad the next day, and if you remind yourself of this as you're imbibing, you may be more likely to go slow and not overdo it.
Doing a dry January or other abstinence period may also be a helpful experiment; if you find that you feel better mentally, or less groggy, anxious, or that you sleep better without drinking, it may be worth reducing your alcohol intake.
Koob recommends doing everything you’d do to avoid physical hangover symptoms, because they’re connected. “That can be anything from getting a good night’s sleep to making sure you’re hydrating properly to eating food with drinks,” he says.
If you’re already hungover and anxious, pop your usual aspirin and drink plenty of fluids, but the best medicine, according to Koob, is getting some exercise. Now, if you’ve just been throwing up or feel very sick, you’re likely not in the shape to go for a long run or powerlifting session, but a short walk around the block or some time on a stationary bike will do the trick. Plus, research has shown that any kind of aerobic exercise can help calm heightened anxiety.
If you think you feel more worked up than you should the day after drinking, it’s worth bringing up to a mental health provider.
To reiterate, having a bout of hangover anxiety is not a direct sign of anxiety disorder. “It is simply the symptom of drinking too much alcohol and causing the mind and body to experience anxiety as a result of alcohol withdrawal,” says Hafeez.
But if you feel so anxious or low after drinking that it's interfering with your day to day or you can't seem to snap out of it, evaluate your relationship with alcohol and examine how it impacts your mental health. The questions Hafeez suggests you ask: What’s the motive for drinking enough alcohol to cause hangxiety in the first place? Are you over-drinking because of social anxiety, depression, or general anxiety, or to escape?
Everyone’s tolerance and response to alcohol is different, but most importantly, Dr. Koob says, it shouldn’t be interfering with a healthy existence.
If you’re struggling with alcohol, consult a professional. The NIAAA site has a treatment navigator where you can find treatment facilities in your zip code.
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