Last Updated on October 1, 2021
If you’ve ever had a long night of drinking, you’ve likely experienced the physical effects of a hangover. These might include a pounding headache, nausea, feeling tired and weak, sensitivity to light, sweating, and a pressing need to drink water.
But for many people, the symptoms of a hangover don’t stop there. The headache and nausea come with another unwelcome companion: hangxiety, or hangover anxiety.
Do you ever feel a sense of dread or worry after a night of drinking? Do you frantically playback everything you said and did the night before, concerned you may have embarrassed yourself or caused offense? That’s hangxiety.
For some people, these post-drinking feelings of shame, worry, and stress are powerful enough to cause an ongoing cycle. They may medicate their anxiety after drinking with more alcohol, compounding the problem.
If all this sounds familiar, you may be wondering: What causes hangxiety? And how can I make it stop?
Why Does Alcohol Give You a Hangover?
All too often, a fun night out with friends ends in a not-so-fun morning. And no matter how much you enjoyed the evening before, you probably hate being hungover. You may find yourself asking: Why does alcohol make people feel so sick?
According to the National Institute on Alcohol Abuse and Alcoholism1, several factors contribute to hangovers.
To begin with, as your body (mostly your liver) metabolizes alcohol, it releases a compound called acetaldehyde2. This toxic compound causes inflammation throughout the body, especially in your liver, gastrointestinal tract, pancreas, and brain. Inflammation plays a role in all sorts of illnesses, and it likely contributes to the “sick” feeling of a hangover too.
Alcohol also dehydrates you, which leads to headache, thirst, and fatigue. It irritates the lining of your stomach, causing nausea and sometimes vomiting. In addition, excessive consumption of alcohol disrupts your sleep, further contributing to fatigue and uneasiness.
Finally, as your brain attempts to rebalance itself after a night of drinking, you may experience a “mini-withdrawal” from alcohol. This can temporarily impact your nervous system, affecting your mood.
Why Does Alcohol Cause “Hangover Anxiety?”
The brain’s effort to rebalance itself chemically post-drinking is a major factor in hangxiety. Like many substances, alcohol disrupts neurotransmitters3 like dopamine, serotonin, and endorphins. Initially, this can cause a short-lived rush of euphoria. But as these “feel-good” chemicals recede, you may remember all the problems you temporarily forgot about, causing you to feel depressed or anxious.
Alcohol also stimulates the production of GABA4 (gamma-aminobutyric acid), a neurotransmitter that slows and calms the brain. Often, medication prescribed to reduce anxiety or improve sleep is designed to increase this brain chemical. If you’ve ever felt more relaxed and cheerful after a few drinks, it’s probably the result of GABA.
After a couple more drinks, your brain also begins to block an excitatory neurotransmitter called glutamate, which studies5 have linked to anxiety. This generally makes you feel even more relaxed, especially if you already struggle with general anxiety or social anxiety. It can feel as though the chatter in your brain has finally quieted. And for a while, this feels wonderful.
But then, your well-meaning brain embarks on a mission to rebalance these chemicals. It begins to block GABA and produce higher levels of glutamate. Sometimes, this prompts a rapid swing from blissful calm to anxiety and dread.
Making matters worse, you may begin to recall embarrassing or unpleasant moments from the night before. Alternatively, you may recall nothing at all, which can also be alarming. The resulting fear or guilt can multiply the anxiety you’re already feeling.
Does Everyone Experience Hangxiety?
Although hangxiety is common enough to have its own term, it is not universal. It’s certainly possible to have a hangover that is not accompanied by hangover anxiety. Hangxiety can happen to anyone, but it’s most prevalent among people who have depression or anxiety, as well as those who are highly shy6.
Individuals with anxiety often experience temporary relief of their symptoms when drinking, which can feel liberating. These same individuals, however, often experience much worse feelings of anxiety once the effect wears off. In contrast to the effects of alcohol, these feelings can be especially overpowering and can lead to a cycle of self-medication.
Studies7 show that people who experience shyness and anxiety may be at greater risk for developing alcohol use disorder (AUD). Their dependence can often be more severe than that of alcoholics who do not have anxiety. They are also more likely to relapse, and may experience more withdrawal symptoms.
How to Manage Hangxiety
If you experience terrible hangxiety, here are a few tips on how to calm anxiety at night or ease your anxiety the day after drinking.
- Addressing the physical symptoms of your hangover can also make you feel better psychologically.
Follow standard hangover recovery procedures like drinking water, sleeping, eating a light meal, and taking a medication like ibuprofen.
- Try relaxation techniques such as meditation and deep breathing.
Relax your body and mind, noticing and accepting your thoughts without judging them. Listen to calming music or do an enjoyable activity that helps you relax, like writing, reading, painting, or going for a walk if you feel up to it.
- Try not to focus on what may have gone wrong the night before.
Remember that others are probably feeling the same way, and they likely didn’t notice or don’t even recall what you said or did. If you were with a trusted friend, it may be helpful to talk to them about your worries.
How to Prevent Hangover Anxiety
Although it’s possible to manage hangxiety to some degree, it’s even better to avoid it entirely. Simple steps to prevent hangxiety in the first place include eating before drinking, and following each alcoholic beverage with a glass of water. Research8 indicates that dehydration plays a role in anxiety and other mood changes, so staying hydrated will help prevent both hangover and hangxiety.
It’s also helpful to drink less alcohol. The more you drink, the worse your hangover (and any hangxiety) will be. Try pacing yourself, and setting a limit for the evening before you begin drinking. Go out with friends who would also like to limit their drinking, rather than friends who will drink to excess. This way, you can keep each other accountable while still having a fun evening.
Of course, this advice may seem obvious, but it’s often much easier said than done. If you struggle to drink in moderation, Ria Health can help. Our convenient, easy-to-use telemedicine platform gives you 24/7 access to the resources and support you need to change your relationship with alcohol. You set your own personal goals, and we help you achieve them.
Our program includes regular online coaching meetings, medical support, and handy digital tools that let you track your progress. We also offer medications like acamprosate, baclofen, and topiramate that rebalance GABA levels, treating both anxiety and alcohol cravings at once.