It’s happened to me before: Sweaty palms, racing thoughts, heart pounding out of my chest, fluttery stomach. A night of drinking leads to a day of indisposing hangover anxiety. Those first few drinks made me feel so good, but then I’d wake up feeling ill and regretful, trying to piece together the events of the night before.
I also started to notice that when I drank to quell my nerves or calm my racing mind, the following day, both nerves and mind would be worse than ever. So why did I continue to engage in this cycle of spree and remorse? And why did alcohol, which was supposed to relieve my nervousness, make my anxiety worse?
To answer all of my questions about what is commonly known as hangxiety (aka hangover anxiety), I turned to two experts; Mercedes M. Cusick MA, LMFT, a licensed psychotherapist specializing in addiction, trauma, EMDR, and self-esteem issues, and Cort M. Dorn-Medeiros, a Certified Alcohol and Drug Counselor III (CADC III), and Assistant Professor in the graduate school at Lewis & Clark College in Portland.
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1. Who experiences hangxiety the day after drinking and why?
“Anyone can experience hangxiety after drinking because alcohol changes the brain’s serotonin levels,” says Cusick. “This can dramatically increase anxiety, especially when the alcohol wears off. Increased anxiety is a symptom of withdrawing from alcohol. If you have consumed large quantities and suddenly stopped drinking, your anxiety can be aggravated by the side effects of alcohol withdrawal. Another factor to consider is the awful feeling that can come the morning after a night of overindulging. The looming anxiety that comes from trying to piece together events and conversations. Individuals who already suffer from generalized anxiety, social anxiety, panic disorders, depression, or PTSD will be more susceptible to increased anxiety the day after tying one on due to their predisposition.”
2. Why are people who suffer from depression and anxiety more likely to experience hangxiety?
“For people who experience anxiety, one or two drinks may help them feel relaxed and act as a social lubricant. I call this the ‘bump’ we get after one or two drinks,” says Dorn-Medeiros.
In this way, drinking can initially make it seem like symptoms of depression/anxiety have “disappeared,” but really, they are just being masked. The effects of alcohol are, of course, short-lived and, when they wear off, depression/anxiety symptoms return and sometimes can even feel more severe for a time as a rebound from drinking before our brain can re-balance itself. Of course, for people with severe alcohol use disorder, the brain may be permanently impacted by chronic, heavy drinking.
3. What is it about alcohol that makes you want to drink more?
Cusick explains, “Drinking alcohol triggers the release of endorphins, which is a chemical that produces feelings of pleasure. This explains why you want to drink more. People don’t often realize that alcohol is a depressant because of its misleading initial impact of euphoria. Alcohol is classified as a Central Nervous System depressant which means that it slows down brain functioning by enhancing the effects of the neurotransmitter GABA.”
4. We keep hearing about alcohol’s effect on the GABA (gamma-aminobutyric acid) receptor, but doesn’t alcohol also release dopamine?
“Yes, alcohol also triggers the release of dopamine,” says Dorn-Medeiros. “Dopamine is the neurotransmitter associated with all things pleasurable. When we take that first drink, we get a poof of dopamine, and we feel happy, joyful, euphoric, etc. This, coupled with our inhibitions being lowered and our stress/worry/anxiety being suppressed, can feel pretty good for a while. But the pleasant effects of alcohol peak after we reach a certain blood alcohol content (BAC), and we start experiencing more negative effects, such as lowered mood, greater physical impairment, sometimes feeling confused and disoriented, and have decreased energy the more and more we drink. Many refer to the effects of alcohol as biphasic, as it makes us feel both better and worse in the same instance.”
5. Tell me about “the hair of the dog” and why that seems to help with hangxiety.
“Hair of the dog, sometimes also called an ‘eye opener’, is when someone has a drink first thing upon waking up to treat a hangover after a bout of drinking,” says Dorn-Medeiros. “For the average person, the idea is that if you prevent your BAC from going down to zero, you will ‘treat’ a hangover by preventing unpleasant symptoms.
However, no matter when you stop drinking, your BAC will eventually go back down to 0, and you can still experience hangover symptoms and increased anxiety. To my knowledge, there is no scientific evidence that this practice actually treats/prevents hangovers outside of procrastinating on the eventual hangover… so perhaps you would have more time to rest, drink water, eat something, etc. and lessen the impact. However, this is very different for a person who has a severe alcohol use disorder. For these folks, an eye-opener is often used to prevent severe withdrawal symptoms and they need to keep drinking. For many of these folks, they need to be medically monitored if and when they decide to cut down or cease their alcohol use.”
6. For those of us who have treated our anxiety with alcohol, what should we do instead?
“I am a firm believer in therapy to address the root cause of their anxiety, whether connected to trauma, grief/loss, relationship issues, or learning how to deal with stress,” says Cusick. “Also, lifestyle changes to help reduce anxiety, such as consistent sleep, limit amounts of caffeine, eating healthy, regular exercise, and setting a time each day to focus on relaxation techniques, such as meditation or yoga.”
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The bottom line is that your mind and body are miracles of science. Putting too much of a depressant like alcohol into your system causes your mind/body to rebel and release chemicals like cortisol and adrenaline to combat the alcohol. Problem drinkers or those diagnosed with alcohol use disorder are even at greater risk to suffer from hangxiety.
As the experts explained, while it may feel like you are alleviating your stress by drinking, day-after feelings of regret, anxiety, and depression may be inevitable. Drinking might be a short-term fix for some, but you won’t find long-term treatments for stress, anxiety, or depression in the bottom of a glass.