Dealing with hangxiety

Anyone who has ever drank to excess (or even just had a few drinks as we get older) will have experienced a hangover and hangxiety – the emotional side of a hangover. The feelings of anxious dread after a night’s drinking can feel as bad as the physical symptoms. But what causes it?

Surprisingly, scientists still don’t know what causes hangovers or hangxiety. Likely, there are many causes.

Irritation of the lining of the stomach seems to be a cause of upset stomach after drinking, while dehydration can contribute to nausea and headaches. Alcohol disrupts sleep, leading to the fatigue most people experience the day after.

Alcohol converts into acetaldehyde in the body as it’s broken down in the liver. Acetaldehyde is a toxic substance that leads to inflammation in the brain, GI tract, liver, and pancreas, which further contributes to the feeling of a hangover. Luckily, acetaldehyde is short-lived, and we process it and clear it out quickly. However, some people have genes that make them worse at breaking it down, which leads to more severe hangovers.

While we don’t fully know what causes them, we do know some of the causes of the physical effects of a hangover. But what causes hangxiety?

What causes hangxiety?

Several things may cause hangxiety, and they are a result of the changes in your brain that happen when you drink, and what happens when alcohol clears from your system and your brain attempts to rebalance.

Endorphins

Endorphins are a type of neurotransmitter that attaches to our opioid receptors. They make us feel good, reduce pain, and enhance pleasure. Because they are released when we feel pain or stress, many people who practice strenuous exercise talk about an ‘endorphin rush.’

Endorphins are also released when we drink alcohol, and this contributes to feelings of euphoria and relaxation. However, when alcohol wears off, there is a rebound effect – and our endorphins can drop below normal levels. When your endorphin levels are lowered, you’ll experience increased pain, lower mood and heightened levels of stress.

This process of the release of feel-good chemicals in the brain followed by a rebound the next day is a typical pattern in hangxiety.

GABA

Gamma-aminobutyric acid (GABA) is a neurotransmitter, and its job is to slow down activity in the brain. People with anxiety disorders can gravitate towards substances that affect GABA, as this slowing down of brain activity makes them feel much calmer. One of the reasons that benzodiazepines are prescribed for anxiety is because of their effect on GABA.

GABA has a counterpart in the brain – glutamate. It does the opposite of GABA and promotes activity in the brain. Alcohol disrupts the balance between these two neurotransmitters – when you drink, glutamate activity is lowered, and GABA activity is heightened, meaning you feel less anxious.

During a hangover, this switches around – GABA activity is reduced, and glutamate activity is increased, sending the brain into ‘overdrive’. This causes many of the unpleasant, anxious effects of a hangover—tremors, sweating, rapid heartbeat, racing thoughts, and anxiety.

Some scientific literature describes hangovers as mini-withdrawals. This process mimics many of the alcohol symptoms that occur when a chronic drinker detoxes from alcohol – but the effects are much more pronounced because they have been using alcohol over much more extended periods. This means the brain will take longer to get back to normal than it would if it was just a hangover.

Stress response receptors

A 2023 study investigated a different reason for hangxiety, looking at corticotropin-releasing factor receptors, or CRF receptors. These receptors are widely distributed in the brain and play a key role in releasing stress hormones like cortisol. While these studies were performed on mice and not humans, they might reveal another way hangxiety manifests in the brain.

The study found that mice exhibited alcohol effects much like humans do after they have drank a lot – they were less anxious and more sociable. The day after, they showed signs of anxiety and stress. The researchers found that if they blocked the activity of one of the types of CRF receptors in the brain, called the CRF1 receptor, these symptoms of anxiety and stress were significantly reduced.

Like GABA, chronic drinking appears to lead to significant changes to CRF receptors, which increases feelings of stress. This points again towards hangovers being very similar to alcohol withdrawal – just less severe and on a shorter timescale.

Chronic hangxiety

One of the symptoms of alcohol abuse is a dysregulated mood. Hangxiety feels extremely unpleasant – and if you’re drinking every day, hangxiety can become your default state when you’re sober, which drives the desire to drink more to alleviate the symptoms. The processes in your brain that contribute to hangxiety worsen if you drink heavily and regularly, and the rebalancing that your brain needs to do after drinking will take more extended periods of abstinence – your brain will need longer to recover. This can contribute to mood disorders or exacerbate underlying mental health problems like depression, anxiety and stress.

Immediate relief strategies

The cure for a hangover is time and rest. Your brain needs time to rebalance, and your body needs time to recover. Despite many attempts to find one, there is no cure for a hangover. Most of the recommendations for dealing with hangovers focus on the physical symptoms, like drinking lots of water, eating certain foods, getting plenty of rest and gently exercising.

The best thing to do for hangxiety is to be gentle with yourself and wait it out. Try to distract yourself from any negative thoughts you’re having – remind yourself it’s just the hangxiety, and they will pass eventually. Don’t try to alleviate the symptoms by taking other substances or drinking more – this risks making the situation worse.

Long-term management

If you’re struggling with long-term hangxiety, this is a cause for concern. Chronically drinking to alleviate anxiety is a symptom of alcohol dependence. If you have an underlying anxiety disorder or social anxiety, the relief found in drinking may be why you started to drink in the first place. However, over time, the delicate balance of neurotransmitters in your brain becomes disrupted, and your anxiety will become worse.

Alcohol isn’t the answer to managing anxiety, and long-term management of hangxiety means treating alcohol dependence and anxiety themselves.

Treating anxiety can mean:

• Lifestyle changes, like diet, sunlight, exercise
• Calming and mindfulness practices, like breathing exercises, meditation, mindfulness, yoga, qi-gong and complementary therapies
• Therapies like CBT
• Speaking to your GP about medications like SSRIs.

Because alcohol works so quickly to alleviate anxiety, it can be hard to give it up and work on long-term solutions. These lifestyle changes and treatments work much more slowly. Even medications like SSRIs can take a few weeks to work, and short-acting medications like benzodiazepines are only prescribed for very short periods and are not a solution, as these can also lead to dependence.

If you’ve been using alcohol to self-medicate for anxiety for a long time, you may need help to stop using it. Get in touch today to find out how we can help you to stop relying on alcohol.