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Hangxiety: 3 reasons why alcohol makes you anxious

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It's the morning after a night out. You know the next 24-72 hours might be a challenge. However, there are ways in which you can improve how you feel once you understand how it works. A hangover initiates when alcohol levels in blood drop and is accompanied by fatigue, thirst, difficulty concentrating, nausea, headaches, dry mouth, and stomach issues. Over 20% of those who drink experience an added symptom- hangxiety [1] - the hangover anxiety that can continue for 14 hours after[2]. Brain’s chemistry can shed light on why this happens and its management. Here are 3 reasons why you experience anxiety after drinking

1. Excitement and relaxation- the delicate balance

Alcohol consumption affects all areas of the brain and its chemicals. Your brain functions at its best when there is a balance between the excitatory and inhibitory (relaxing) chemicals. The connection of alcohol and anxiety is due to changes in this balance. Upon intake, alcohol can increase the effect of the relaxing brain chemical called GABA, thus promoting sedation. It also decreases the levels of the excitatory chemical called glutamate, which is responsible for activating brain cells. Thus, disrupting their balance. The next morning when alcohol levels drop, the brain tries to normalize the imbalance by increasing glutamate production by over 200% [3]. GABA release is decreased [3]. Relative imbalance of the GABA and glutamate induces anxiety behaviours [4].

2. Alcohol adds to the stress

Due to the changes alcohol creates, the body sees it as a stress response. Alcohol increases the level of stress hormone, cortisol, and keeps it high the next day. This increase is 2-5 times higher compared to those who abstain. After you stop drinking, it can take up to a week for the cortisol levels to normalize [5]. High stress levels are associated with higher levels of anxiety [6].

3. Alcohol’s breakdown increases hangxiety

Alcohol is converted to a compound called acetaldehyde, which the body clears away. Clearing out alcohol takes time and increased levels of acetaldehyde partly causes hangover symptoms. Like alcohol, this compound also increases cortisol levels [7], which increases anxiety. In animal studies, acetaldehyde was associated with increased anxiety behaviours [8].

Being shy can increase hangxiety

Shyness is a mild form of social anxiety. Shy individuals might also drink more in social situations as a coping mechanism due to alcohol’s initial relaxing effect. They reported a higher level of hangxiety [4] regardless of the level of alcohol consumed.

How to manage hangxiety?

Since the body eliminates alcohol at a specific rate, decreasing and spacing out the intake will help reduce hangover and hangxiety symptoms. Lower the alcohol intake, less severe will be the hangover.

Getting good quality sleep will improve hangover effects. Those who slept better experienced lesser hangxiety [9].

Alcohol dehydrates the body. Dehydration is associated with increased anxiety [10]. Ensuring adequate water intake during a hangover can help lower hangxiety.

Certain food nutrients can help lower the harm done by acetaldehyde. These are called antioxidants and are found in berries, nuts, dark chocolate and green tea.

The only foolproof hangxiety cure is abstinence. Even among heavy drinkers, brain repair and blood flow improved within 2 weeks of abstinence [11]. Alcoholics with anxiety disorders reported lower anxiety levels six weeks into abstinence [12].

Controlling alcohol intake, getting adequate rest, rehydrating efficiently, and getting enough antioxidants can help you navigate your hangover better, and help you spring back into action soon.

References

van Schrojenstein, M. et al. (2017). The impact of alcohol hangover symptoms on cognitive and physical functioning, and mood. Human Psychopharmacology: Clinical and Experimental, [online] 32(5), p.e2623.
Karadayian, A.G. et al. (2013). Alterations in affective behavior during the time course of alcohol hangover. Behavioural Brain Research, [online] 253, pp.128–138.
Brousse, G. et al. (2012). Alteration of Glutamate/GABA Balance During Acute Alcohol Withdrawal in Emergency Department: A Prospective Analysis. Alcohol and Alcoholism, 47(5), pp.501–508.
Marsh, B. et al. (2019). Shyness, alcohol use disorders and ‘hangxiety’: A naturalistic study of social drinkers. Personality and Individual Differences, 139, pp.13–18.
Keedwell, P.A. et al. (2001). Salivary cortisol measurements during a medically assisted alcohol withdrawal. Addiction Biology, 6(3), pp.247–257.
Adinoff, B. et al. (1998). Disturbances of the Stress Response. Alcohol Health and Research World, [online] 22(1), pp.67–72.
Brancato, A. et al. (2017). Acetaldehyde, Motivation and Stress: Behavioral Evidence of an Addictive ménage à trois. Frontiers in Behavioral Neuroscience, [online] 11.
Ezequiel Leite, L. et al. (2012). The negative effects of alcohol hangover on high-anxiety phenotype rats are influenced by the glutamate receptors of the dorsal midbrain. Neuroscience, [online] 213, pp.93–105.
Mc Kinney, A. et al (2005). Alcohol hangover effects on measures of affect the morning after a normal night’s drinking. Alcohol and Alcoholism, 41(1), pp.54–60.
Ganio, M.S. et al. (2011). Mild dehydration impairs cognitive performance and mood of men. The British journal of nutrition, [online] 106(10), pp.1535–43.
van Eijk, J. et al. (2012). Rapid Partial Regeneration of Brain Volume During the First 14 Days of Abstinence from Alcohol. Alcoholism: Clinical and Experimental Research, 37(1), pp.67–74.
Driessen, M. (2001). The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders. Alcohol and Alcoholism, 36(3), pp.249–255.