Enjoying a few drinks with friends during a night out or at a party can make for a fun evening. But the hangover you get the next day? That’s a lot less fun.
You’re probably familiar with the usual physical symptoms of a hangover — the pounding headache, the nausea, the need to wear sunglasses at the first hint of daylight.
But hangovers can have psychological symptoms too, especially feelings of anxiety. This phenomenon has been so widely reported that it even has its own name: hangxiety.
Why does it happen?
The whole concept of hangover-related anxiety is fairly new, and experts haven’t identified a single cause. But they have a few theories.
“Many people use alcohol as a social lubricant,” says Cyndi Turner, LSATP, MAC, LCSW.
If you live with anxiety, particularly social anxiety, you may find that a drink or two helps you relax and cope with nervous or anxious feelings before (or during) a social event.
“About two drinks, or a blood alcohol concentration of 0.055, tends to increase feelings of relaxation and reduce shyness,” Cyndi goes on to say.
But as the effects of alcohol begin to wear off, anxiety tends to return. Physical hangover symptoms can compound anxiety and make you feel even worse.
Whether you have one drink or five, your body eventually has to process the alcohol out of your system. This detoxification period, which can be considered a mild form of withdrawal, can take up to 8 hours, according to Cleveland Clinic.
During this time, you might feel restless, anxious, nervous, or jittery, just as you might if you were dealing with more severe alcohol withdrawal.
A type of emotional withdrawal can also occur, according to Turner.
She explains that when endorphins, your body’s natural painkillers and feel-good hormones, are released in response to traumatic events, their levels naturally decrease over a period of several days.
Drinking alcohol also triggers the release of endorphins and an eventual comedown.
So at first, drinking alcohol may seem to help numb any physical or emotional pain you’re feeling. But it won’t make it go away.
The combination of decreasing endorphins and the realization that your problems are still there is a recipe for feeling physically and emotionally unwell.
There are a lot of reasons why that bathroom line at the bar is so long. One is that drinking tends to make people urinate more than usual. Plus, despite your best efforts, you probably don’t drink as much water as you should when you’re drinking.
The combination of these two factors can lead to dehydration. Research suggests this can contribute to anxiety and other changes in mood.
Folic acid deficiency
Not getting enough of the right nutrients can also affect mood symptoms. A 2011 study on adults with depression or anxiety suggests a link between low levels of folic acid and these conditions.
Alcohol can also cause your folic acid levels to dip, which could explain why you don’t quite feel like yourself the next day.
People are also more likely to indulge in foods that might also trigger anxious feelings.
Certain medications, including some anxiety and anti-inflammatory medications, may interact with alcohol. Your medications may be less effective, and you may feel anxious, restless, or agitated.
Some medications also carry a risk of other side effects, including memory impairment or serious physical health concerns like ulcers or organ damage.
If you’re taking any medications, check the label to make sure it’s safe to drink alcohol while you’re taking them. The same goes for any vitamins, herbal supplements, and other over-the-counter medications.
Regret or worry
Alcohol helps lower your inhibitions, making you feel more relaxed and comfortable after a few drinks. “But more than three drinks can begin to impair balance, speech, thinking, reasoning, and judgment,” Turner says.
That impact on your judgement and reasoning can make you say or do things you usually wouldn’t. When you remember (or try to remember) what happened the next day, you might feel embarrassment or a sting of regret.
And if you’re not totally sure what you did, you might feel nervous as you wait for your friends to tell you what happened.
Sometimes called alcohol allergy, alcohol intolerance can cause many symptoms that resemble the physical symptoms of anxiety, including:
- rapid heartbeat or pounding heart
- head pain
Other symptoms include sleepiness or excitability and warm, flushed skin, especially on your face and neck. It’s also possible to experience mood-related symptoms, including feelings of anxiety.
Alcohol use can affect your sleep, even if you don’t drink much. Even if you’ve gotten plenty of sleep, it probably wasn’t of the best quality, which can leave you feeling a bit off.
If you live with anxiety, you’re probably familiar with this cycle that happens with or without alcohol: Your anxiety symptoms get worse when you don’t sleep enough, but those same symptoms make it hard to get a good night’s sleep.
Why doesn’t it happen to everyone?
Why do some people wake up after drinking feeling relaxed and ready for brunch, while others stay wrapped in a blanket, feeling the weight of the world? New research suggests highly shy people may have a higher risk of experiencing anxiety with a hangover.
A 2019 study looked at 97 people with varying levels of shyness who drank socially. Researchers asked 50 of the participants to drink as they usually would, and the other 47 participants to stay sober.
Researchers then measured levels of anxiety before, during, and after the drinking or sober periods. Those who drank alcohol saw some decrease in anxiety symptoms when drinking. But those who were highly shy tended to have higher levels of anxiety the next day.
Alcohol is also known to make anxiety worse, so you may be more prone to hangxiety if you already have anxiety to begin with.
How to deal with it
If this isn’t your first time at the anxiety rodeo, you probably already have a toolbox of coping methods. But you probably don’t feel up to taking a walk, doing yoga, or journaling about your feelings if you’ve got a pounding headache or the room spins when you move.
Manage physical symptoms
The mind-body connection likely plays a big role in hangxiety. Feeling physically well won’t completely resolve anxiety, but it can make you better equipped to tackle racing thoughts and worries.
Take a deep breath — and then another
Deep, slow breathing can help you relax and slow a racing or pounding heart.
Breathe in while counting to four, then breathe out while counting to four again. Do this for a few minutes, until you notice your heartbeat slowing down. You can also try the 4-7-8 breathing technique.
Try mindfulness meditation
You can meditate while sitting or even lying in bed, if you don’t feel up to being upright. It can help to start with some deep breathing, so lie or sit back, close your eyes, and focus on your thoughts and how you feel, physically and emotionally.
Don’t try to judge your thoughts, avoid them, or unpack them. Simply notice them as they come up into your awareness.
Put the night into perspective
Often, a big part of hangxiety is worrying about what you might have said or done while drinking. But remember, what’s true for you is likely true for everyone else.
In other words, you probably weren’t the only one who said or did something you regret. It’s also possible no one noticed what you said or did (or already forgot about it).
Fixating on what happened can make your feelings worse. If you were with a close friend, you might feel reassured by talking to them. But for the moment, it might help to take a few minutes and examine your thoughts.
What are you most worried about? Why? Sometimes, talking yourself through what you’re afraid of and challenging that fear can help you manage it.
How to prevent it from happening again
A bad hangover, even without hangxiety, can make you never want to drink again. That’s one way to avoid future bouts of hangxiety, but there are other things you can do to reduce your risk of experiencing alcohol’s less desirable effects.
Drinking alcohol isn’t inherently bad or problematic. There’s nothing wrong with occasionally letting loose or even having a hangover from time to time. But moderation is harder for some people than others.
If you find yourself frequently experiencing anxiety after drinking, it might be time to take a step back and reevaluate things.
“If alcohol use causes a problem, it is a problem,” Turner says. In her practice, she teaches alcohol moderation. This is a strategy that can help some people avoid some of the negative effects of alcohol.
“Moderation is typically less than two drinks at a time for women and three for men,” she says. “This amount allows people to enjoy the pleasurable effects of alcohol before physical impairment occurs.”
She also suggests that alcohol moderation works best when you:
- know why you use alcohol
- develop alternative methods of coping with difficult situations
- keep your alcohol use at safe levels
Keep in mind that this approach doesn’t work for everyone.
Alcohol use disorder
Alcohol use disorder can be hard to manage with moderation alone. If you find that moderation isn’t working, consider reaching out for additional help. You may be dealing with alcohol use disorder (AUD).
It’s easy to fall into a cycle of drinking to reduce anxiety symptoms, only to have them return ten-fold the next morning. In response, you might drink more to deal with the anxiety. It’s a hard cycle to break on your own, but a therapist can help you work through it.
“In session, I have clients think about an anxiety-provoking situation where they might use alcohol,” Turner explains. “Then we break the situation down, step-by-step, and prepare a different way to handle it.”
Not quite ready to take that step? Both of these hotlines offer 24-hour free, confidential support:
- American Addiction Centers hotline: 888-969-0517
- Substance Abuse and Mental Health Services Administration hotline: 1-800-662-HELP (4357)
The bottom line
Like other hangover symptoms, hangxiety may be a passing discomfort. But sometimes it’s a sign of something more serious. If your anxiety persists, or if you feel like you need to drink more alcohol to cope with it, consider talking to a therapist or healthcare provider.
Otherwise, set some boundaries for yourself and make sure to prioritize food, water, and sleep the next time you drink.