Anxious after a night of drinking? It may be 'hangxiety,' the hangover's neurotic cousin.
Years ago, I shared a drink with a friend who was leaving the city. She offered some parting advice, including cutting back on hard alcohol if it began to cause me to experience anxiety, as it had for her.
At the time, I wrote it off, unfamiliar with the phenomenon she was referring to. Now, at the ripe old age of 25, I understand a bit better. Like many others, I have become all too acquainted with the rapid heartbeat and untraceable melancholy that sometimes follows a night of drinking.
Colloquially dubbed “hangxiety,” this uncomfortable set of feelings can make a hangover feel like a mental health tug-of-war. If Advil and fried food ease the physical ramifications of one too many tequila sodas, what can help ease the mind?
We spoke to experts to find out. Here’s what they had to say about what causes "hangxiety" and how you can blunt its effects.
What is hangxiety?
Hangxiety is the mash-up term pop culture has given to that feeling of anxiety or sadness that can follow an evening of heavy drinking.
“It’s this feeling of overwhelmed anxiety, of doom,” says Dr. Akhil Adnand, an addiction psychiatrist at the Cleveland Clinic. “It's not only psychological but physical. You get heart racing. You get uneasy butterflies in your stomach. You're very fidget.”
Anecdotally, he says, nearly a quarter of his patients report experiencing hangxiety. “It is a cultural term, but I have seen it and other medical professionals have seen it,” he says.
Its cause can be traced to a number of neurological factors. “Alcohol causes a muck in your brain neurochemistry, and it effects all the neurotransmitters,” Adnand says.
For one, dopamine, which helps the body to manage anxiety, is hindered as you recover from ingesting alcohol, clinical psychologist Dr. Kendra Kubala shares in an email to USA TODAY. Additionally, cortisol, often dubbed the “stress hormone” ticks up during that recovery.
There is also an element of recalibration. Alcohol is called a "social lubricant" for a reason. It can make people feel more at ease. It does this by mimicking our natural relaxation hormone, known as GABA. But when that cloak of relaxation wears off, our bodies have to return to their baseline, resulting in what Kubala calls “a bit of a chemical battle.”
After alcohol has really enhanced the GABA neurotransmitter, glutamate, its natural counter tries to balance it out. The day after drinking (even if you didn’t drink heavily), depending on your personal biology, your brain’s rebalancing of that glutamate may cause anxiety and agitation, Adnand says.
In trying to "reset," your brain can take you on a bit of a mood roller coaster.
“Alcohol itself is a depressant and has sedating effects,” Dr. Arielle Baskin-Sommers, a professor of psychology and psychiatry at Yale, said in an email to USA TODAY. “It helps us feel relaxed when drinking, but when we stop drinking the brain tries to recalibrate from the more sedating effects leaving some to feel worked up, anxious and irritable,” she says.
And then there’s the endorphins. Consuming alcohol can cause the body to release endorphins, resulting in a feeling of happiness and a positive mood. However, there is a yo-yo effect once those endorphin levels come back down, sometimes causing a more severe “crash” in mood, Kubala warns.
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What are the symptoms of hangxiety?
“There are a lot of individual differences, and not everyone who drinks will experience what you call ‘hangxiety,’” Baskin-Sommers says.
While we often think of a run-of-the-mill hangover as purely physical – a headache, nausea, maybe some sensitivity to bright light and loud noise – psychological ramifications are actually quite common. In fact, Baskin-Sommers lists anxiety, low mood and jitteriness as frequent symptoms. Essentially, hangxiety is just a catchall term for the psychological effects endemic to a hangover.
Not everyone is equally likely to experience them, however. “People who have preexisting anxiety or other mental health conditions are at higher risk for experiencing the psychological effects after having alcohol,” Baskin-Sommers says. Adnand adds that in his experience, women, and those who experience social anxiety, are also more likely to be affected.
Increased heart rate, sweating, increased anxiety, worry, and general distress for no known reason can all be symptoms of hangxiety, Kubala says. Because alcohol consumption also disrupts healthy sleep patterns, it may become more difficult to make decisions, complete simple tasks and concentrate your attention on any one thing.
"Alcohol does help people get to sleep, but it doesn't help the quality of sleep and it affects your REM sleep," Andand says. "So you're not really rested, that can also increase the anxiety."
A patchwork memory
Another key component that can drum up hangxiety is faulty memory, Andand says.
Oftentimes patients who engage in heavy drinking are unable to remember all the events of the night before. If you're already an anxious person, not being able to remember all your interactions can lead you to ruminate, which makes anxiety worse.
How long does hangxiety last?
Hangxiety is not a monolith. Age, alcohol tolerance, hydration, body weight and medications can all contribute to how long a person’s symptoms persists, Kubala says.
It’s all about how long your body takes to recalibrate after various hormones and neurotransmitters have been disrupted. “Generally speaking, people experience the physical symptoms for a shorter period of time than the psychological symptoms,” Dr. Baskin-Sommers says of a hangover. “Ultimately, it depends on what it takes for each person’s brain to return to its set point.”
That’s the medical side. The challenge with hangxiety, though, is that it can be situational as well. Drunk decisions often create sober regrets. So, if a person has made a poor decision while intoxicated or hungover, the worry, anxiety, guilt, shame and uncertainty associated with hangxiety might last longer, Kubala says.
Usually hangxiety will last about a day. If it begins to drag on into two or three days, Adnand warns, this may be your body trying to tell you something more urgent. "That may not be anxiety; that might be alcohol withdrawal, and that suggests dependence to alcohol, which is a very high-risk factor for addiction."
How do I get rid of hangxiety?
All this sounds pretty awful. Is there a quick fix? Not really. Curbing hanxiety can be as nuanced as fighting general anxiety. The key is to be patient with yourself and examine the root causes.
From a prevention standpoint, it’s good to watch what you drink. For example, many cocktails have large amounts of sugar and dyes, Dr. Kubala says. That can result in an energy “crash” and a dip in mood.
“Examining why you drink alcohol can help make healthier decisions,” she advises, especially if you are drinking to numb a specific feeling, because it is likely that feeling will return once you sober up, maybe even more forceful than before.
Baskin-Sommers recommends reducing the total amount of alcohol in the system by alternating between hard and virgin beverages on a night out. Staying hydrated is also key, so throwing a few glasses of water into the rotation is never a bad idea, nor is making sure you've eaten a full meal before you start drinking.
As for lessening the pain once the hangxiety has already arrived, Adnand recommends creating a day that revolves around self-care. If you know you're planning to go out for an evening of drinking, clean your space before you leave – coming home to a house in disarray can aggravate hangxiety, he says.
Ticking off items on your to-do list ahead of time can also help. "When you have nothing else to do that day, and you're just resting ... it does make your anxiety a little bit better. You can just do self-care," Adnand suggests. That means exercise, healthy food, lots of hydration, and setting yourself up for better sleep hygiene the following night.
The best cure is moderation
All three experts agreed that the best way to combat hangxiety is to drink less and to take real time to evaluate your relationship with alcohol.
While hangxiety is quite common, Adnand says, if it becomes too much of a recurring pattern in your life, it might be time to draw back and reflect. Is the relationship you have with alcohol still serving you?
"Considering your motivation for drinking and the state you are in when you start drinking can be useful," Baskin-Sommers says. "If you are drinking to “feel better” or you already are feeling down when you start drinking, it is most likely that these feelings will get worse after you drink."
Adnand suggests a dry January, starting off the year with a full 31 days of alcohol abstinence. If that seems a bit too dry, you can try a few weeks or stick to some of the tips and tricks meant to dull the effects of hangxiety, like increased hydration.
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This article originally appeared on USA TODAY: What is hangxiety? Here's how to cure these hangover symptoms.