It’s a scene that is likely familiar for many. You wake up the morning after a night out with blurry recollections of the evening and a hangover.
You check your phone, cringing as your read through texts or glance at outgoing calls. You shoot off a few apology texts, or texts trying to fill in the blanks of the night before, all the while feeling the pit in your stomach grow.
If that sounds familiar, you’ve likely experienced what is referred to as “hangxiety,” and there can be both physiological and psychological reasons for this.
What causes hangxiety?
There are various factors that come into play when someone experiences hangover anxiety or hangxiety. According to some experts, hangovers are actually small withdrawals from alcohol, including the anxiety component. For those who drink more heavily and suddenly try to stop, they would experience the same symptoms on a more intense level.
The way alcohol impacts the brain also has an effect on those morning-after feelings. Initially, when you take in alcohol, the reward pathways in the brain become more active. But when they cease being as active, the levels of dopamine, serotonin and endorphins drop and impact emotions, Aparna Iyer, M.D., a psychiatrist and assistant professor at University of Texas Southwestern Medical Center, explains to SELF.
However, the most impacted region of the brain, according to experts, is likely the GABA (gamma-aminobutyric acid) pathway, which affects motor control, memory and anxiety. The way alcohol affects the GABA is why drinking can feel relaxing in the moment. But for those with an alcohol use disorder, the lack of alcohol can lead to the system being confused and induces anxiety.
When can hangxiety indicate a bigger problem?
For some, the presence of hangxiety can be a clue pointing to bigger problems. Those, particularly at risk, are individuals who may have had anxiety disorders prior to introducing alcohol, or those who rely on alcohol as a social lubricant.
“People who already have a pre-existing anxiety disorder, even if it’s a small one and kind of underlying everything, whatever they have quieted by drinking the alcohol, that can come back full force or even worse,” Aparna Iyer, a psychiatrist and assistant professor at University of Texas Southwestern Medical Center, tells SELF.
In fact, a study conducted in 2019 found that very shy individuals likely felt less anxiety when drinking, but higher anxiety the following day and were more prone to Alcohol Use Disorder (AUD).
“This study suggests anxiety during hangover is linked to AUD symptoms in highly-shy individuals, providing a potential marker for increased AUD risk, which could inform prevention and treatment,” researchers concluded.
Additionally, the continued use of alcohol even after feelings of depression or anxiety is listed as one of the DSM–5’s criteria when it comes to determining whether someone is facing AUD.
Can hangxiety be managed?
If you’ve determined that you struggle with hangxiety, you likely want to know what you can do to manage or avoid in. The simplest answer is often the hardest for people: cut back on drinking or stop completely.
Celia Morgan, a professor of psychopharmacology at the University of Exeter in the UK and an author of the 2019 study, tells The Guardian that thinking ahead is sometimes the key.
“Before drinking in a social situation you feel anxious in, try fast-forwarding to the next day when you’ll have much higher anxiety levels,” she said. “If you can’t ride that out without drinking, the worry is that you will get stuck in this cycle of problematic drinking where your hangxiety is building and building over time. Drinking might fix social anxiety in the short term, but in the long term it might have pretty detrimental consequences.”
Morgan adds that drinking to smooth over social situations doesn’t allow people to take part in exposure therapy, which has to do with confronting fears to overcome them.
David Nutt, a professor of neuropsychopharmacology at Imperial College in London, adds that drinking in order to combat hangxiety just starts a vicious cycle for the individual.
“Never treat hangxiety with a hair of the dog,” he said. “When people start drinking in the mornings to get over their hangxiety, then they’re in the cycle of dependence. It’s a very slippery slope.”
However, in the future, there may be an alternative option for avoiding hangxiety, as Nutt says he is working to develop a drink called “Alcosynth.” In short, the drink would have the same effects as alcohol but without the impact on the GABA.
“We’re in the second stage of fundraising to take it through to a product,” he said. “The industry knows [alcohol] is a toxic substance. If it was discovered today, it would be illegal as a foodstuff.”
In the end, it’s up to you to determine how your relationship with alcohol is contributing to experiencing hangxiety. If it’s a sensation you feel more often than not after drinking, it may be time to take a long, hard look at your relationship with alcohol and whether the pros outweigh the cons in your life.
This blog post has been reviewed for medical accuracy by Paul Leonard, MD.