How to get over ‘hangxiety’ after drinking

01/07/2024

'Hangxiety' includes headaches, restlessness and feelings of panic

It’s a hangover with panic and paranoia thrown in. It’s a headache, a churning gut as well as a churning mind. It’s waking after a heavy drinking session feeling not just physically fragile but emotionally fragile, too – overwhelmed, on edge, worried about the night before, unable to sleep or settle.

This state – known as “hangxiety” – is a common side effect of drinking more than the body can comfortably handle, though some of us are more prone to it than others. It seems most prevalent among the younger generations – 40 per cent of drinkers under the age 35 experience it regularly, compared with just 12 per cent of drinkers over 35. According to research by Alcohol Change UK, one in three young adults who drink opted to reduce alcohol consumption partly because of hangxiety.

In fact, hangxiety symptoms are a straightforward consequence of the chemical reactions triggered by drinking alcohol. So what’s behind it? And what calms it down?

What is hangxiety?

“It’s a mixture of hangover and anxiety,” says David Nutt, a professor of neuropsychopharmacology at Imperial College and author of Drink? The New Science of Alcohol and Your Health. “They go together very well because the nature of hangover at a chemical level – the changes in neurotransmitters brought on by heavy drinking – are the same changes that you find in anxiety disorders.”

What are the typical symptoms?

Feelings of panic – increased pulse and fast heart rate
Guilt and intensely self-critical rumination
Existential dread
Restlessness, racing thoughts and inability to calm your mind
Fear and worry about your behaviour and events the night before
Thumping headache
Light and noise sensitivity
Churning, upset stomach (sickness and/or diarrhoea)
Trouble sleeping

What causes anxiety after drinking?

“There are two main chemical causes,” says Nutt. The first is caused by changes in a neurotransmitter called Gaba (gamma-aminobutyric acid). “When we drink in small amounts, the relaxation, the conviviality we experience, is a result of increasing amounts of Gaba, a calming and soothing chemical in our brain. That’s why alcohol is the ultimate social drink. Humans are anxious socially – it’s an evolutionary protective trait to be wary in gatherings – so we drink alcohol to increase Gaba and chemically reduce that anxiety.”

However, our body’s natural response to a sudden increase is to try to rebalance, so it starts to turn down our Gaba. “When the drinking is finished and alcohol leaves the body, the Gaba calming system is still turned right down.”

The second – and more powerful – chemical cause is down to our glutamate levels. “Glutamate is the other side of the Gaba coin,” says Nutt. “While Gaba calms the brain, glutamate excites it, making you super-alert and focused. When you are on about your fourth drink, alcohol begins to block glutamate – and that’s why you start to have problems with memory and balance, you become hazy and disinhibited and do things you can’t remember. Glutamate is important for memory formation.” Your brain hates it and again, tries to correct it. “Your brain is terrified because if you keep blocking glutamate, eventually you die, so it rapidly starts to compensate by upregulating your glutamate receptors, and making more of it.”

At the end of all this, as the alcohol clears after a heavy drinking session, the balance hasn’t yet reset, the chemicals are in disarray, with too little Gaba and too much glutamate – and that is the anxious state.

On top of this, there is plenty to feed that anxiety. Memory disruption is disturbing – and if you’re in a heightened state of anxiety, you’re more likely to fill in the blanks with worst-case scenarios. Alcohol compromises sleep quality and causes sleep disruption, which again disrupts brain chemistry. It also wreaks havoc with our blood sugar levels, which fuels the stress hormone cortisol and interrupts sleep. “At the same time, you have the pain and discomfort caused by inflammation in the brain and the gut,” says Nutt. All in all, there are a lot of reasons to feel anxious.

While any drinker can be hit with hangxiety, alcohol tolerance, metabolic rates and certain genetic factors might make a difference. Research also suggests that the shyest among us are most vulnerable. Highly shy people may find the greatest decrease in anxiety while drinking, but also the most debilitating anxiety the following day.

Dos and Don’ts with hangxiety

Don’t try hair-of-the-dog

“The key message is that you must never use alcohol to dampen hangxiety,” says Nutt. “It will work – but then you’ll be on the vicious cycle downwards. It’s what we call ‘relief drinking’ – drinking to deal with the symptoms of drinking, and it takes you through the door to being an alcoholic.”

Do manage the physical symptoms

Feeling physically well will help you attend to your anxiety. Rehydrate with plenty of water and take an electrolyte supplement to replace the sodium, potassium and chloride you have lost. “Any headache is down to inflammation in the brain, which you can dampen with medication like ibuprofen,” says Nutt. “Take a warm bath if it helps you relax, or a shower. Sleep if you can.”

Do eat

“Eating is a way of calming the inflammation and over-excitement in both the gut and the brain,” says Nutt. “There are nerves between the two – they’re very connected. There’s a lot of Gaba in the gut so foods that increase Gaba can help calm.”

Try these foods:

Wholegrains
Spinach
Mushrooms
Tomatoes
Anti-inflammatory foods containing omega-3 fatty acids, such as salmon and eggs
Fermented foods to replace the good gut bacteria killed off by the alcohol

However, Nutt says that all food will stretch the stomach wall to release hormones, and the best food at a time like this is really whatever you find appealing. Be wary of coffee though – it might shake off some of the grogginess but it’s also a stimulant when you’re seeking calm.

Don’t allow critical self-talk

“Critical thoughts about yourself and your behaviour are not helpful and this is really the time to be kind to yourself,” says psychotherapist and anxiety expert Kamalyn Kaur. “Reframe it and imagine you’re talking to a family member or loved one who is going through this. What would you say? ‘Whatever happened last night has happened. What can I help you with right now to feel better? This time will pass.’”

Do use breathing and deep relaxation techniques

“It’s using your body to switch off an anxious mind,” says Kaur. “Meditation, yoga, whatever helps you relax your muscles and slow your heart rate down. The breathing doesn’t need to be complicated. Just deep breaths in through your nose, and out through the mouth, slowly, deeply as if you’re blowing out candles.”

Do ask yourself, ‘what do I need right now?’

“It might be that you need to spend time with people as a distraction,” says Kaur. Sometimes the stark contrast between a busy, sociable, alcohol-fuelled night out and a quiet, empty home and an empty day can be especially uncomfortable. Seeing friends can be a gentle social buffer, somewhere to point your focus. “If that’s the case, think carefully about who you want to be with,” says Kaur. “Do you need someone fun and high energy, or someone relaxing?” Alternatively, you might need to clear your diary and spend a day at home. “It’s asking, ‘What do I need today to help me feel better?’”

Do exercise

If you can face it, a light jog or gentle workout can release endorphins to dampen pain and provide a good distraction from anxiety. “If you’re out running, it gives you another, healthier reason for a pounding heart,” says Nutt. “We often encourage people experiencing panic attacks to exercise because, over time, exercise also increases Gaba in your brain.”

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Pace yourself

Try eating something protein-rich before you start drinking, in order to slow the absorption of alcohol into the blood – eggs are good for this as they contain the amino acid cysteine.

Make sure you are well hydrated and, when you’re out, dilute your alcohol with ice, soda or other mixers. It means you consume the alcohol more slowly, giving your body a chance to process it so your blood alcohol peak won’t be so high. When you get home, try having something to eat before going to bed to stabilise your blood sugar and absorb more of the alcohol – aim for protein and fibre – and drink more water.

Try changing your drink

Drinks high in congeners (chemical byproducts of fermentation), evidence shows, are more likely to make you suffer the next day. These are the darker drinks, such as whiskey and red wine, so switching to lighter-coloured drinks like vodka or gin may reduce the risk of both a hangover and hangxiety. You could also try non-alcoholic spirits with supposed health-boosting botanical plant extracts, mixed in with ice and all your usual favourite garnishes, to mimic alcohol, but without the nasty after-effects.

Make time for reflection

“A few days after a hangxiety episode, sit down and think about the night that caused it,” says Kaur. “Reflect on what you might have done differently. It helps some people to write down their thoughts. It might be, ‘I should have stopped after the fourth drink’, or ‘I should have called a taxi at midnight.’” This might just come to mind next time someone offers you that tempting final drink before closing time.