Hangover Anxiety: What is ‘Hangxiety’?

What is hangxiety, and what does it feel like?

Hangxiety, a portmanteau of 'hangover' and 'anxiety,' is a colloquial term describing the intense feelings of anxiety following a bout of heavy drinking. The physical symptoms of a hangover, such as headaches or nausea, compound and aggravate this psychological distress.

Individuals experiencing hangxiety report feelings of unease, guilt, worry, and heightened stress. These emotions are disproportionate compared to their usual day-to-day worries. Individuals may experience a deep sense of regret, embarrassment, and rumination – hence the word ‘hangover guilt.’ ^[1]

Those suffering from alcohol anxiety often report a sense of heightened stress, unease, and, in severe cases, panic attacks. Cognitively, hangxiety can manifest as excessive worry about past events, a feeling of impending doom, or irrational fears about the consequences of actions taken while drinking.

What causes hangxiety?

Hangover guilt has physiological and psychological factors, which we will review in the following section.

Physiological causes

Hangxiety results from a combination of neurotransmitter imbalance disrupted sleep, and physical stress.

• Neurotransmitter imbalance: Alcohol consumption increases the production of GABA (gamma-aminobutyric acid), a calmness-promoting neurotransmitter. As the alcohol effects taper, the levels of GABA plummet quickly, thus creating the alcohol anxiety phenomenon.^[2]
• Disrupted sleep: Excessive alcohol consumption also alters sleep quality, preventing the body from entering the deeper sleep stages, which are restorative. As a result, people experience fatigue and heightened anxiety levels the following day.^[1][3]
• Physical stress: Metabolizing alcohol is a taxing process for the liver. This physical stress stemming from the additional work to eliminate alcohol-induced toxins exacerbates the feeling of hangover guilt.^[3]

Psychological causes

Hangxiety is not just a physiological process because individuals experience different emotional reactions after ingesting the same quantity of alcohol. Psychological causes behind anxiety include:

• Temperament: Shy people are likelier to experience hangover anxiety after a binge drinking episode. One explanation is that their inhibition level is higher, making them likelier to feel guilt after acting more freely. People who catastrophize pain are also likelier to experience hangxiety.^[1][4]
• Tendency to rumination: Alcohol lowers inhibitions, sometimes leading people to make decisions they later regret. An existing tendency to ruminate increases the natural feelings of worry, guilt, or embarrassment related to inappropriate behavior.
• Social relationships: The interactions occurring under the influence of alcohol trigger different emotional consequences. If people believe they have damaged certain relationships beyond repair or caused extensive social embarrassment, their hangover guilt is exacerbated.
• Existing mental health issues: A preexisting anxiety, depression, or bipolar disorder may enhance the normal feelings of worry after a heavy drinking episode, causing alcohol anxiety.

How long does hangxiety last?

Hangxiety typically fades within 24 hours in most cases. This figure depends on the quantity of alcohol ingested, individual physiology, and co-occurring mental health issues.

In most cases, alcohol anxiety does not last longer than a typical physical hangover, which spans a few hours to a day. Hangover guilt decreases as the body metabolizes the alcohol and the hangover’s physical symptoms subside.^[3]

Excessive alcohol use correlated with co-existing mental health disorder may lead to longer hangxiety, up to several days. The prolonged effects are caused by the lingering physical alcohol effects and the individual’s psychological response.

Factors such as body weight, metabolism, overall health, and tolerance to alcohol also influence how long hangxiety lasts. The social environment and stressful events during the drinking episode may also affect the duration of hangover guilt.

How to manage hangxiety

Managing alcohol anxiety involves self-care practices, both from a physiological and psychological standpoint. The best measures for alcohol anxiety relief include:

• Hydration: Alcohol is a diuretic, leading to dehydration, which can worsen alcohol anxiety. Drinking plenty of water or hydration drinks alleviates these symptoms.^[3]
• Rest: The body needs energy to recover from the effects of alcohol, and energy replenishes with rest. If sleeping is difficult, try relaxing activities like reading or listening to calm music.^[3]
• Healthy eating: Alcohol disrupts blood sugar levels, thus heightening anxiety. However, nutritious and easy-to-digest foods stabilize blood sugar levels, reducing hangxiety.^[3]
• Mild exercise: Light exercise like walking or Pilates boosts endorphin levels, improving mood and reducing anxiety. However, exercise is best when the physical hangover is mild to moderate.^[5]
• Breathing exercises or meditation: These techniques calm the mind, reduce rumination, and alleviate anxiety.^[1]

Getting help for alcohol use

When episodes of hangxiety are too frequent and severe, you may consider getting help for alcohol use disorder. In this scenario, you may consider:

• Medical assistance: If you experience physical withdrawal symptoms, medication may be necessary to reduce alcohol intake safely.
• Professional counseling: Therapy provides you with personalized strategies to reduce alcohol consumption. Counseling may also address underlying triggers like stress, anxiety, or depression.
• Support groups: Groups like Alcoholics Anonymous (AA) or SMART Recovery provide much-needed peer support, as well as a safe space for sharing stories.
• Inpatient or outpatient rehabilitation programs: These programs rely on structured treatment plans, including counseling, group therapy, and educational resources.
• Family and friends support: A support network of your loved ones creates a safe environment for growth and recovery.