What is Hangxiety—and How Can I Get Help?

Have you ever felt anxious after a night of heavy drinking? You’re not alone. Many people experience post drinking anxiety that’s commonly referred to as hangxiety, a blend of hangover symptoms and a heightened state of anxiety.[1] But what does it mean when these issues co-occur—that is, when they happen together—and how can you find help?

Understanding this potential interaction and seeking the appropriate support can significantly improve how you manage your overall health. Today, Clear Behavioral Health will explore what hangxiety entails, and the steps you can take to get the support you need.

What is Hangxiety, Exactly?

Hangxiety is a term coined to describe the unique blend of hangover symptoms and anxiety that many people experience after a night of heavy drinking.[2] It represents the convergence of physical hangover symptoms—such as headaches, nausea, and fatigue—with the psychological symptoms of unease and worry commonly associated with anxiety. This phenomenon often occurs the morning after drinking alcohol, as the body tries to recover from the effects of intoxication while the mind grapples with feelings of guilt, regret, or nervousness about actions taken while under the influence.

The experience of hangxiety can vary from person to person, but it generally involves a sense of unease or dread coupled with the physical discomfort of a hangover. For some, the anxiety may stem from memories of behavior or decisions made while intoxicated, while for others, it may be a more generalized feeling of apprehension about facing the day or the tasks ahead.

Regardless of the specific triggers, hangxiety can serve as a harsh reminder of the interconnectedness of mental and physical well-being and the impact that alcohol consumption can have on your health.

What is the Relationship Between Anxiety and Alcohol Use?

The relationship between anxiety and alcohol use is complex and multifaceted, with each able to influence the other in several ways.[3] While some individuals may turn to alcohol as a means of coping with anxiety symptoms, and drinking alcohol can also worsen anxiety over time:

• Self-medication: Some people who experience anxiety may turn to alcohol as a form of self-medication to alleviate symptoms temporarily. Alcohol’s depressant effects can initially provide relief from feelings of tension, worry, or social anxiety, leading individuals to rely on it as a coping mechanism.
• Biological factors: There may be underlying biological factors that contribute to the relationship between anxiety and alcohol use. For example, disruptions in neurotransmitter systems, such as those involving serotonin, can play a role in both anxiety disorders and alcohol dependence.
• Co-occurrence: Anxiety disorders and alcohol use disorders frequently co-occur, meaning that individuals with one condition are at increased risk of developing the other. These coexisting conditions can complicate treatment efforts and worsen overall outcomes if both conditions are not addressed simultaneously.
• The cycle of dependency: Over time, reliance on alcohol to cope with anxiety can lead to a cycle of dependency. As tolerance develops, individuals may require increasing amounts of alcohol to achieve the desired effects, which can further magnify anxiety symptoms and lead to the development of an alcohol use disorder.
• Withdrawal effects: Abrupt cessation of alcohol consumption can trigger withdrawal symptoms, including heightened anxiety, irritability, and restlessness. These withdrawal effects can perpetuate the cycle of alcohol use and anxiety, making it difficult for individuals to quit drinking without professional help.
• Impacts on treatment: Alcohol use can interfere with the effectiveness of treatments for anxiety disorders, such as psychotherapy or medication. Additionally, individuals with co-occurring anxiety and alcohol use disorders may be less likely to seek treatment or adhere to treatment recommendations due to stigma, shame, or denial.

Why Can Anxiety Be Worse After Drinking?

Anxiety can often intensify after drinking due to several factors related to the effects of alcohol on the body and brain chemistry.[4] While alcohol initially acts as a central nervous system depressant, inducing feelings of relaxation and euphoria, its effects can lead to disruptions in neurotransmitter levels in the brain and other physiological changes that contribute to increased anxiety:

Disruption of neurotransmitter balance

Alcohol causes many changes to occur in the brain. Initially, it enhances the effects of gamma-aminobutyric acid (GABA), leading to initial feelings of relaxation. As alcohol is metabolized, GABA levels can decrease, resulting in rebound anxiety and heightened stress responses. Chronic alcohol consumption can also deplete serotonin levels, contributing to feelings of depression and anxiety.

Sleep disturbances

Alcohol disrupts sleep patterns, particularly REM (rapid eye movement) sleep, which is crucial for processing emotions and consolidating memories. Poor sleep quality can leave individuals feeling anxious, groggy, irritable, and more vulnerable to stress and anxiety the next day.

Behavioral effects

Impaired judgment and inhibition due to alcohol consumption can lead to situations that provoke anxiety upon reflection. Individuals may experience regret, embarrassment, or shame over actions or decisions made while under the influence, contributing to heightened anxiety levels.

Temporary relief followed by worsening symptoms

While alcohol may temporarily alleviate feelings of anxiety, its effects on neurotransmitter levels in the brain and sleep quality can ultimately lead to worsened anxiety symptoms over time.

Related: The Link Between Anxiety Disorder and Substance Abuse

What Are the Signs and Symptoms of Hangxiety?

The signs and symptoms of hangxiety encompass a unique blend of physical symptoms and psychological unease that often follows a night of heavy drinking. Physically, you may wake up to a throbbing headache, queasy stomach, an overwhelming sense of fatigue, and other hangover symptoms. These physical symptoms are typical of a hangover, reflecting the body’s struggle to process and metabolize alcohol effectively. Dehydration, another common consequence of excessive alcohol consumption, can further worsen these symptoms, leaving you feeling parched and depleted.

In addition to the physical toll, hangxiety also hampers people psychologically. Feelings of guilt, regret, and shame may weigh heavily on the mind as you reflect on your behavior while intoxicated. Memories of embarrassing moments, impulsive decisions, or interactions that went awry can flood the consciousness, creating a sense of unease and self-doubt.

The combination of physical discomfort and psychological turmoil can create a difficult array of emotions, making it even more difficult to shake off the lingering effects of the night before.

How Long Can Hangxiety Last?

The duration of hangxiety can vary widely, depending on individual factors such as the amount of alcohol consumed, tolerance levels, overall health, and your current coping mechanisms. In most cases, the acute symptoms of hangxiety, including physical discomfort and heightened anxiety, tend to peak within the first few hours after waking up with a hangover and gradually subside over the course of the day.

For some people, hangxiety may dissipate relatively quickly as the body metabolizes the alcohol and rehydrates, and as they engage in self-care practices such as rest, hydration, and nutritious food. However, for others—particularly those who have consumed larger quantities of alcohol or who are prone to anxiety—hangxiety may persist for an extended period, sometimes lasting well into the next day or beyond.

Ultimately, the duration of hangxiety is individualized, and there is no one-size-fits-all timeline for recovery. However, taking steps to prioritize self-care, manage stress, and establish healthier drinking habits can help mitigate the impact of hangxiety and promote a smoother recovery process.

What is Alcohol Use Disorder?

Alcohol use disorder (AUD) is a condition where a person has a problematic relationship with alcohol.[5] It’s not just about drinking heavily occasionally; it’s a pattern of drinking that leads to significant distress or problems in different areas of your life.

Some of the signs of potential AUD include:

• Drinking more alcohol than intended or for longer than planned.
• Wanting to cut down or stop drinking but not being able to.
• Spending a lot of time drinking or being hungover.
• Craving alcohol or feeling like you need to drink to feel “normal.”
• Neglecting responsibilities at work, school, or home because of drinking.
• Continuing to drink alcohol despite it causing problems in relationships or health.
• Giving up activities you used to enjoy because of drinking.

AUD can range from mild to severe, and it can affect anyone regardless of age, background, or gender. It’s important to recognize the signs and seek help if you or someone you love is struggling with alcohol use.

Treatment for Anxiety, Alcohol Use Disorder, and Co-Occurring Issues

Treating anxiety and AUD often requires a comprehensive approach that addresses both conditions simultaneously. Here’s how the full spectrum of care can be applied to individuals primarily struggling with anxiety, those primarily struggling with alcohol use disorder, and those dealing with both conditions simultaneously through co-occurring or dual diagnosis programs:

Treatment for Anxiety

Individuals primarily struggling with generalized anxiety disorder or other types of anxiety can benefit from various mental health treatment approaches for anxiety, including therapy and medication. Cognitive-behavioral therapy (CBT) is a common form of therapy that helps individuals identify and challenge negative thought patterns and behaviors contributing to anxiety.[6[ Other therapeutic modalities, such as mindfulness-based stress reduction or acceptance and commitment therapy (ACT) can also be effective in managing anxiety symptoms.

Medication, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), may be prescribed to alleviate symptoms of anxiety.[7] These medications work by balancing neurotransmitter levels in the brain, helping to reduce feelings of worry, fear, and nervousness.

Treatment for Alcohol Use Disorder

For individuals primarily struggling with alcohol use disorder, addiction and substance abuse treatment often involves a combination of behavioral therapies, support groups, and sometimes medication, along with potentially beginning the recovery process with a medically-supervised detoxification to ensure a safe withdrawal period.[8] Behavioral therapies, such as cognitive-behavioral therapy (CBT) or motivational interviewing (MI), help individuals explore their relationship with alcohol, identify triggers for drinking, and develop coping strategies to manage cravings and prevent relapse.

Support groups like Alcoholics Anonymous (AA) provide a great community of individuals who understand the challenges of recovery from alcohol addiction. Peer support and encouragement can be invaluable in maintaining sobriety and navigating the ups and downs of the recovery journey.

Dual Diagnosis Programs

For individuals dealing with both anxiety and alcohol use disorder, dual diagnosis programs offer specialized treatment that addresses both conditions concurrently. Treatment programs for a dual diagnosis integrate elements of mental health treatment for anxiety and alcohol use disorder treatment to provide comprehensive care.

Therapists and counselors in dual diagnosis programs are trained to recognize the complex interplay between anxiety and alcohol use and tailor treatment plans to meet the unique needs of each individual. This may involve combining therapeutic approaches, medication management, and relapse prevention strategies to promote long-term recovery and improve overall well-being.

Get Help with Your Hangxiety

By offering a full spectrum of care that addresses both mental health and substance use concerns, individuals struggling with anxiety and alcohol use disorder can receive the support they need to overcome these challenges and live healthier, more fulfilling lives.

If you or someone you know is struggling with substance abuse, mental health challenges, or both, contact Clear Behavioral Health to learn more about our treatment programs. We offer a full continuum of care for substance abuse and mental health including drug detox and rehab for stabilization, dual diagnosis outpatient programs for ongoing support, mental health residential treatment for severe mental health issues, outpatient mental health programs, as well as a virtual mental health IOP to suit the unique needs of every individual. Your choice is Clear—give us a call and let’s explore how to begin the recovery process together.

References:

1. What is hangxiety? – Alcohol and Drug Foundation. (n.d.). Adf.org.au. https://adf.org.au/insights/what-is-hangxiety/ on April 21, 2024
2. Marsh, B., Carlyle, M., Carter, E., Hughes, P., McGahey, S., Lawn, W., Stevens, T., McAndrew, A., & Morgan, C. J. A. (2019). Shyness, alcohol use disorders and “hangxiety”: A naturalistic study of social drinkers. Personality and Individual Differences, 139, 13–18. https://doi.org/10.1016/j.paid.2018.10.034 on April 21, 2024
3. Anker, J. (2019). Co-Occurring Alcohol Use Disorder and Anxiety: Bridging the Psychiatric, Psychological, and Neurobiological Perspectives. Alcohol Research: Current Reviews, 40(1). https://doi.org/10.35946/arcr.v40.1.03 on April 21, 2024
4. Clinic, C. (2022, September 16). Anxiety and Alcohol: Does Drinking Worsen Symptoms? Cleveland Clinic; Cleveland Clinic. https://health.clevelandclinic.org/emotional-hangover-why-alcohol-can-give-you-anxiety on April 21, 2024
5. National Institute on Alcohol Abuse and Alcoholism. (2024, January). Understanding Alcohol Use Disorder. Www.niaaa.nih.gov; National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder on April 21, 2024
6. Otte, C. (2011). Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues in Clinical Neuroscience, 13(4), 413–421. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263389/ on April 21, 2024
7. Gomez, A., & Hofmann, S. (2020, May 26). SSRIs and Benzodiazepines for General Anxiety Disorders (GAD). Anxiety and Depression Association of America. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/ssris-and-benzodiazepines-general-anxiety on April 21, 2024
8. Alcohol withdrawal: MedlinePlus Medical Encyclopedia. (2018). Medlineplus.gov. https://medlineplus.gov/ency/article/000764.htm on April 21, 2024