Al Tyers Therapy
Why do I have anxiety after drinking alcohol? Hangover hangxiety explained
That horrible sinking feeling the morning after the night before has been termed ‘hangxiety’, a word that captures perfectly that blend of hangover and anxiety that can come after drinking too much alcohol. If you’ve ever stared gloomily into your morning coffee wondering “why do I feel anxious after drinking?” then here is an explanation of the science behind it.
We’ll also look at broader relationship between anxiety and alcohol, and think about whether alcohol could be making you anxious, or contributing to anxiety. First though, here is a very hungover gargoyle from Dunfermline.
Wait: but alcohol makes people relaxed, right?
Alcohol works on the brain’s Gaba (gamma-aminobutyric acid) receptors, calming the central nervous system by stopping nerve cell activity. This is why the first drink or two can make you feel relaxed.
By drink three or four, your brain begins to block glutamate, which is your major excitatory transmitter. With reduced glutamate you feel even less anxious: noticed anecdotally when some people are giddy and carefree with "it's all good" vibes when they are drunk.
The problem with both of these factors is that a few hours later, it’s payback time.
So what causes the anxiety hours after drinking?
Your body and brain, which crave homeostasis and balance, try to normalise: bring Gaba down and increase glutamate. This is what causes anxiety, and is also seen in withdrawal.
But doesn’t alcohol help you fall asleep?
Yes, it can. But it is not the sleep that your body needs. If you’ve had that experience of falling asleep after a big night, but then waking up feeling rotten and stressed at 3am you’ll recognise this. That's because alcohol puts us into a knockout deep sleep for about five hours, but we are not getting REM sleep during this.
The brain works overtime to produce the stimulating chemicals needed to correct the alcohol, meaning that once the alcohol wears off, i.e. is processed, you are full of over-stimulated, jittery chemicals.
You also have a comedown from the endorphins and dopamine released by the good times/the alcohol. And just to top off this, er, cocktail: noradrenaline is increased by drinking alcohol, putting you in a fight-or-flight mindset.
So to recap: drink alcohol, lots of Gaba and reduced glutamate, which allows us to crash out into a deep sleep. Then the Gaba is metabolised, too much glutamate, and you wake up in the middle of the night.
And here comes the anxiety…
The feeling in the middle of the night, or the morning after of “oh no, what did I do?” Or “what did I say that for?” Or even “I can’t remember what happened” can be really disturbing, and is not something to be taken lightly.
On a brain chemistry level, it may be because memory formation is impeded by low glutamate levels. And there are obviously lots of concerns with being sufficiently drunk that you are having black-outs and memory problems.
Important: if a heavy regular drinker stops suddenly, the combo of low Gaba function and spiking glutamate can be really dangerous, leading to fits and seizures. Do not stop drinking suddenly without seeking medical advice.
Alcohol: 'the social lubricant'
It can sometimes seem, not least in Britain, that alcohol has to be a factor at any social event. Dutch courage, a bracer, a stiffener… booze has been marketed as the short-cut to having a good time if you’re shy, the fizz that gets the party going, the substance to drown the sorrows.
Interestingly, some studies show that people who describe themselves as shy might experience worse hangxiety. This could be on a personality or social level that they are less familiar with disinhibition, getting messy, more likely to agonise over something said off-the-cuff and so on; it has also been suggested that Gaba levels may be lower at baseline.
Regardless, medicating shyness or social anxiety with alcohol might or might not work at the time, but is going to cause problems the next day, because of the effects it has on the brain’s neurotransmitters.
And that cycle of
feeling anxious => drink to calm yourself down => brain makes you more anxious
is a horrible one to be trapped in. Not least because of the disturbed and disrupted sleep, as well as the feelings of regret and stress, shame and self-recrimination. These are the sort of issues that you might wish to explore in therapy.
What can be done about alcohol and anxiety?
If you find that you are using alcohol to self-medicate or regulate anxiety it might be worth taking some time to think why, and what might lie behind this need. The first port of call might be a GP, and you could also consider talking to a therapist about alcohol and anxiety. In the meantime, rest, recover, be kind to yourself, and maybe consider going easy when dousing anxiety with alcohol.