Drink long enough — or hard enough — and you’re probably familiar with the dreadful feeling that comes the morning after a night of over-imbibing. Maybe you try to replay the evening’s conversations in your mind or scroll through text messages to make sure you didn’t send something you regret. Or maybe you immediately start issuing mass apologies to friends and family.
While this can be a normal reaction to binge drinking, it can also be a sign of a deeper issue, something called “hangxiety.”
“Anxiety is a common feeling when people drink too much,” says Elizabeth Bulat, M.D., a substance abuse specialist at Henry Ford Health. “And for people who are already prone to depression and anxiety, alcohol can worsen symptoms of those conditions.”
Hangxiety Explained
Hangxiety has become a buzzword that describes the uneasy feeling that often accompanies heavy alcohol use, but what does it really mean? We asked Dr. Bulat to explain what hangxiety is and how to manage it best.
Q: What is hangxiety?
A: Drinking alcohol dumps a flood of dopamine into the pleasure center of the brain. The feel-good chemical swirls through your head, but the rush only lasts for a short while. When dopamine levels dip back down, feelings of anxiety rebound. Researchers think that may be one reason why people who experience hangxiety, especially those who are extremely shy, may have a higher risk of developing alcohol use disorder (AUD).
Q: How does alcohol boost anxiety levels?
A: Heavy drinking produces physiological changes in the brain. When you’re drinking, there’s an influx of the GABA (gamma aminobutyric acid), which causes you to feel relaxed and calm. When you stop drinking, you have withdrawal symptoms. Your body gets used to that crutch to feel calm. Take it away and anxiety often follows. Add interrupted sleep to the mix, which often happens when people drink to excess, and feelings of depression and anxiety can get even worse.
Q: Who is most likely to develop hangxiety?
A: People who suffer from depression and anxiety are more likely to experience anxious feelings after drinking. Though alcohol can suppress anxious feelings while a person is imbibing, the rebound effect can be far worse than their baseline level of anxiety. Unfortunately, those uncomfortable emotions can drive people straight back to the culprit: alcohol.
Q: How does alcohol compare to medications used to treat anxiety?
A: Like alcohol, medications such as benzodiazepines that are used to treat anxiety target GABA in the brain. In fact, some people with depression and anxiety turn to alcohol to self-medicate. Unfortunately, self-medicating with alcohol or other substances increases the risk of developing substance abuse disorders, which can lead to negative effects on your heart, liver and other vital organs.
Q: How do you know if your hangxiety indicates an alcohol use disorder, or AUD?
A: If you’re using alcohol to soothe anxiety, that’s a red flag. It becomes a vicious cycle: You drink, you get anxious, then you drink more to relieve that anxiety. That’s how the trouble starts — and continues. Over time, you become dependent on the alcohol to function in your daily life. If alcohol becomes a coping mechanism, or you realize your body is getting used to the effects — not just anxiety, but also shakes, sweats and interrupted sleep — the risk of negative consequences skyrockets.
Q: How do doctors treat hangxiety?
A: If you’re drinking to manage feelings of anxiety — or if you regularly experience hangxiety after a night of drinking — talk to your primary care provider. There are a number of effective treatments available, not just for depression and anxiety, but also for AUD. Your doctor may suggest a variety of therapies ranging from cognitive behavioral therapy and psychotherapy to prescription medication for AUD or anxiety.
Put Hangxiety to Bed
Your best bet to avoid hangxiety is to drink responsibly, says Dr. Bulat. Pay attention to family members and loved ones who say they notice an increase in your drinking habits and stay within the recommended limits of alcohol consumption (one drink per day for women; two drinks per day for men).
If, despite these efforts, you still periodically wake up after drinking with feelings of anxiety, practice mindfulness. Pay attention to how you feel while you’re drinking and afterward. And when anxious feelings surface, turn to healthy alternatives like meditation, deep breathing or exercise.
To find a doctor or therapist at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).
Dr. Elizabeth Bulat is the medical director of addiction medicine at Henry Ford’s Maplegrove Center in West Bloomfield.
