Feeling hanxious? You might think that your 'hangxiety' is because you are the worst person in the world - but it’s actually because of chemical imbalances in the brain caused by drinking too much alcohol.
As Monday rolls in after a weekend filled with relaxation and celebration, a familiar foe for some may be rearing its ugly head: hangxiety. This post-drinking anxiety, often underestimated, can cast a shadow over the start of the week, leaving individuals feeling uneasy, apprehensive and overwhelmed as they face the challenges of the week ahead.
The word ‘hangxiety’ comes from the combination of the English "hangover" and "anxiety" and is now a true term for drinkers. This term describes the feeling of depression, shame and especially anxiety while recovering from alcohol consumption. This particular feeling can feel like a double "hit", as it combines the physical consequences he has left behind the previous night and is disturbing, to the point that it can also cause panic attacks, as experts report.
Hanxiety is caused by the chemical changes that occur in the brain during alcohol consumption. These changes, at the beginning of drinking, make us feel calmer and more relaxed, but when we stop drinking and the positive effects of alcohol begin to wear off, then feelings of anxiety, shame and guilt increase.
“Almost anyone who drinks alcohol will experience changes in their brain when they come off alcohol. With a small amount of alcohol that can manifest as confusion, but after larger amounts you can have anxiety,' says Professor David Nutt, a neuropsychopharmacologist specialising in the effects of alcohol on the brain at Imperial College London, author of Drink? The New Science of Alcohol and Your Health and who was asked to resign as the UK government’s chief drug adviser in 2009 for saying that alcohol is more dangerous than ecstasy and LSD.
Hanxiety, which in some people manifests as irritability rather than excessive worry, can occur alongside other hangover symptoms or can occur alone, according to Dr Edwin Kim, medical director of a psychiatric centre of addiction treatment at the University of Pennsylvania. "It can happen to people who aren't generally anxious and people without a formal anxiety diagnosis," he says.
What happens to our body when we drink alcohol?
Neuropsychopharmacologist David Nutt explains the mechanics of how alcohol causes crippling anxiety, painting a devastating picture: “Alcohol targets the Gaba (gamma-aminobutyric acid) receptor, which sends chemical messages through the brain and central nervous system to inhibit the activity of nerve cells. Simply put, it calms the brain, reducing arousal by making fewer neurons fire. Alcohol stimulates Gaba, so you feel relaxed and happy when you drink.
The first two drinks lull you into a pleasant Gaba-induced state of chill, he says. By the time you get to the third or fourth drink, another brain-relaxing effect occurs: you start to block glutamate, the main excitatory transmitter in the brain. More glutamate means more stress. Less glutamate means less stress. That's why when people get really drunk, they're even less anxious than when they're a little tipsy – alcohol not only reduces the chatter in your brain by stimulating Gaba, but further reduces your anxiety by inhibiting glutamate.
In your blessed state, you will probably feel that this is all good – but you would be wrong. The body registers this new imbalance in brain chemicals and tries to fix things. When you're drunk, your body goes on a mission to bring Gaba levels back to normal and restore glutamate.
“When you stop drinking, you end up with abnormally low Gaba function and a spike in glutamate – a condition that leads to anxiety. It also leads to seizures, which is why people have withdrawal seizures," says Nutt.
“It may take the brain a day or two to return to the status quo. If someone drinks heavily for a long time, it can take weeks for the brain to readjust. In alcoholics, we have found changes in GABA for years."
Alcohol also causes a small increase in noradrenaline – known as the fight-or-flight hormone. As Nutt explains: “Noradrenaline suppresses anxiety when you first take it and increases it on withdrawal. Severe anxiety can be thought of as a surge of noradrenaline in the brain.
“Another major cause of anxiety is the inability to remember the soothing things you are sure you must have said or done while drunk – another result of reduced glutamate levels. You need glutamate to leave your memories, and once you've had the sixth or seventh drink, the glutamate system is blocked, so you can't remember things."
How can we prevent and deal with stress after drinking?
The bad news is that there seems to be little we can do to avoid stress other than drinking less and maybe taking painkillers, which will at least ease the headache. "In theory, ibuprofen would be better than paracetamol because it's more anti-inflammatory – but we don't know how much of a hangover is caused by inflammation. It's something we're working on, trying to measure," Nutt explains.
Celia Morgan, professor of psychopharmacology at the University of Exeter, is one of the authors of a study published in the journal Personality and Individual Differences that found that hangxiety does not affect us all equally.
“The people who were more shy had much higher levels of anxiety [the following day] than the people who weren’t shy,” she says.
Her team also found a correlation between having bad hangxiety and the chance of having an alcohol use disorder. “Maybe it’s playing a role in keeping problematic drinking going,” says Morgan.
Morgan suggests trying to break the cycle: “Before you drink in a social situation in which you feel anxious, try to fast-forward to the next day, when you'll have much higher levels of anxiety. If you can't make it out without drinking, the worry is that you'll get stuck in this cycle of problem drinking, where your stress builds and builds over time.
“Drinking can fix social anxiety in the short term, but in the long run it can have quite damaging consequences. Exposure therapy is a common treatment for phobias where you sit with your fear to help you overcome it. By drinking alcohol, people are not giving themselves the opportunity to do so."
With next weekend looming on the horizon, it's worth considering the implications of hangxiety and how to mitigate its effects. By being mindful of alcohol consumption and understanding the chemical imbalances it can cause in the brain, steps can be taken to ensure a healthier and happier weekend experience, free from the shadow of hangxiety.
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