Hangover Anxiety

Hangover Anxiety and Depression: Adding Insult to Injury

As if hangovers weren’t bad enough— headaches, nausea and feeling utterly wiped out—for many people the physical misery you endure after a session of overdoing it is often accompanied by mood changes, leading to hangover anxiety and depression. Understanding what’s happening both physically and emotionally can help you anticipate, and maybe even prevent, feeling so rotten after a night out.

What is Hangover Anxiety?

Have you ever felt a wicked spike in anxiety or depression the day after an especially intense night of drinking? You’re not alone. In addition to the well-known and oft joked about physical symptoms of a hangover, anxiety and depression due to alcohol withdrawal are common and can be quite severe.

Alcohol withdrawal is the correct medical term for a hangover. Alcohol is a drug— a central nervous system (CNS) depressant. Getting drunk is essentially a drug overdose, and sobering up is the process of that drug being detoxified by your liver. As your liver works to rid your bloodstream of this drug, you feel the symptoms of a hangover. These are most commonly:

  • Nausea
  • Thirst
  • Shaking/trembling
  • Sweating
  • Headache
  • Fatigue (physical exhaustion, sleepiness, lethargy)
  • Mental fatigue (difficulty concentrating, feeling foggy, “just can’t get it together” feelings)
  • Dizziness

Mood symptoms are often dismissed as not part of the drinking equation. Many people assume the anxiety is due to either feeling embarrassed about your behavior while drunk (and maybe not being able to fully remember all of it) and that feeling a bit blue after a fun night out can be due to either guilt over how much you had to drink, or some other specific aspect of the night—a perceived rebuff by a friend or failure to connect with a specific cutie.

While most people who experience anxiety and/or depression as part of a hangover suffer relatively mild and short-lived symptoms, panic attacks and suicidal thoughts are not unheard of. Both anxiety and depressive symptoms can be mild, moderate or severe, and the intensity of these symptoms will vary based on how much you had to drink as well as many other factors. Whether or not you already have an anxiety disorder, or a history of trauma, or other psychological or physical issues that might exacerbate mood symptoms all contribute to how severe hangover anxiety can be. Stress, lack of sleep or poor health can further intensify hangover anxiety and depression.

Why Does Hangover Anxiety and Depression Happen?

Understanding what alcohol does to the different organs in your body can help you understand why hangover anxiety and depression occur. Alcohol, as a CNS depressant, slows down a number of bodily functions, including heart rate, respiration, digestion, cognition and other systems. Being slowed down or dulled can make you feel tipsy and giddy if you have only ingested a small amount of alcohol, or numb, slurred and staggering if you have ingested a larger quantity. If you drink enough alcohol in a short period of time, you can sedate the impulse in your brain that tells your heart to beat and your chest muscles to breathe— and that is what a fatal alcohol overdose looks like.

Once you stop drinking for the evening, the reverse process begins. As your liver works to detoxify the alcohol in your blood stream, you begin to feel that slowed down or numb sensation leave you, and you may be able to rest or sleep for a while. However, it is very common that after a few hours of sleep you wake up feeling irritable, jittery, agitated and restless. Although many people think alcohol will help them sleep better due to the depressant or sedative effect of the drug, insomnia often results. For people who experience hangover anxiety and depression, this agitation or jittery feeling escalates into a full blown anxious or depressive episode.

Why all the jangled nerves and inability to sleep? It’s easiest to conceptualize it as a rebound effect: what goes down must come back up. All of your body systems are trying to get back to normal but, just as they were slowed down for a while, now they will be speeded back up in the effort to land back at normal. This means that your body’s systems are in “overdrive”—increased heart rate, pulse, respiration, etc. can all make you feel anxious even before we start to talk about the impact of alcohol withdrawal on specific brain chemistry.

Your moods and your sense of well-being are in part a chemical affair: neurotransmitters in the brain help facilitate smooth communication both within the brain and between your brain and other organs. As long as that communication is flowing smoothly, aided by neurotransmitters such as serotonin and dopamine, you tend to feel well and maintain a decent mood. Alcohol disrupts brain activity and impedes the work of these neurotransmitters. It takes a while for brain activity to sort itself out and get back on track after an episode of drinking. While your brain chemistry is returning to normal, it is common to experience at least some anxiety or depression.

In addition to these physiological reasons why hangover anxiety and depression occur, you may also have some emotional reasons. Sometimes, anxiety is worsened due to guilt and/or shame about drinking behavior. If you did things while under the influence that you don’t remember, or remember all too well, anxiety and depression are a natural response. If you have been struggling with anxiety and/or depression and have been drinking for relief, the unfair truth is that alcohol tends to make both of those conditions much worse. You may feel better temporarily while under the influence, but due to the disruption in brain chemistry, you end up feeling much worse over time.

Some people are more prone to feeling anxious and/or depressed after drinking. A number of factors increase your susceptibility:

  • A diagnosed anxiety or mood disorder
  • Current increase in stress (exams, moving, divorce, new job, etc.)
  • Chronic pain or a current physical illness
  • Sleep deprivation (for example a new mother, or someone working the night shift)

Preventing or Minimizing Hangover Anxiety and Depression

What can you do to minimize hangover anxiety and depression? If you are a social drinker and are struggling with these symptoms after a night out, consider taking some of the following steps to ease your pain:

  • Drink more slowly. For men, one drink (one pint of beer, one mixed drink or one shot of hard liquor) per hour is the maximum; for women, make that one drink per hour and a half. This gives your liver time to keep up with the alcohol coming in and detoxes it as you go. Hangovers happen when you overwhelm your liver.
  • Drink less. Find ways to reduce your overall consumption in any one drinking episode. This might mean substituting water or a “mocktail’ for every other drink, or drinking more slowly, or simply ending your evening out earlier. The severity of a hangover is related to the amount you consume, so less is better.
  • Drink less frequently. Give your brain and organs a break from the cycle of detoxing and get some restful sleep. If you are drinking frequently, you may not ever be fully detoxifying that alcohol, and you may need a longer period of time between alcohol doses in order to restore healthy brain functioning.
  • Take a long hard look at why you’re drinking. If you are drinking because you’re anxious and/or depressed, get help. Use self-help groups, or see a therapist, or talk to someone you trust about what’s going on. If you are drinking because you’re bored or lonely, and drinking is just what it seems like everyone else is doing, take a break from drinking and do a little fun “research” on what else you might enjoy. Martial arts classes? Figure drawing? Check out local meet-up groups in your area: you’d be amazed at the variety of options for fun things to do with others. Drinking might be easy, but you may find that swing dance lessons are a lot more fun!
  • If you are currently taking any medications (not necessarily for anxiety or depression, but any medications at all), discuss your hangover symptoms with your doctor. You may find that you have been experiencing a drug interaction that is making you feel worse, or rendering your prescription medications less effective.

If you try these tips and find you are unable to change your drinking habits, you may be developing a more serious drinking problem or alcoholism. If you suspect you might be developing an addiction to alcohol, seek help. The anxiety and mood issues will only get worse as your addiction worsens. Use self-help groups such as Alcoholics Anonymous, or talk to a therapist or faith-based counselor. Be honest about how much and how often you’re drinking and what you’ve done so far to try to cut back. It’s hard to open up about drinking, and it’s normal to feel ashamed about being unable to stay in control, but communicating honestly about your drinking is the first step to feeling better.