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Hangxiety

Hangxiety, Causes, Duration, Symptoms, & Treatment

What is Hangxiety (Hangover Anxiety)?

Hangxiety is the collision of a hangover and severe anxiety. ”Hangxiety” refers to the experience of feeling the physical effects of alcohol-related to a hangover (tiredness, headache or stomach ache, nausea, etc), compounded by psychological uneasiness. It is the feeling of being “on edge” after a night of drinking. It is also the feeling that “something’s not right” and being paranoid or flat out scared and can’t explain why.

While “hangxiety” is not an official medical term, hangxiety is a phenomenon that can happen on an occasional or more regular basis, as it can be connected to several factors. The most common reason (and the most obvious) is linked to a generally reduced dopamine secretion. Known as the “happy hormone,” dopamine is produced by the brain and used to send messages among nerve cells, regulating our anxiety levels [1]. And the greater the alcohol consumption, the greater the drop in dopamine, which can lead to feelings of anxiety.

Hangxiety
As alcohol messes with the serotonin levels and neurotransmitters in the brain, the more one drinks the more one is prone to suffer from hangxiety.

Cortisol may also play a role in the emergence of feelings of “hangxiety.” Unlike dopamine, this hormone, which is linked with carbohydrate regulation, can increase stress if it is secreted in too large amounts. Excessive alcohol intake will lead to an overproduction of cortisol and may therefore lead to stress and anxiety.

Does alcohol help anxiety? Heavy drinking causes an influx of gamma-aminobutyric acid (GABA) which makes a person feel calm and relaxed. This becomes a “crutch” for chronic drinkers. When alcohol is taken out of the picture, and the effects of alcohol withdrawal kick in, GABA is no longer present. Thus, the feeling of calmness is also taken away, leading to hangxiety. When you stop drinking for the night, your brain has been trying to adapt to the alcohol’s sedative effects, and this often leads to irritability, jitters, and anxiety.

Alcohol Anxiety 

The co-occurrence of alcohol and anxiety disorders is relatively common [2]. The research found that 20% of those with social anxiety have an alcohol misuse problem. Alcohol abuse and anxiety often make each other significantly worse. This is especially problematic as the two are often closely connected. As is the case with many dual-diagnosis conditions, anxiety and alcoholism commonly exist together within the same person. Anxiety is both a reason that many people drink and a result of drinking [2], it becomes a vicious cycle. In fact, drinking alcohol can make an anxious person feel worse.

Here’s an illustration of a typical cycle:

  • A person drinks alcohol
  • They initially feel calm as the alcohol affects the brain
  • They feel anxiety as a symptom of alcohol withdrawal as the body processes the alcohol
  • They may want to drink again to try to relieve their anxiety
  • But this only starts the process from the origin. As the initial calming effect disappears, the person can feel anxiety after quitting drinking alcohol build again as the effects wear off

Remember, the more a person drink alcohol, the greater the tolerance will be. Over time there is a need to drink more alcohol to feel the same effects. Over time this may negatively affect mental health, resulting in a higher level of depression and anxiety after drinking. Anxiety disorder makes a person start drinking alcohol, which worsens their anxiety, which leads them to drink more and worsens their anxiety further. It’s a never-ending vicious cycle of alcohol and anxiety.

Can Alcohol Cause Anxiety?

The long-term alcohol consumption can cause a variety of health problems, including mental health disorders. Research shows that individuals with alcoholism find it hard to recover from traumatic events. This is possible because of the effects of alcohol abuse, which can actually change brain activity.

Long-term heavy alcohol consumption may be predisposed to developing an anxiety disorder. However, there is no evidence that moderate drinking will cause anxiety. Alcohol withdrawal and anxiety are deeply connected. Increased anxiety is also a symptom of alcohol withdrawal. If you’ve consumed alcohol in large amounts for a long period of time and suddenly stop drinking, your anxiety can be aggravated by the side effects of alcohol withdrawal.

Hangxiety
Unlike regular anxiety, hangover anxiety, or hangxiety, isn’t found in the DSM-5, meaning it’s not an actual medical condition.

How Does Alcohol Worsen Anxiety?

Alcohol shifts the serotonin levels and other neurotransmitters in the brain, which can worsen anxiety. In fact, you may feel more anxious after the alcohol wears off. If you drink excessively for long enough, alcohol will begin to alter your brain chemistry. Otherwise, healthy people can begin to develop anxiety disorders after long-term consumption [3]. First, you may start to experience alcohol-induced anxiety, which can last for hours or even an entire day after drinking. Then, that next day, jittery feeling and a racing heart that you can’t shake.

Why Does it Happen?

When someone consumes alcohol, their bodies metabolize it, releasing toxic compounds called acetaldehyde. This compound causes inflammation around the body, such as in the pancreas, the liver, the gastrointestinal (GI) tract, and the brain. This inflammation, combined with dehydration, causes the person to feel sick. As the brain and body try to regain the chemical balance (especially that of dopamine) after excessive alcohol drinking, there is a chance that one experiences some degree of alcohol withdrawal. These alcohol withdrawal effects can temporarily alter the nervous system and also mood – this may mean hangxiety for some. Researchers haven’t identified a single cause. But have proposed several theories.

Alcohol Related Actions

In some situations, hangover anxiety is the result of a person’s actions rather than the alcohol itself. One may feel anxious if they are unable to recall what happed after an excessive amount of drinking. Decreased cognitive function, which is common during a hangover, can create a reduced ability to make good decisions, and thus may result in anxiety when later reflected upon.

Social anxiety 

Many socially anxious people find a drink or two helpful in easing anxious feelings before or during a social event. With a blood alcohol concentration (BAC) of 0.055 (approximately two drinks), feelings of relaxation and reduced shyness begin heightening. However, as the effects of alcohol begin to wear down, feelings of anxiety tend to return and may increase due to simultaneously felt physical symptoms of a hangover.

Poor Sleep

Alcohol consumption can affect sleep, even if little is consumed. Even with a full night’s rest, the quality of sleep may be compromised. In addition, this lack of sleep can result in increased anxiety levels the night after drinking. Alcohol and Insomnia are known correlated problems. Alcohol should not be used as a sleep aid. Consuming alcohol robs us of REM sleep. While it may help induce sleep at first, later during the night it is disruptive. Decreased time spent in REM can impact concentration, motor skills, and even memory. Alcohol also results in more frequent awakenings throughout the night and increases alpha wave sleep, which makes us feel less refreshed in the morning and causes poor daytime functioning.

Medication Use

Certain anxiety and anti-inflammatory medication can negatively interact with alcohol, making them less effective and leaving people in anxious, agitated, or restless states. Mixing prescription drugs with alcohol also impairs the medication’s desired impact, which often leads people to drink or ingest more substances to achieve a similar high. When you receive prescription drugs, whether it’s a depressant like Xanax for anxiety treatment, an opioid painkiller like methadone for opioid withdrawal symptoms and addiction treatment, or a stimulant like Adderall for ADHD treatment, you’ll often find stringent warning labels about the risks of mixing prescription drugs with alcohol.

  • Alcohol and anxiety meds are especially dangerous when combined. Problem drinkers were 1.5 times more likely to drink and use anxiety meds. Taking Xanax and alcohol together will intensify the effects of both substances.
  • Trazodone is an FDA-approved antidepressant for treating major depressive disorders. The deadly combination of Trazodone and alcohol can lead to delirium, hallucinations, and seizures in extreme cases. Mixing Trazodone and alcohol can lead to severe side effects that affect a person’s overall health.
  • Valium (diazepam) is a benzodiazepine prescribed for anxiety, muscle spasms, seizures, and insomnia. While some people mix Valium and alcohol or other drugs to intensify their calming effects, others take Valium with other substances without being aware that they are endangering their health and safety. 
Hangxiety
Hangxiety is experienced differently by different people. However, generally, it is described as an uneasy or stressed feeling that occurs during a hangover.
  • Benadryl (diphenhydramine) is a brand name for an over-the-counter (OTC) medication that’s classified as an antihistamine. People who are addicted to Benadryl often have simultaneous addictions to alcohol and other drugs. Both Benadryl and alcohol are classified as CNS depressants.
  • The advice that you shouldn’t mix antibiotics and alcohol does hold true for a small group of anti-infective drugs, including metronidazole (Flagyl, Metronide, or Metrogyl), tinidazole (Fasigyn or Simplotan), and sulfamethoxazole/trimethoprim (Bactrim, Co-trimoxazole). Mixing Bactrim and alcohol can increase the side effects of both, making the person extremely uncomfortable.
  • Benadryl (diphenhydramine) is a brand name for an over-the-counter (OTC) medication that’s classified as an antihistamine. People who are addicted to Benadryl often have simultaneous addictions to alcohol and other drugs. Both Benadryl and alcohol are classified as CNS depressants.
  • The advice that you shouldn’t mix antibiotics and alcohol does hold true for a small group of anti-infective drugs, including metronidazole (Flagyl, Metronide, or Metrogyl), tinidazole (Fasigyn or Simplotan), and sulfamethoxazole/trimethoprim (Bactrim, Co-trimoxazole). Mixing Bactrim and alcohol can increase the side effects of both, making the person extremely uncomfortable.
  • Adderall is a brand name for the combination of dextroamphetamine and amphetamine. It is prescribed for attention deficit hyperactivity disorder treatment and narcolepsy (sleep disorder). Some people think that taking Adderall before drinking will help them keep up their energy. People intentionally mix alcohol and Adderall in order to party longer and drink larger amounts. Unfortunately, this practice is extremely risky and dangerous because it can result in potentially-fatal consequences, including anxiety, depression, seizures, alcohol poisoning, and even heart attack.
  • Ritalin. or Methylphenidate hydrochloride—the generic for Ritalin, is a stimulant prescribed for ADHD treatment. Using Ritalin with alcohol also increases your risk of alcohol poisoning. People who are addicted to Ritalin and alcohol typically experience alcohol and Ritalin withdrawal symptoms when they stop using the substances. They may feel severely depressed, anxious, or irritable and suffer from headaches. 
Hangxiety
If you do have hangxiety, know that feeling anxious is a common reaction to getting drunk.
  • Percocet is a prescription painkiller containing oxycodone (a semi-synthetic opiate) and acetaminophen (the active ingredient in Tylenol). Alcohol can intensify the Percocet side effects, but taking Percocet and alcohol together makes it more likely that the user will experience overdose and stop breathing.
  • Melatonin dietary supplements may be an effective and safe treatment of chronic insomnia, sleep anxiety, and insomnia. There are cases where individuals use alcohol to self-medicate from insomnia, and they sometimes combine melatonin and alcohol. First, if you combine melatonin and alcohol, negative side effects may happen. These can include extreme dizziness, drowsiness, and increased anxiety. 

Alcohol Detox

The body eventually has to process alcohol consumed out of its system. This detoxification can be deemed as a mild form of alcohol withdrawal, which can take up to 8 hours. During this time, it is common to feel nervous, anxious or jittery.

Alcohol Intolerance

Often confused with alcohol allergy, alcohol intolerance can lead to multiple symptoms similar to physical symptoms of anxiety. These include nausea, rapid heartbeat or pounding heart, flushed skin, or excitability. It is also plausible to feel mood-related symptoms, including feelings of anxiety.

Hangxiety Symptoms

Hangxiety symptoms vary from individual to individual, like with all other illnesses and disorders. Some of the common signs and symptoms of hangxiety are as follows:

  • Anxiousness – this goes without saying. People experience anxiety, which can be uncomfortably intense.
  • Paranoia
  • Feeling extreme shame, guilt, worry and/or embarrassment – this is usually about the previous night that was spent drinking.
  • Restlessness – this is persistent and constant and makes concentration, sleep, and relaxation strangely difficult.
  • Difficulty focusing – loss of the ability to focus. It also occurs due to restlessness.
  • Stomach knots – this is figurative, but it feels very real and puts the person in a state of unease.
  • Increased heart rate – a racing heart is a consequence of anxiety.

How long does hangxiety last?

Hangxiety can linger 14 to 16 hours after the first hangover symptoms. So, while the hangover anxiety may not stay long, it is not always the case. Anxiety can persist for 3 to 7 days in those who are addicted to alcohol. Anxiety might last for up to seven days in some people. The uneasiness associated with a hangover lasts as long as it takes the body to restore normal chemical levels. If you find your hangxiety is lasting longer than a day, you definitely need to make an appointment with your doctor. Chronic stress and anxiety can do major damage to your health and quality of life.

How to Avoid Hangxiety

There are ways to prevent hangover anxiety, including:

  • Keep a log of anxiety episodes that follow drinking. This may help you understand whether certain situations or quantities of alcohol cause you stress.
  • Drink plenty of water. Hydrate during and after alcohol consumption and avoid coffee and other stimulants that may enhance anxiety.
  • Do not drink too quickly. Try to stick to one alcoholic drink per hour. If you tend to drink quickly, try enjoying a simple drink on the rocks that is better suited for sipping. The more alcohol you drink in a short span of time, the worse the hangxiety will be.
  • Avoid drinking on an empty stomach. Have a snack or quick meal before you want to drink. If that does not fill you up, you can always eat while drinking or just before bed.
  • Only drink with trusted friends. Avoid people and places that may encourage behavior that you regret the next day. You may also decide to prevent hangover anxiety by reducing or eliminating alcohol altogether.
  • Set yourself a limit. When you are in the moment and having fun, you may feel fine to keep drinking. However, those drinks will eventually catch up to you. Set a limit and stop drinking when you’ve reached that limit.

How to Rid of Hangxiety

Rehydrate

As we just mentioned, dehydration can be a major factor in bringing about or worsening hangxiety. It’s crucial, then, to make sure you’re getting enough water the morning after to combat this dehydration. While regular old water is just fine, we like to add an electrolyte enhancer like the ones from Liquid I.V. These dissolvable powders or tablets are meant to deliver hydration to the bloodstream faster and more efficiently than water alone.

Focus on your breath

Especially if your hangover anxiety turns into a panic attack, focusing on your breath is hugely helpful. Sit quietly, upright and focus on your breath to feel present in the moment As soon as thoughts come in, focus on the breath again. This is a form of mindfulness meditation, Researchers at Johns Hopkins University found that mindful meditation can help ease symptoms of anxiety and depression.

Distract Yourself

Start a new show on Netflix, listen to some music, and try that new recipe you’ve had flagged for weeks—whatever sounds appealing that will take your mind off of the negative thoughts you’re having. Self-care—whatever that may look like for you (chilling on the couch, going for a long walk, ordering your favorite Thai takeout)—is often a helpful antidote to anxiety. Anything to get your mind off all the things you think you did and said wrong last night, you know?

Put things into perspective

Ask your friends if they’ve ever felt anxious after a night out. Even if they don’t know the term hangxiety, we’re pretty sure they’ve felt it at least a little bit. When you’re stuck in an anxious loop, it can be hard to see things from an outsider’s perspective. Chances are you’re blowing whatever you think you did or said out of proportion. Beyond that, even if you did say or do something cringey, it probably didn’t even register as cringey to the people you were with at the time. Remember that no one is thinking about you as much as you’re thinking about yourself, and it’s very likely your embarrassment or regrets are unfounded.

Hangxiety
If you or someone you know has been affected by hangxiety there are resources to help you recover.

How to Cure Hangxiety 

While hangxiety can occur after just one night of drinking, it can also be a sign that a person may be drinking too much. Aside from asking how to cure hangxiety, start by asking yourself why you’re drinking. One of the criteria in diagnosing an alcohol use disorder is to continue to drink even though it is making you feel anxious, depressed, or adding to another health problem. If you are frequently experiencing anxiety and are having trouble cutting back on drinking, it’s worth consulting a medical professional.

There is a strong link between mental health conditions, such as anxiety, and alcohol abuse. Individuals who struggle with mood disorders like anxiety are more susceptible to developing an addiction to drugs or alcohol, often to self-medicate symptoms of their underlying mental health condition. These co-occurring disorders can make each other worse without proper treatment.

To determine the most effective ways to treat hangxiety, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional.

Medically-Assisted Detox

Detox is often considered the first stage of treatment. It will help you navigate the complicated process of alcohol withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.

Psychotherapy 

Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
  • Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use disorders and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

If you or a loved one are struggling with long-term drug abuse and a co-occurring mental health condition such as depression, contact one of our helpful treatment specialists today. We Level Up can provide information on dual diagnosis and detox programs that may fit your specific needs.

Hangxiety
Dual diagnosis is the treatment of mental illness, like anxiety, along with substance use disorders.
Sources:

[1] NIH – https://medlineplus.gov/anxiety.html

[2] WHO – https://www.who.int/news-room/fact-sheets/detail/depression

[3] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1295099/

[4] NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860396/