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Hangover Anxiety: Why You Get ‘Hangxiety’ After a Night of Drinking

For some drinkers, hangxiety—that’s hangover anxiety, for the uninitiated—is almost as reliable as the pounding headache and queasy stomach. It’s the feeling of dread that follows a night of heavy imbibing. That chill, fun vibe that accompanies having a few (or a bunch) of drinks is gone. Now you just feel anxious. Your mind races, maybe your palms sweat, maybe you get a stomachache. Maybe you’re replaying everything you said last night and frantically scrolling through your texts to make sure you didn’t send a message you super wish you hadn’t. Or maybe you just feel really worried and full of dread, even if you can’t think of a specific thing to be worried about.

For some people, these doubts and worries are fleeting—run-of-the-mill nerves from letting their guard down after a few too many drinks the night before. But for others, the anxiety is overwhelming, and it’s not just regret from drinking too much or your mind’s effort to piece together a hazy night. The overwhelming feeling of worry and anxiety after drinking too much is an experience common enough that Reddit has devoted threads to the term: “hangxiety.”

It turns out that hangxiety might in fact be a thing that has both physiological and psychological explanations. One thing to keep in mind: Alcohol affects various neurotransmitter systems in the brain and trying to nail down how it affects any one is difficult because they interact with one another. That said, we did talk to experts who helped us understand the big picture.

The physiological factors behind hangover anxiety

Although not everyone experiences hangover anxiety—some people just feel achy or have an upset stomach—it’s a relatively common symptom of a hangover. Michael Bogenschutz, M.D., professor in the Department of Psychiatry at NYU Grossman School of Medicine, explains that the symptoms you experience after a night of heavy drinking tend to be milder versions of what clinical alcohol withdrawal looks like. So, the morning after a night of hard partying, you may feel sick to your stomach, nauseated, irritable, and anxious. Someone who drinks heavily often—and then stopped suddenly—would experience more severe versions of those symptoms—vomiting, diarrhea, maybe even a panic attack. In other words, hangover anxiety can be one of these subclinical (not severe enough to be diagnosed) symptoms of withdrawal. George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) agrees: “I think of a hangover as, more or less, a mini-withdrawal from alcohol, and anxiety is one of the components,” he tells SELF.

When you drink alcohol, dopamine neurons in areas of the brain associated with reward start firing more and more, explains Aparna Iyer, M.D., a psychiatrist and assistant professor at University of Texas Southwestern Medical Center. The problem is, that dopamine rush is short-lived with alcohol, Dr. Iyer says. That’s part of why your mood and anxiety levels might be impacted for the worse later on.

Alcohol also interrupts the activity of other neurotransmitters, including serotonin and endorphins, which can affect your mood, Dr. Iver explains. The feelings that you have after you drink alcohol, or even the day after, can result in a whole range of feelings and moods and anxiety symptoms,” she says. “It can range from panic to feeling depressed to feeling impulsive to feeling agitated and irritable.”

Alcohol actually has effects on multiple neurological pathways. But when it comes to hangxiety, perhaps the most significant one is the gamma aminobutyric acid, or GABA, pathway. Alcohol increases GABA activity in the brain. GABA is involved in several brain functions—motor control, memory, anxiety—and it’s also the principal inhibitory neurotransmitter, says David Kareken, Ph.D., a neuropsychologist at Indiana University Health. A number of medications used to treat anxiety, including benzodiazepines, also target GABA. Here’s how and why alcohol’s relationship to GABA activity is so important to understanding hangxiety.

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