10 Minutes

Alcohol is one of the most commonly used substances in the world, with millions of people using it to socialize and relax. However, for many, the experience can be marred by a troubling anxiety session, often known as hangover anxiety or anxiety after drinking. The phenomenon involves experiencing heightened levels of anxiety soon after drinking, usually significant enough to impact mental health and well-being. [1]

Understanding what causes anxiety after drinking, the possible symptoms and the impacts can help individuals develop the necessary skills to manage and possibly prevent it.

Alcohol is a depressant of the central nervous system, meaning it slows down neural activity and brain function. While this slowing down initially causes euphoria and relaxation, these calm feelings eventually convert to anxiety as the body continues to process alcohol.

Following are some effects of alcohol on the body which may potentially trigger anxiety after drinking:

Neurotransmitter Imbalance

Alcohol can directly affect certain neurotransmitter chemicals in the brain, including glutamate and gamma-aminobutyric acid (GABA). While GABA exerts a calming effect on the body, glutamate works the opposite. Alcohol works by elevating GABA activity, which causes relaxation, and decreasing glutamate activity, which reduces excitability. However, when the effects of alcohol wear off, this new balance also reverts to the normal baseline with high glutamine and low GABA levels. This sudden shift can trigger high anxiety levels. [2]
 

Alcohol Metabolism

When you drink alcohol, it travels to the liver, which breaks it down through a multi-step process. These steps include the following:

  • Alcohol Conversion: In the first step, a liver enzyme called alcohol dehydrogenase (ADH) acts on alcohol and breaks it down to form acetaldehyde.
  • Acetaldehyde Conversion: Acetaldehyde has a toxic effect on the body and can cause headaches and nausea. Hence, the liver quickly breaks it down to acetate through an aldehyde dehydrogenase enzyme (ALDH).
  • Acetate Metabolism: In the last step, acetate breaks down into carbon dioxide and water, which are later removed from the body.

During the alcohol breakdown process, the high levels of acetaldehyde can contribute to hangover issues, including anxiety. Moreover, the process also takes many essential electrolytes and nutrients from the body, which further exacerbates anxiety and other symptoms.

Hormonal Fluctuations

Drinking alcohol can impact several hormones, which ultimately lead to anxiety. Some examples of these hormones include the following:

  • Adrenaline: This hormone level increases with alcohol use, leading to jitters, sweating, and elevated heart rate.
  • Cortisol: Also known as the stress hormone, alcohol can also increase serum cortisol levels, contributing to the buildup of stress and anxiety.

Dehydration and Electrolyte Imbalance

Alcohol is a diuretic, which means that it removes water from the body by excreting more urine. Consequently, drinking often triggers dehydration while forcing the loss of essential electrolytes. These imbalances in the electrolytes, coupled with dehydration, can contribute to the development of anxiety.  [3]

Sleep Disturbance

Drinking alcohol can severely impair the sleep cycle, reducing sleep quality and triggering feelings of irritability and fatigue the following day. Research also confirms the connection between poor sleep and heightened anxiety levels.

Blood Sugar Imbalances

Drinking alcohol can cause fluctuations in the blood sugar. It mainly causes the blood sugar to drop, a condition called hypoglycemia, which makes a user sweaty, anxious, and shaky.

Folic Acid Deficiency

Nutritional imbalances and nutrient deficiencies can affect mood. For instance, research proposes a link between folic acid deficiency and anxiety and depression. [4] It is important to remember that drinking can also cause folic acid levels to drop, which may further exacerbate the issue.

Medication Use

Certain medications, such as those for anxiety management and reducing inflammation, can interact with alcohol and become less effective. When these medications are unable to do their job correctly, it may cause anxiety to rebound, making people restless, agitated, and anxious.

Regret and Worry

Many people wake up with a fuzzy memory after an alcohol session. With no clear recollection of the night before, many people have racing thoughts about what they did, what others saw, and what they will think about them. Such people may also worry about doing something while drinking that may have made others angry or disappointed and may regret engaging in drinking. These worries and regrets can trigger anxiety and exacerbate it if it has already kicked in.

Expectations

Most people normally expect to feel at rest and relaxed after drinking. When things do not go as anticipated, they may worry and fear as they struggle to understand why they are feeling anxious instead of calm and relaxed.

Anxiety after drinking may manifest in different ways, including mental and physical symptoms. Some of these common symptoms include the following:

  • Increased heart rate: This may be a symptom and cause of anxiety, pushing people into a vicious cycle.
  • Panic attacks: In severe cases, anxiety due to alcohol use may cause panic attack symptoms, such as chest pain, intense fear, and shortness of breath.
  • Sweating: It is common for individuals to sweat profusely as a response to anxiety.
  • Catastrophic Thinking: This involves excessive worry about irrational fears and worst-case scenarios.
  • Restlessness: Anxiety due to alcohol may make it difficult for an individual to stay still and relax.
  • Irritability: Frequent mood swings and increased irritability are common symptoms of hangover anxiety.
  • Tremors and Shakes: These physical symptoms often occur due to alcohol-induced hypoglycemic episodes and anxiety.
  • Poor Concentration: Anxiety may make it hard for an individual to focus and concentrate, negatively affecting their work and daily activities.

Not everyone who drinks alcohol develops anxiety following a drinking session. Even those who feel anxious after having a drink may have variable experiences based on factors such as the following:

Genetics

Genetic variations can determine how an individual metabolizes alcohol. Some individuals have genetic mutations in the enzymes involved in alcohol breakdown, i.e., ALDH and ADH. These mutations impact how quickly such people can process alcohol and its byproducts, consequently determining the severity of alcohol-related anxiety and its duration.

Previous Mental Health History

People with pre-existing anxiety disorders or any other psychiatric issue are more susceptible to experiencing hangover anxiety. For such people, drinking can exacerbate the underlying conditions, making the symptoms more pronounced.

Social and Environmental Factors

The context of drinking is an essential factor that determines and influences the severity and duration of anxiety levels. Drinking in unfamiliar environments or stressful social situations can increase the possibility of acquiring anxiety.

Tolerance Levels

Regular drinkers typically have a higher tolerance level to alcohol’s effects. As a result, they may drink excessively to achieve the desired effects, worsening the hangover symptoms and causing anxiety in the process.

Experiencing anxiety day after drinking, or hangover anxiety, can affect multiple aspects of a person’s life, such as the following:

Productivity and Work

Anxiety and other alcoholic hangover symptoms can mess with concentration, cognition, and productivity at work. In the long run, it can lead to poor performance and heightened stress levels. [5]

Physical Health

Poor sleep and chronic anxiety due to regular alcoholic anxiety symptoms can negatively affect physical health. Some long-term side effects include increased risk of cardiovascular disease, weakening of the immune function, and overall reduced well-being.

Relationships

Anxiety after alcohol can make a person irritable and socially isolated with an unstable mood. All of these symptoms can strain personal and professional relationships by creating conflicts and misunderstandings, which feed the underlying anxiety.

Mental Health

Repeated experiences with alcohol and anxiety can worsen the underlying anxiety disorders and other mental health issues. Many individuals get stuck in a vicious cycle, attempting to drink to relieve anxiety only to experience heightened fear.

Understanding how to manage anxiety after drinking is imperative to maintain physical and mental health. The following strategies can be implemented to alleviate the symptoms and make recovery quicker.

Nutrition & Hydration

As the most critical aspects of alcoholic anxiety treatment, consider the following tips:

  • Rehydrate: Drink water and electrolyte-rich beverages to manage the dehydrating effects of alcohol.
  • Eat Healthy Meals: Focus on foods rich in proteins, complex carbohydrates, and healthy fats to stabilize blood sugar and get the body the nutrients it lacks.
  • Say No to Caffeine: While a cup of coffee may seem tempting to combat alcohol-related fatigue, caffeine is known to heighten anxiety levels and worsen dehydration.

Physical Activity

Use physical activity to recover from anxiety after drinking through the following:

  • Deep Breathing & Relaxation: Deep breathing, progressive muscle relaxation, and meditation are different ways to calm down an overactive mind and manage anxiety after drinking alcohol.
  • Exercise: Light to moderate exercise boosts endorphin levels to improve mood and reduce anxiety. Activities such as yoga, stretching, and walking are particularly beneficial.

Rest & Recovery

Give the body a good chance to rest and recover through the following tips:

  • Take Strategic Naps: Short naps throughout the day can boost energy levels without negatively affecting your nighttime sleep schedule.
  • Get Enough Sleep: Prioritizing rest and sleeping well can help improve mood and manage anxiety following a drinking session.

Mental Health Tips

Consider using the following tips to boost mental health:

  • Mindfulness Meditation: This practice can help individuals ground in the present moment while reducing anxious thoughts
  • Cognitive Behavioral Strategies: These strategies help identify and challenge negative thought patterns to alleviate anxiety. [6]
  • Seeking Support: Talking to a close family member, trusted friend, or therapist about your emotions and feelings can also help with relief.

For those who experience anxiety after drinking regularly, experts advise implementing long-term strategies to address the underlying problems and improve overall mental health.

Assessment of Drinking Habits

  • Reflect on how alcohol fits in your life and whether it is exacerbating your mental health issues, including anxiety.
  • If you are unsure about your relationship with alcohol, get in touch with a professional to seek guidance and understand how to reduce your consumption.

Acquiring Healthy Coping Mechanisms

  • Many people rely on alcohol to cope with their everyday issues. For them, finding healthier alternatives that bring them joy and relaxation without involving alcohol is advisable. These alternatives may include alcohol-free socialization, exercise, and book reading.
  • Build a strong network of family and friends who understand your goals and can support you stay on track.

Addressing Underlying Mental Health Issues

  • Consider seeking professional therapy, such as cognitive behavioral therapy, to address anxiety after drinking and acquire healthier strategies to overcome it instead of drinking.
  • In case your anxiety is refractory to self-help tips, consider talking to a healthcare provider regarding the need for an anti-anxiety medication.
  • Engage in regular self-care practices, such as exercise, healthy eating, and meditation, especially if you are drinking, as a self-medication for your underlying anxiety. [7]
  • Come up with a meditative routine to manage stress and the risk of anxiety.

In situations where drinking becomes unavoidable, utilizing the following strategies can help mitigate the risk of feeling anxious following alcohol consumption:

  1. If you are going to a place where alcohol is unavoidable, have a light meal or snack before drinking. The aim is to fill the stomach up so that there is little room for alcohol.
  2. Be careful while ordering an alcoholic drink, as some of them have a higher chance of triggering hangover anxiety. For instance, drinks with high levels of congeners are more likely to cause stress. Stick to clear spirits like gin and vodka to minimize this risk.
  3. For every alcoholic drink you consume, drink a glass of water to reduce overall alcoholic consumption.
  4. Set a rate of drinking, such as one alcoholic drink per hour. For those who tend to sip on alcohol, choose a simple drink on rocks.
  5. Do not mix alcohol with other substances, such as recreational drugs or caffeine, as this may heighten anxiety along with different side effects.
  6. Pre-decide on the number of drinks you wish to consume for every event you go to. Partner with a friend to stick to this number and hold each other accountable.

Anxiety after drinking is a multifaceted phenomenon affecting many people from time to time. Understanding the mechanisms and causes can help mitigate its effects, and long-term strategies can be applied to reduce its recurrence in the future. Proper hydration and nutrition, exercise, mindfulness, and rest can provide immediate relief, whereas evaluating drinking habits and seeking professional help may be needed to maintain overall well-being in the long run.

By taking proactive steps to manage anxiety after alcohol consumption, it is possible to reduce its impacts on personal and professional lives and live with well-balanced mental health.

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