Here’s the rub: When you stop drinking, you’re left with a brain that’s been adapting to alcohol’s sedative effects by dialling down the inhibitory system and dialling up the excitability system. What you experience bodily when this happens is jitteriness, irritability, and anxiety. In other words, cue the hangxiety.
Alcohol’s effect on the GABA system is “one reason why alcohol intoxication can be perceived as relaxing,” says Dr. Kareken. The problem is that once you stop drinking, that influx of GABA goes away, taking with it the feelings of calm and relaxation. Particularly if you’re someone who relies on alcohol’s calming effects to feel OK, the absence of that calm can be anxiety provoking.
The link between hangxiety and anxiety
Of course, just about anyone can feel anxious after a night of drinking. After all, alcohol makes you feel less inhibited which can lead you to do things you otherwise might not, which can lead you to wake up the next day and start to piece together hazy memories of texting your ex and demanding a selfie with your Lyft driver. But that kind of hangover anxiety is different than what people who already experience anxiety may end up feeling. If you are already prone to anxiety, it’s even worse, sometimes lasting all day and disrupting your ability to function.
Hangxiety is more prevalent for people who are prone to anxiety, especially those who use alcohol as a social lubricant to quell their nerves.
Now look, having a drink when you’re feeling a little wound up or tense is a time-honoured way to chill out, but the thing is that the relaxation you get from that delicious cocktail that goes down so smooth is actually pretty temporary, particularly for people who are already anxious in general. What’s more, those temporary calm vibes will likely be interrupted by an anxiety rebound. “People who already have a pre-existing anxiety disorder, even if it’s a small one and kind of underlying everything, whatever they have quieted by drinking the alcohol, that can come back full force or even worse,” Dr. Iyer says.
If you get intense hangover anxiety frequently, it could be an indicator of a bigger problem. In 2018, a small study found that highly shy people (the researchers posited that extreme shyness could be a subclinical manifestation of social anxiety disorder) experienced decreased anxiety when drinking, only to then experience elevated anxiety the next day. The researchers concluded that the relief from shyness and anxiety followed by acute anxiety after drinking could mean that highly shy people may be at increased risk of developing alcohol use disorder (AUD), in part because they might be more likely to self-medicate with alcohol.
When hangxiety could indicate a problem
The DSM-5 lists 11 criteria that could lead to a diagnosis of AUD, defined by the NIAAA as “problem drinking that becomes severe.” One of those is continuing to drink even though it made you feel depressed or anxious. According to the DSM-5, AUD can be classified as mild, moderate, or severe depending on how many symptoms you’ve checked off.
A red flag for someone who may be wondering whether or not they have an alcohol use disorder, Koob says, is if they self-medicate anxiety with more alcohol. “[People] who drink and then get anxious, and then start using the anxiety as an excuse for drinking… you’re beginning to get in trouble in my view,” Koob says.