You’re not the only one who feels anxious after drinking. Here’s how to cope

In the moment, having a drink can seem like a good idea. Alcohol can make you feel relaxed, less inhibited and even euphoric. The next morning, though, you might find yourself regretting that extra glass of wine.

Beyond the unpleasant physical signs of a hangover – headache, nausea, thirst and sensitivity to light and sound – alcohol can also cause lingering emotional symptoms. Sometimes called “hang-xiety”, this can show up as brain fog, anxiety, irritability and feelings of regret or shame.

Sally Adams, an associate professor of psychology at the University of Birmingham who studies the cognitive and behavioral effects of alcohol, says that she used to have a few drinks after a stressful week to relax and quell her anxiety, but that “it always came back tenfold the next morning”.

These day-after feelings are just one of the mental health effects of alcohol. Long-term excessive use has also been linked to depression and anxiety.

“We know that people are starting to make this link between mental health and alcohol, and it’s a reason that they are giving for cutting down or not drinking at all,” Adams says. (In her case, Adams quit drinking because her next-day anxiety wasn’t worth the short-lived enjoyment, she says.)

Here’s a look at what experts believe might cause post-drinking emotions, and how you can deal with them.

What happens in your brain when you drink

Drinking has wide-ranging effects on the body. In the brain, it disrupts a delicate balance of signalling molecules called neurotransmitters that help your cells communicate. When you start to drink, alcohol triggers a release of dopamine in the pleasure centre of your brain, making you feel buzzed and happy. It also enhances the effects of a neurotransmitter called GABA, which can make you feel relaxed and sleepy, and it dampens the effects of the neurotransmitter glutamate, which can impair your memory and movement.

“Alcohol is a pretty complex drug,” says Dr Stephen Holt, a primary care physician and director of the Addiction Recovery Clinic at the Yale School of Medicine. “It’s doing all those things simultaneously, and that’s why it has so many different effects.”

As your body metabolises the alcohol, your brain works to return to baseline. That can make you feel “pretty rubbish the next day,” Adams says. Some studies have found that people report feeling less “tranquil” and more fatigued the day after drinking. And in 2021, Adams and other researchers found that hungover volunteers were less able to regulate their emotions than their peers. “Everything seemed a bit more negative when they were hungover,” Adams says.

Alcohol has complex effects on mood

Dr Hugh Cahill, a neurologist at NewYork-Presbyterian The One, says it can be difficult to pin post-drinking emotions on a single cause, given the array of factors at play when you drink.

Take sleep: while alcohol can make you fall asleep faster, it also reduces the amount of REM sleep you get, which can make you feel anxious. Drinking also makes you dehydrated, which can affect your mood, according to some studies. And because alcohol lowers your social inhibitions and impairs your memory, it can lead you to make decisions you regret or can’t remember.

The severity of a hangover can vary based on factors like genetics, body weight and body fat, as well as what you’ve eaten and how hydrated you are, Adams says. Emotional responses can be individualised, too. One 2019 study found that highly shy people were more likely to report anxiety the morning after drinking than people who were less shy, for example.

Research suggests that chronic alcohol use can also change the brain’s baseline neurotransmitter levels and make you more likely to become hyper-excited – or to have a panic attack – if you stop drinking abruptly. Experts say it’s not clear what amount of alcohol causes those effects.

How to cope

To avoid a night that might leave you with an emotional hangover, try to “play the tape through” and envision not only the benefits you’ll get from drinking that night but also how you’ll feel the next morning, says Hayley Treloar Padovano, a psychologist and associate professor of psychiatry and human behaviour at the US Centre for Alcohol and Addiction Studies at Brown University.

Researchers don’t yet have strategies for decoupling the physical and emotional effects of alcohol, but approaches such as spacing out drinks and adding ice to dilute them can help you consume less alcohol and prevent hangovers in general.

Because alcohol and hangovers are complex, there’s unlikely to be a single cure for hang-xiety, Adams says. If you’re experiencing a low mood related to drinking, she says, remember that those emotions are part of the hangover and will pass eventually.

Unfortunately, Cahill says, the reality is that your body just needs time to break down alcohol. An afternoon nap, he says, probably “provides the biggest bang for the buck”.

The New York Times

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