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Anxious After Alcohol?

You May Have “Hangxiety”

Have you ever felt an increase in stress, worry, jumpiness, hunger, or tension the day (or two days) after a night of drinking? “Hangxiety” is the common name for the creeping feeling of worry, stress, and tension that comes 12-36 hours after a night out (or a night in).

Beyond the classic hangover symptoms of headache, queasiness and fatigue, alcohol has a lingering effect on your brain and mood, and it’s more than simple dehydration or sleep loss.


1) Neurotransmitter Imbalances

Alcohol targets GABA and glutamate systems in the brain, and they each have a powerful rebound effect.

GABA is a natural calming neurotransmitter. We have it all the time (some more than others) and when we drink alcohol, the brain gets a signal as if we have a large increase in GABA. We feel calm and even a bit cheerful with this alcohol-induced GABA surge.

On the other hand, glutamate is one of the excitatory neurotransmitters in the brain that causes surges in energy, and plays a role in learning and memory. Glutamate is decreased by alcohol. In the short term, this has a similar effect to increasing the GABA: we feel more relaxed and mellow, and maybe even start to have a dip in our memory or learning abilities. If this goes too far, it completely impairs our ability to lay down memory and is called “blackout”.

With moderate amounts of alcohol, we may be feeling pretty good. But the brain is not used to such high levels of GABA and low levels of glutamate. While we’re drinking, it’s already starting to correct this imbalance and reverse the calming mix of neurotransmitters.

The rebound result is a spike in excitatory glutamate that causes anxiety, tension and even tremors at very high levels (which is why alcohol withdrawal seizures can happen). Also, GABA production is being suppressed after drinking, so we don’t have our normal calming chemicals to help us relax and talk down our anxiety. The alcohol wears off, but this rebound reaction by the brain can last for 1-3 days.


2) Blood Sugar Crashes

Another factor in post-alcohol anxiety is the blood sugar rollercoaster that happens after drinking. Alcohol raises blood sugar, even after just 1-2 drinks it can raise it to the point where the body releases insulin to bring it back down and put the sugar into cells (liver, muscle or fat cells, usually).

Once the alcohol is gone, the body can experience a sugar crash that plummets energy and can cause brain fog, hunger, and a subjective feeling of stress because it increases your stress hormone cortisol. This crash can happen in the middle of the night, about 4 hours after drinking (depending on how fast you process alcohol), which is why sleep is often disrupted even after just a few drinks. A telltale sign for low blood sugar after drinking is shakiness and hunger in the morning or middle of the night.



3) Vitamin Depletion

Vitamin B6 is an important nutrient involved in energy, and the production of the “happy neurotransmitters”, serotonin and dopamine. Alcohol depletes vitamin B6 because it is used up in the liver when it processes the alcohol out of your blood.

Low B6 is linked with a subjective feeling of stress, and a higher likelihood of having anxiety and depression. Low B6 is also linked with more intense physical and emotional symptoms of PMS.



How to Reduce Anxiety After Alcohol

The best way to reduce anxiety after drinking is to reduce drinking. Aside from that, there are several things you can do to help reduce the intensity of the rebound, including:


  • Take vitamin B6 or a B complex before bed to avoid vitamin depletion

  • Eat a hearty meal with protein, fat, and fibre with your alcohol to reduce the chance of a blood sugar crash AND eat balanced meals the next day, not just carbohydrates that will exacerbate the blood sugar rollercoaster and extend the anxiety.

  • Drink plenty of water to help your liver. Dehydration is also a part of feeling awful the next day

  • Consider a supplement to help support GABA production if you’re someone who is particularly sensitive to hangxiety, even after very little alcohol (like me!). Options include oral GABA supplements, magnesium, L-theanine, kava, and passionflower.


Are you struggling with isolation? Do you want to talk about coping strategies? Do you want help reducing your intake of alcohol or other substances? We’re here for you. Talk with a naturopathic doctor before starting any new supplement as there may be interactions with medications or your physiology.


References

1) Kashem, M. A., Šerý, O., Pow, D. V., Rowlands, B. D., Rae, C. D., & Balcar, V. J. (2020). Actions of alcohol in brain: Genetics, Metabolomics, GABA receptors, Proteomics and Glutamate Transporter GLAST/EAAT1. Current Molecular Pharmacology

2) Lydiard, R. B. (2003). The role of GABA in anxiety disorders. The Journal of clinical psychiatry, 64, 21-27

3) Ngo, D. H., & Vo, T. S. (2019). An Updated Review on Pharmaceutical Properties of Gamma-Aminobutyric Acid. Molecules, 24(15), 2678

4) https://www.addictioncampuses.com/alcohol/vitamin-b-deficiency/

5) https://www.theguardian.com/lifeandstyle/2019/jan/27/hangxiety-why-alcohol-gives-you-a-hangover-and-anxiety

6) https://thesleepdoctor.com/2018/06/19/understanding-gaba/

Photos by Alex Holyoake and Ram Ho c/o unsplash

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Lachlan Crawford, ND

Toronto, ON

416-214-9251

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