Hangxiety: The Truth About Anxiety and Alcohol

Curious why you wake up all panicky after a night of drinking? Our columnist breaks down exactly what’s happening.

by Eddie McNamara Health Writer

I used to tell people that alcohol was the only drug that ever helped me with my anxiety. I said it in a joking way, like I was some kind of comedian, but it’s probably the most radically honest statement I’ve made. It’s an unpopular opinion, and one that I’m not even sure I’m allowed to have, but it’s the truth.

Look, alcohol’s a sedative. In the past, if I was waiting for a bus and a panic attack hit, I’d just dip into the closest bar. I’d order a beer and a shot, and they’d settle me down faster and more completely than all the breathing exercises I knew put together. When that alcohol hit my brain, the anxiety from the panic attack dialed down, the sense of impending doom dissipated, and I’d feel a hell of a lot more mellow than I did before I walked into the bar.

The likely reason I (and other highly anxious people) turned to drinking: Alcohol boosts serotonin-receptor functioning, which mimics the results of fast-acting SSRI antidepressants, according to research from the University of Texas at Austin. Your brain gets hooked up with dopamine, serotonin, and GABA, all of which relax your central (very, very) nervous system and cheer your brain up. Those drinks act much the same way that anti-anxiety meds like benzodiazepines (Xanax, Klonopin, and Valium) do by inhibiting nervousness and fear.

When I surpassed a few drinks and got straight-up drunk, the extra alcohol blocked glutamate (a neurotransmitter that correlates to anxiety), so I’d no longer feel abject terror or even normal levels of anxiety (the kind that can be healthy and prevent you from making terrible or dangerous decisions you wouldn’t make sober). The drunker I got, the more glutamate was blocked, which accounted for the blissful emptiness that washed over me. They don’t call it self-medicating for nothing; it kind of works.

So why doesn’t any reputable doctor prescribe a couple of drinks for their anxious patients? Because treating anxiety with alcohol is a great way to turn one problem into two (or more). Imagine if there was an oxycodone shop on every corner that you could pop into to deal with a chronic pain. Eventually, you’d still have the pain and an opioid addiction on top of it. Alcohol is an addictive drug of abuse that can and will make anxiety issues worse if you’re using it regularly. I know because that’s what I used to do before I knew better.

When I started having anxiety issues, I went from a slightly-more-than-social drinker to a drink-the-panic-and-anxiety-and-all-the-feels-away type drinker within a few months. (Some might use the term “alcoholic.”) Once I developed a tolerance for alcohol, it took more and more to get the desired numbing effect. But once my anxious body became dependent on the booze, my morning headaches, cottonmouth, and general hangover-ness came with a massive side of fresh anxiety. There’s even a name for this: Hangxiety—a portmanteau for “anxiety hangover.” And the hell it can bring is all the proof you need that drinking to calm your fears is a really bad idea.

When you’re kicking back those cocktails, your brain loves that alcohol-induced flood of brain chemicals, especially the GABA. So once the alcohol is gone, it starts searching like Sherlock Holmes to find it. When it realizes no more is coming, the brain’s new goal is simply to get back to baseline—how you felt before you took that first sip. And the way it gets there is by churning out norepinephrine to balance out the relaxing influence of the hooch. This stuff, however, has no chill. If you wake up to racing thoughts, panic, and anxiety, it’s likely due to overstimulation from norepinephrine coursing through your veins like an IV drip of Red Bull.

Your hungover body also tries to regulate other neurotransmitters like endorphins, glutamate, and serotonin. The state of dysregulation and correction that follows can lead to feelings of depression, panic, agitation, inability to relax, and it can really put you in a foul and combative mood. Waking up to rebound anxiety because of withdrawal feels a hundred times worse than the usual levels of anxiety you walk around with. Let me assure you that these feelings are way worse in real life than they seem on the page. They were so bad that I stopped drinking completely because of them, and I’ve been sober for 10 years.

This is a case of the poison being the cure. If you drink to calm your anxious nerves, and you do it regularly, you are going to experience much worse, and potentially dangerous, anxiety on the rebound. Hangxiety is the mildest form of nervous withdrawal, but some people actually go through seizures, delirium, and hallucinations. Eff all that.

The last thing I want to do is preach about the joys of sobriety. Truth be told, it’s kind of boring. The friends you used to meet up with for a drink are probably going to stop calling after the third soda water and pineapple juice you order. A lot of the things that were fun in the haze of a drunken hour are likely to make you miserable now that you’re sober. It’s not only your tolerance for booze that goes down—you will likely not be able to tolerate mediocre bands, unfunny comedians, or wack conversations either.

If you want to have a drink or even a couple, go ahead—as long as it’s improving the quality of your life. In my case it totally wasn’t. I drank to numb myself to the feelings of panic and anxious thoughts in my head. There’s no healthy or socially acceptable way to do that. I’d spend all day in a very anxious state, then get drunk, act like an ass, pass out, and wake up to more anxiety. Then I’d do it all over again and again and again. That’s not living. One day I woke up to hands so shaky I was messing up in band practice, and I had this overwhelming need to apologize to everyone I was with the night before (for what, I don’t know). That was the last day of drinking for me. I tried to go one day without taking a drink, and it became a decade. If you can’t do it on your own, try a therapist or a 12-step program.

If you’re self-medicating due to an anxiety issue, it’s time to make an appointment with a psychiatrist and get legit treatment. And when you do, be totally honest with them about how much you really drink. Truth is, it’s an important factor for them to consider when designing your treatment. If you happen to get a prescription, please promise me that you’re not going to be one of those people who drink while taking psych meds, it’s death and disaster waiting to happen. If you need help getting sober, get it. If someone you know needs help, give them some encouragement. I needed a therapist, my wife, and lots of yoga to deal with anxiety as a sober person. If I can do it, so can you. Go! Do it. Start today.

Eddie McNamara
Meet Our Writer
Eddie McNamara

Eddie McNamara is a 9/11 first-responder and former cop turned vegetarian chef and author. He's been living with panic disorder and PTSD for 17 years, and he'll be sharing his experiences, thoughts, and seriously hard-won advice every month. Check out all his columns for "Panic in the Streets."