Many people are familiar with a hangover, headache, nausea, tiredness and dehydration after drinking alcohol. But there is another effect that is talked about less often: hangxiety. This word is commonly used to describe feelings of anxiety, worry, restlessness or low mood that appear after drinking alcohol, usually the next day.
Hangxiety is not a medical diagnosis; it is a real and well-understood reaction of the body and brain to alcohol.
Alcohol directly affects the brain chemicals that control mood. When you drink, alcohol increases the effect of GABA, a calming chemical, and reduces glutamate, a chemical linked to alertness. This is why alcohol initially makes people feel relaxed, social and less anxious. At the same time, alcohol increases dopamine, which creates a temporary feeling of pleasure. However, these effects are short-lived and come at a cost.
Once alcohol starts leaving the body, the brain tries to rebalance itself. GABA levels drop and glutamate activity rises. This leads to a state of over-alertness, which can feel like nervousness, racing thoughts, irritability, or panic. This rebound effect is one of the main reasons hangxiety occurs. The brain essentially swings from “too relaxed” to “too stimulated.”
Alcohol also increases levels of cortisol, the body’s main stress hormone. Even a single night of heavy drinking can raise cortisol levels the next day. High cortisol can cause feelings of tension, unease and anxiety, and can also interfere with sleep. Poor sleep after drinking further worsens anxiety, as the brain does not get enough time to recover and regulate emotions properly.
Another factor behind hangxiety is low blood sugar. Alcohol interferes with the liver’s ability to release glucose into the blood. When blood sugar drops, the body releases adrenaline to compensate. Adrenaline can cause symptoms that feel very similar to anxiety, such as a fast heartbeat, sweating, shaking and nervousness. People may mistake these physical signs for emotional anxiety, which can intensify worry.
Alcohol also affects memory and judgment. People may say or do things while drinking that they later regret. The next day, this can lead to guilt, embarrassment, or excessive overthinking about conversations and actions. For individuals who already struggle with anxiety or social anxiety, this mental replay can strongly contribute to hangxiety.
Certain people are more prone to hangxiety. Those with existing anxiety disorders, panic disorder or depression are more likely to experience it. Regular or heavy drinkers may also feel stronger anxiety symptoms because repeated alcohol use changes how the brain handles stress. Women may experience hangxiety more intensely than men due to differences in how alcohol is metabolized. Drinking on an empty stomach or consuming sugary or high-alcohol drinks can also increase the risk.
The most effective way to prevent hangxiety is to reduce or avoid alcohol. Drinking slowly, staying hydrated, eating before and during drinking, and setting limits can help reduce symptoms. Getting good sleep, eating balanced meals, and doing calming activities like walking or deep breathing the next day can also help the nervous system settle down. Importantly, using alcohol to “manage” anxiety often backfires and makes anxiety worse over time.
Hangxiety is a clear example of how closely alcohol and mental health are linked. Understanding this connection can help people make informed choices about drinking and recognise when alcohol may be contributing to their anxiety rather than relieving it.
(Dr Gupta is senior consultant, internal medicine, Indraprastha Apollo Hospitals)