One of the many things I have noticed about life after 40 is that even a single glass of wine can make me feel icky the next day. I wake up tired, foggy-headed and anxious — even more so than I usually do. Chardonnay, why do you fail me?
After conferring with friends, I discovered there’s a popular term for this mild alcohol-induced ennui — “hang-xiety.” It’s not an official diagnosis, but people sometimes use the word to describe the emotional plunge they feel after drinking that doesn’t quite constitute a proper hangover.
I find it happens after drinking very little, but experts who have looked at heavier drinking have made the same connection. Post-drinking mood-related issues such as anxiety are quite common, and even have been documented in the research literature. “I see this all the time, clinically,” said Dr. Judson Brewer, a psychiatrist and neuroscientist at the Brown University School of Public Health.
Why might alcohol affect our mental and emotional state — and what can we do about it? For answers, I dug into the research and spoke with three psychiatrists who study anxiety and addiction.
Alcohol’s effects are many and varied.
The first thing to know about alcohol is that it does many things to the body. “It really causes profound physical effects across a variety of different systems,” explained Dr. Carl Erik Fisher, an addiction psychiatrist at Columbia University. Among other things, it affects the kidneys, immune system, brain, hormones, metabolism and the circulatory system, he said. No wonder consuming it can make us feel weird the next day, even if we don’t have that much.
As for post-drinking anxiety in particular, there could be a few causes. First, alcohol mimics a calming brain chemical called GABA, which is one reason why drinking often makes us feel relaxed. Afterward, however, the body fights to return its chemistry to normal, reducing calming GABA activity and increasing the activity of an excitatory chemical called glutamate, which has the opposite effect, making us feel restless and excited, said Dr. Ellen Vora, a psychiatrist in Manhattan who wrote a book about anxiety.
Also, alcoholic drinks such as mixed cocktails can contain lots of sugar, and after we metabolize it, we can experience a blood sugar crash, Dr. Vora said. In response, the body releases stress hormones including cortisol and adrenaline, which induce the liver to release glycogen and normalize blood sugar levels. (Low-carb drinks, such as pure spirits, can lead to drops in blood sugar too because the liver may initially focus on breaking down the alcohol rather than releasing glycogen to maintain a healthy blood sugar balance.)
True to their name, these stress hormones also cause mental stress that “can feel identical to anxiety or even panic,” Dr. Vora said. After drinking, these effects can start in the middle of the night — hence why you might find yourself up at 3 a.m. feeling flushed and panicky — and could continue into the next morning, too.
I asked Dr. Vora if alcohol’s effects intensify as we age and got a mixed answer. On the one hand, she pointed out that our livers work less efficiently as we age, so they might not clear the body of alcohol and its byproducts as well. On the other hand, people can build tolerances to alcohol over time, Dr. Vora said, which could make some people feel less affected by alcohol as they get older, and some research does support that notion. As for me, I think my poor liver must be exhausted, because I certainly feel the effects of one or two drinks far more than I did in my 20s.
Sleep (or lack thereof) plays a role.
The chemical aftereffects of drinking have another important effect, too: They disrupt our sleep. Both the blood sugar shenanigans and excess glutamate affect the quality and quantity of our shut-eye and “are going to make us cranky, irritable and tired the next day,” Dr. Vora said.
In a 2022 study, researchers served one group of volunteers alcoholic drinks — men had approximately five, while women had four — and another group mocktails throughout the evening and then monitored their nighttime sleep. They found that alcohol consumption reduced both the total amount of time the subjects slept and also the amount of time they spent in R.E.M. sleep, compared with the non-alcohol drinkers. Although the researchers in that study did not find a strong link between alcohol consumption and negative mood the next day, other studies have shown that sleep deprivation can spark feelings of anxiety.
After you drink, “your sleep quality is just not as good, even though the number of hours you’re spending unconscious may be the same,” Dr. Fisher explained.
These sleep disruptions may be more severe for women, many of whom already have lower sleep quality than men. Women who menstruate often sleep more poorly than usual during the luteal phase of their cycle — the period between ovulation and menstruation — and menstrual cramps can also wake us up, she said. Women going through peri-menopause, menopause and who are past menopause also experience higher levels of insomnia, she added.
“If we’re already not sleeping well, and we drink, it’s hitting us harder than our male counterparts,” she said.
Listen to your anxiety.
Consuming alcohol might ramp up your anxiety, but it’s important to consider that the relationship could work in reverse, too: Perhaps you drink in part because you feel anxious. “A lot of people use alcohol because of anxiety, or because of some other suffering in their life,” Dr. Fisher said, largely because alcohol can have the initial calming effects I mentioned earlier. In other words, the anxiety you feel the next day could, in part, be anxiety that was also there before.
Whether the anxiety is causing your drinking or drinking is causing your anxiety, don’t ignore your unsettled feelings, Dr. Fisher suggested. They “may be trying to tell you something, and that might be useful to listen to,” he said. Maybe you find that the morning after having a few drinks, you can’t stop thinking about how much you hate your job, or that you wish you had more time to mountain bike. Even though the alcohol may be intensifying your feelings, they are still valid, he said.
“We have a really strong impulse to treat anxiety as if it’s a problem in and of itself — like, ‘I don’t want to be anxious, how do I get rid of the anxiety?’ And I think that’s really harmful,” Dr. Fisher said. Anxiety can be a beautiful teacher when you lean into the feeling, he said, and “really listen to it.”
To cut down, remember how hang-xiety feels.
One question I (of course) asked experts was whether there’s a way to drink alcohol and somehow avoid the next-day nastiness. The answer I got was pretty much “no,” but Dr. Vora reminded me that it helps to eat a healthy meal before drinking and to stay hydrated — she suggested alternating alcoholic drinks with non-alcoholic ones.
Still, these fixes will only do so much, so if you’re sick of feeling yucky after a few cocktails, the obvious solution is to quit drinking. But that can be easier said than done, and sometimes the message to “just stop” can backfire, Dr. Brewer said. People who have trouble going cold turkey may feel ashamed of themselves and wonder if there’s something wrong with them, he said, which makes change even harder.
Another problem is that people often convince themselves that drinking isn’t the cause of their morning-after woes. “It’s easy for our brains to say, ‘Oh, no, it’s not the alcohol. You can keep drinking. It’s something else,’” he explained. When his patients want to stop drinking, Dr. Brewer advises them to focus on how they feel the morning after they drink, and to compare that to how they feel after nights they don’t. In doing so, they can more easily pinpoint the cause-and-effect relationship and decide that drinking isn’t worth it.
“They see that it’s just not that rewarding, and that’s what helps them change,” he said.
That’s not to say drinking occasionally is the worst thing in the world, but if it is causing you hell the next day, it’s not a bad idea to weigh the benefits of scaling back. I’m still going to have a few glasses of wine at social gatherings, but on other nights, I’ll remind myself how much better I will feel the next day if I drink seltzer instead.