What is Hangxiety and Why is it Important?
Hangxiety arises when a person experiencing a hangover becomes anxious about decisions or actions performed during a past alcohol use episode. An alcohol hangover is defined as a combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero. Hanxiety can often occur from chemical changes in the brain during a hangover. When drinking alcohol, GABA (a neurotransmitter that gives feelings of relaxation) levels rise and glutamate (a neurotransmitter that gives feelings of anxiety) levels fall. In a state of hangover, however, the brain tries to correct the chemical imbalances by increasing glutamate levels and decreasing GABA, which is a large cause of the anxious feelings one may experience after a drinking episode.
While limited studies have researched the direct impacts of hangxiety among adolescents and young adults, many studies have researched the impacts drinking has on mental health outcomes and next-day wellness. This review investigates literature to determine the motivations behind alcohol use, symptoms and impacts on health regarding alcohol use, and associations between hangovers and other symptoms, while also considering the role social media may play.
Is hangxiety more likely to occur in adolescents who already experience anxiety on a daily basis, or is it possible for anyone to experience the negative outcome of hangxiety from drinking? Literature tends to lean toward the former.
Alcohol Prevalence in College Students
Previous literature has found specific reasons for alcohol use among adolescents and young adults, specifically college students. Alcohol misuse has been listed as a problematic addictive behavior for the college student population in the United States. It has been found that college students consume more alcohol and engage in binge drinking more frequently than their non-college attending peers, and the prevalence of consequences from alcohol, such as drinking and driving and taking avoidable risks, has not decreased in comparison with decreases in consumption.
Social anxiety and alcohol expectancies, which are the expectations one has about the outcomes of alcohol use, have offered reasonable relationships with alcohol use. Positive alcohol expectancies, or common reasons for using alcohol, including tension reduction, socialization, and sexuality, were positively related to drinking, meaning more alcohol expectancies were associated with increased drinking. Anxiety sensitivity has been found to be a statistically significant predictor for alcohol-related problems and coping motives for drinking.
Across anxiety, there have been differences found in alcohol use between genders. Greater anxiety scores for women related to whether they consumed alcohol or not, while greater anxiety scores for men related to how many drinks they consumed during an alcohol use episode.
Post-Alcohol Use Outcomes and its Effects on Adolescent Mental Wellbeing
The resulting hangover from a previous night of alcohol use can have a range of negative impacts on the health and well-being of adolescents. Hangovers have been found to affect one’s mood, ability to multitask, and stress that arises from cognitive demand. In a past study, participants who reported experiencing a hangover after a night out described symptoms of lower alertness and sleep satisfaction, and higher anxiety, mental fatigue, and perceived effort while completing a task.
Past research has investigated differences between hangover-resistant and hangover-sensitive populations. Hangover-sensitive alcohol users were found to have higher levels of anxiety and stress compared to hangover-resistant alcohol users. Furthermore, hangover-sensitive alcohol users reported experiencing many hangover-related symptoms, such as sleepiness and fatigue, concentration problems, and headaches.
Hangover sensitivity and severity has been significantly associated with mood, mental resilience, and avoidant coping. While higher levels of mental resilience was associated with less severe hangovers, poorer mood was found to be associated with more severe hangovers.
Media’s Role
Exposure to alcohol use in media has been found to be associated with alcohol use among adolescents. This exposure includes pro-alcohol messages and unregulated marketing strategies, which has been correlated with offline alcohol use and risky drinking behaviors within the adolescent population. Within this population, alcohol messages are displayed a majority on social networking sites. These references were a possible source of influence on adolescents, especially due to the references from peers, as the most common alcohol use motivation found was peer pressure.
This information could allow for more questions regarding social media restriction and education for adolescents. Social media use has been identified to become problematic if it starts to interfere with one’s daily life and well-being. Interventions, such as restriction, for social media have been effective in improving mental well-being.
A previous SMAHRT study, Social Media and Health Information (SMAHI), investigated a different form of intervention online among college students. This study focused on forms of positive, effective, and feasible web-based alcohol intervention. References to sobriety, abstinence, and moderation posts on social media were also evaluated. One main finding was that the intervention type was deemed to be a feasible approach and most students involved continued on to complete the intervention.
Conclusion
Alcohol prevalence among adolescents, specifically college students, has become a more severe topic of conversation among the research community. My hope is to include into this conversation the hangxiety variable, which is often seen as a side effect of drinking, but more research must be done in order to determine whether there are differences in impact of hangxiety among the population of previously noted anxious users versus the opposite.
References
Benson S, Ayre E, Garrisson H, Wetherell MA, Verster JC, Scholey A. Alcohol Hangover and Multitasking: Effects on Mood, Cognitive Performance, Stress Reactivity, and Perceived Effort. J Clin Med. 2020 Apr 17;9(4):1154. doi: 10.3390/jcm9041154. PMID: 32316689; PMCID: PMC7230521.
Crisafulli MJ, Flori JN, Dunn ME, Dvorak RD. College Student Alcohol Use: Understanding the Role of Alcohol Expectancies, Social Anxiety, Social Connectedness, and Need to Belong. Psychiatry. 2024 Spring;87(1):21-35. doi: 10.1080/00332747.2023.2286845. Epub 2023 Dec 4. PMID: 38048159; PMCID: PMC11151340.
Kim AJ, Merlo A, Mackus M, Bruce G, Johnson SJ, Alford C, Sherry SB, Stewart SH, Verster JC. Depression, Anxiety, and Stress among Hangover-Sensitive and Hangover-Resistant Drinkers. J Clin Med. 2023 Apr 7;12(8):2766. doi: 10.3390/jcm12082766. PMID: 37109103; PMCID: PMC10145060.
Mackus M, van de Loo AJAE, van Neer RHP, Vermeulen SA, Terpstra C, Brookhuis KA, Garssen J, Scholey A, Verster JC. Differences in Next-Day Adverse Effects and Impact on Mood of an Evening of Heavy Alcohol Consumption between Hangover-Sensitive Drinkers and Hangover-Resistant Drinkers. J Clin Med. 2023 Mar 7;12(6):2090. doi: 10.3390/jcm12062090. PMID: 36983093; PMCID: PMC10055860.
Moreno MA, Briner LR, Williams A, Brockman L, Walker L, Christakis DA. A content analysis of displayed alcohol references on a social networking web site. J Adolesc Health. 2010 Aug;47(2):168-75. doi: 10.1016/j.jadohealth.2010.01.001. Epub 2010 Mar 20. PMID: 20638009; PMCID: PMC2907358.
Moreno MA, Whitehill JM. Influence of Social Media on Alcohol Use in Adolescents and Young Adults. Alcohol Res. 2014;36(1):91-100. PMID: 26259003; PMCID: PMC4432862.
Plackett R, Blyth A, Schartau P. The Impact of Social Media Use Interventions on Mental Well-Being: Systematic Review. J Med Internet Res. 2023 Aug 11;25:e44922. doi: 10.2196/44922. PMID: 37565693; PMCID: PMC10457695.
Smit T, Mayorga NA, Zvolensky MJ. Perceived discrimination and anxiety sensitivity in terms of alcohol consumption, alcohol-related problems, and drinking coping motives among racially/ethnically minoritized college students. J Am Coll Health. 2025 Apr 14:1-8. doi: 10.1080/07448481.2025.2492172. Epub ahead of print. PMID: 40227155.
Terpstra C, Verster JC, Scholey A, Benson S. Associations between Mental Resilience, Mood, Coping, Personality, and Hangover Severity. J Clin Med. 2022 Apr 17;11(8):2240. doi: 10.3390/jcm11082240. PMID: 35456334; PMCID: PMC9029171.
Torres OV, Estep JC, Gwin M, Aramovich NP, Thomas G, Villalta L. Distress symptoms and alcohol consumption: anxiety differentially mediates drinking across gender. Front Psychol. 2023 Jul 31;14:1191286. doi: 10.3389/fpsyg.2023.1191286. PMID: 37583609; PMCID: PMC10423919. Waterman G. Social media as an avenue for intervention. Social Media and Adolescent Health Research Team. 2022 Nov 28. http://smahrtresearch.com/social-media-as-an-avenue-for-intervention/