The familiarity of hangover symptoms never seems to render them less crippling: the headache, the lethargy, the nausea.
But the psychological side effect of drinking known as “The Fear” — the low-level anxiety and spectre of doom — is one that can’t always be soothed by Tylenol and a greasy breakfast.
The Fear is deeper than the vague sense you embarrassed yourself with the confessions or confrontations of the uninhibited. According to Urban Dictionary, that online lexicon consulted by parents when they don’t understand their kids’ lingo, The Fear is “the sense that you have done yourself some lasting damage after a night of drinking.”
Symptoms include “the feeling that you are going to die soon” and the “sense that people or organizations are out to get you,” along with angst and foreboding. The only solution seems to be waiting for the misery to be over, clinging to the faint hope you survive it.
“I call it the ‘shameover,’” said Jenny Morris, cocktail critic and columnist for Toronto website She Does the City. “I feel guilty for throwing my day away, and I get extremely moody. Things that felt possible become impossible. . . I become the black swan.”
That can lead to what Morris called a shame spiral.
“Whatever I’ve been working towards, like eating healthy, forget it. Not going to happen. Going to exercise? Forget it, not happening. You want to get a jump start on applying for jobs? Nope. Go for brunch? Maybe.”
Though hangovers and alcohol withdrawal, which can become a medical emergency, are different conditions, both may result in serious anxiety, said St. Michael’s Hospital addiction physician Wiplove Lamba.
That relaxed feeling after a glass of wine is believed to be the alcohol working on the brain’s GABA receptors to reduce neuron firing.
“When that starts to wear off, there is a rebound effect where the firing gets heightened a little bit, and you start to get an anxiety-type feeling where your pulse goes up,” Lamba said.
It’s more intense for daily drinkers, but that rebound can still happen to anyone after big night of boozing.
(And, as Centre for Addiction and Mental Health psychiatrist Jan Malat points out, casual drinking that descends into problem drinking will change the brain itself by disrupting its chemical balance, which can result in anxiety disorders and even depression.)
Still, The Fear is real. In a survey of 1,410 Dutch university students, nearly half reported agitation the day after drinking, and more reported regret, confusion and guilt than vomiting, according to a 2012 report in the journal Alcohol and Alcoholism.
Anatomy of a hangover