The middle-aged are now more likely to drink to excess than any other age group. But after 40 that bottle of wine is followed by morning-after guilt. Jane Mulkerrins reports.

As my Uber sped along the Westway, every bump and jolt brought a fresh threat that I might finally incur that hefty and humiliating cleaning fine. The open window blasting a faceful of freezing air was helping quell the seated seasickness a little as I huddled under my coat-as-blanket, but it was still looking doubtful whether I could make it as far as Heathrow without having to pull over.

The day had not started auspiciously. After managing – by some miracle, or possibly still being drunk – to stagger to an 8am appointment, I had dashed home, passed an undignified hour simultaneously packing and puking, and was now finally en route to the airport, berating myself for the 3am finish the night before (well, I think it was 3am), with the strong suspicion that I’d made a total hash of said 8am interview, and a growing conviction that what felt like a hangover might actually be Covid, which I was about to take on a plane and then home to my family. Sweaty, anxious and panicky, I was in a doom spiral of self-flagellation and questioning my choices. And why I had a chronic inability to call it a night. And whether I would ever see the brand new MacBook Air I had left in the cab again. And mostly whether everyone hated me as much as I hated myself.

“That’s the hangxiety talking – you’ll be fine,” my friend texted wisely, before adding, possibly not quite so wisely, “Have a little beer at the airport.” (I did anyway.)

Hangxiety – also known as “the beer fear” or “the booze blues” – has, in recent years, become a part of the everyday lexicon of my friends and I. So badly do some of my gang suffer now that, unable to cope with the soul-crushing existential angst that frequently follows a nice pinot, they’ve slapped a total booze ban on themselves.

I’ve always been a proudly robust drinker though – I wasn’t made president of my college drinking society for nothing – but I’ve also always secretly harboured a bit of a post-booze black dog. Even in my twenties, when those partying alongside me seemed to get away scot and struggle-free.

Now in my forties, however, it’s not only become sharper, more pronounced and something of an epidemic among my peers, but also completely capricious in its appearances. After a recent wheels-off rampage in which I stayed out all night and engaged in undignified behaviours that would definitely not make my mother proud, I was blithely hangxiety-free the following day. By contrast, I celebrated my recent birthday with a sedate Sunday roast with ten close friends, plus assorted toddlers. Yes, the red wine was flowing, but it was hilarious, wholesome and life-affirming, and I was tucked up in bed by 10pm. Cut to Monday, however, and instead of basking in the warm glow of a day well spent with loved ones, I was down, gloomy, fidgety with anxiety and self-doubt.

Maybe it’s time to stop drinking so much, I hear you suggest. Well, actually, for various reasons, I have spent long periods of this past year sober – sometimes for months at a time. Unfairly, I have found, when I do step deliberately off the wagon, my hangxiety is deeper and more debilitating than ever.

Is it just age? Yes, partly – I am 45 and, while individual capabilities vary widely, it’s well documented that most of us lose the ability to metabolise alcohol as effectively as we get older. This is down to the depletion over time of antioxidants such as glutathione, which is crucial for the liver to carry out its detoxification tasks.

But – and yes, call me deluded if you like – I also suspected it might be more involved than simply my vital organs’ dwindling middle-aged capabilities to detoxify.

“Alcohol is still very mysterious. We actually don’t understand a lot about it and the way it works in the body relative to other drugs,” says Dr Carl Erik Fisher, author of The Urge: Our History of Addiction. “It’s a dirty drug – much dirtier than cocaine or heroin – and hits a ton of different receptors scattered throughout the brain, causing a lot of havoc. And,” he adds, “there have been relatively few studies done on hangovers.”

When we start drinking our anxiety decreases. When that wears off, however, anxiety level goes up just a little more than it went down with the drinks. Photo / 123RF

Undeterred, one recent Friday morning, deep in a jittery hangxiety hole of self-loathing, I decided to delve more deeply into what was going on in my head. A growing body of scientific research suggests that a large part of what happens in our fevered, anxious brains is actually happening in our bodies. Hangxiety, experts now agree, is a physiological condition rather than a psychological one.

One major player in this is gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter (or chemical messenger) of the central nervous system – the main neurotransmitter that lowers our inhibitions and helps us feel calm. When we drink, alcohol floods the brain with GABA. “And that’s why we like alcohol,” says Dr Ellen Vora, psychiatrist and author of The Anatomy of Anxiety: Understanding and Overcoming the Body’s Fear Response. “Because when we’re feeling wound-up, tense, nervous, anxious, insecure, we drink, we have a rush of GABA, and we feel suddenly at ease and relaxed and show confidence. But, unfortunately, the story doesn’t end there.”

Our brain doesn’t care about us feeling relaxed, she says; it cares about our survival. “It sees all this GABA and worries that should a real threat present itself – should a leopard come round the corner – we would be too buzzed to care and we could be in danger.”

So, the brain attempts to restore balance by converting the GABA to another, very different neurotransmitter: glutamate, one of our primary excitatory neurotransmitters. If GABA is the calming, soothing auntie of the neurotransmitter world, making you a cup of tea and some toast, glutamate is the rowdy, hectic one, screaming obscenities in your face at the bus stop. It’s surging glutamate that wakes you up at 4am with racing thoughts after a night out, and glutamate that stops you getting back to sleep as you toss and turn with a pounding heart, then feel anxious, edgy and irritable as you stand muttering in the shower and scramble to face the day.

Put simply, says Dr Tim Cantopher, psychiatrist and author of books on both alcohol and anxiety, “Alcohol is a drug, and it’s not a very good one, as it reverses its own effect – and increasingly so.”

When we start drinking, says Cantopher, our anxiety decreases (thanks, GABA) and we feel more confident. When that wears off, however, and the glutamate takes hold, “Your anxiety level goes up just a little more than it went down with the drinks. So, if you drink every or most days, you’re going to get this slow ratcheting-up effect. It’s like a saw tooth with a slightly upward gradient.”

In addition, the insulin rush that follows drinking (alcohol being a high-sugar hobby) is followed by a blood sugar crash, which not only further disrupts sleep but fuels stress. “The way the body is designed,” says Vora, “is that it responds to a blood sugar crash by releasing stress hormones such as cortisol and adrenaline. They help create some kind of urgency to forage for food, so we can restore blood sugar to normal levels. But as a side effect, we’re now in an all-out stress response.”

All this takes a sledgehammer to sleep quality (when/if you’ve made it to bed, that is), says Vora, and, “Sleep is its own independent factor in contributing to anxiety the next day, because if we’re not sleeping, none of our brain chemistry functions well.”

This, I tell Vora, is all hugely comforting to know. Sure, there’s still the nagging question of whether I tried to snog my (married) friend at the cab rank after the fifth negroni, and why I then also apparently tried to drunk-dial my ex when I got home, plus that empty pizza box on the table, but it’s helpful to know that while I might be sleeping on a metaphorical bed of nails today, I’m not actually going mad.

“Our brain will tell us a story about content, and it will make meaning of the sensation, but it’s really just trying to justify what is first and foremost a physical sensation,” she says. “So much of what we call mental health really has a basis in our physical body. We think about mental health from the neck up, that it’s just our thoughts and our cognition, but it really has a physical basis. And that’s incredibly helpful and empowering. So much easier than seven years of psychotherapy and repairing all of the stressors in our lives is keeping our physiology a little bit more stable.”

A particularly gnarly element of hangxiety, however, is the mystery. You may have no idea whether your fears about your inappropriate behaviour are even true. How could you know what actually went down when you can’t remember anything after the second bar?

This, say the experts (to my eternal relief), is also chemical.

“Glutamate helps us encode memories,” explains psychologist Andrea Bonior, author of Detox Your Thoughts and presenter of the new podcast Baggage Check. “So when glutamate function is artificially disrupted because of alcohol, that’s what makes things hazy.” By the sixth or seventh drink, the glutamate system is almost entirely blocked. In extreme circumstances, that’s what causes a “blackout”, those uncomfortable missing hours of a night where it feels like the tape recorder stopped working. “Memory disruption can add to our anxiety immensely,” says Bonior.

And if it feels like your hangxiety, like mine, has grown more acute over the past two and a half years of rolling turbulence – the pandemic, the cost-of-living crisis, war, fuel shortages and now the inability to sell your home or afford a mortgage – you are, unsurprisingly, correct.

“If people are starting with higher baseline anxiety when they drink, then there’s going to be a more marked reduction of anxiety by drinking, and a more noticeable difference the next day in terms of hangxiety,” says Bonior.

“Anxiety is the pH scale of the age we are in at the moment,” agrees Vora. “There are plenty of big existential fears, but fear also sells. We’re living in a cesspool of sources of physiological imbalance and our mental health is the collateral damage.”

I’m curious for Bonior’s professional opinion on whether my hangxiety has also truly, cruelly become more acute since I started experimenting with substantial periods of sobriety. It is, she says, most likely that my tolerance for alcohol itself has reduced “and alcohol can sort of take you for a ride and hit you over the head a little bit more”.

This dwindling tolerance is unfortunately lethal when combined with our diminished ability to process booze that comes with ageing. “The hangover might last longer or feel worse because it takes your body more time to rid itself of alcohol,” says Bonior. Many of us are also more prone to poor sleep as we age. “When all those things combine, it’s going to be more pronounced.”

Intersperse alcoholic drinks with soft drinks or water to help avoid hangxiety the next morning. Photo / Kelsey Knight, Unsplash

In a body blow for equality, Vora also reports “some evidence to support that women tolerate alcohol less well than men.

“And for women of reproductive age, where you are in your cycle is a consideration,” she continues. “We might be better able to tolerate alcohol in our follicular phase [pre-ovulation], when our hormones are flush, and less able to tolerate it in the luteal phase [the second half of the cycle as we get closer to bleeding], given that waning levels of progesterone towards the end of the cycle are already having an impact on sleep quality and mood. This effect seems to be exaggerated through the perimenopausal period,” she says, “so it stands to reason that a perimenopausal woman in her luteal phase might be especially prone to hangxiety.”

While we can point the finger at encroaching middle age and, for half of us, the accompanying joys of perimenopause, we should probably – heavy sigh – also address our own boozy middle-aged behaviours. I fear we may never have the satisfaction of telling today’s teenagers and twentysomethings to stop being so smug and just wait until this morning-after misery wallops them around the face too. It may well never actually happen to them, since they don’t build their social and recreational lives around drinking as my generation did from the minute we could get served illegally in the off-licence. (And now we buy our wine by the case from Waitrose, we middle-aged drinkers are more likely than any other age group to consume more than the recommended 14 units a week.)

Generation Sensible, by contrast, eschew the litres of Strongbow in the NCP car park I fondly recall from my own youthful Friday nights. According to a study by Drinkaware, 26 per cent of 16 to 24-year-olds are completely teetotal, compared with just 15 per cent of 55 to 74-year-olds. And in a 2022 British Journal of Sociology study targeting young people who did not drink, about 30 per cent of respondents said they enjoyed arts and crafts in place of boozing. Certainly, it is hard to imagine one would feel the same depth of regret the morning after running up a pair of curtains.

So, what can be done to swerve the horrors of hangxiety? The usual pre-game tactics apply: make sure you are well hydrated, eat something protein-rich before going out and also before going to bed. Intersperse alcoholic drinks with soft drinks or water.

But the context and company in which you face down your hangxiety also matters, says Bonior. “When you’re using alcohol to lubricate connectedness and you’re dancing and talking and hugging, and then you wake up alone, it’s such a stark contrast, and there’s much more room for self-doubt to creep in.”

This chimes with me. After more than two decades of dealing with my booze-induced self-loathing, there’s only one strategy I know to ward it off effectively: being around other people. Alone, with only Netflix and Wotsits for hangover company, I can easily spiral into a dark headspace. In the company of friends, however, the gentle social buffer acts as a soothing, metaphorical hair-stroke, often until the worst of the psychological storm has passed.

“Being around people that we trust and processing our experiences helps lower our anxiety and our stress response,” says Bonior. “So when we don’t have that the next morning, and we aren’t able to be reassured, there’s just more room to worry about what we did.

“There are many ways in which modern adult life cuts us off from that sense of community,” she notes.

While much of what I gleaned from the experts about the causes of hangxiety was comforting, none of them seemed to be able to tell me how long it generally lasts and, when you’re in full-blown hair-shirt misery, when you can expect it to pass. It depends on myriad factors, they say, including how anxious you were to start with, what you drank, when you drank and whether or not you’re a regular drinker.

Dr Tim Cantopher will say, however, that after prolonged drinking, “It takes up to six weeks off the booze for your anxiety level gradually to go down to the level that it was before you ever started. It’s a sort of withdrawal.” Six weeks is a very long time to spend hating yourself.

‘I cringe at my hangxiety memories’

By Michael Odell

Once upon a time I used to interview a lot of musicians, hang out with a lot of aspiring bands. Due to the effects of alcohol, more than once I found myself in a dingy basement or the backroom of a pub, having convinced myself that I was watching the Next Big Thing.

Two drinks in and I was down the front playing air guitar. Four, I was back-stage forcing my way into the dressing room. Six, I was announcing myself as the only manager who could steer them to the big time.

Of course the next morning, the “hangxiety” would always kick in. Did I really offer them the use of my camper van for an inaugural UK tour I had suggested?

I am a freelance writer. That means spending a lot of time alone. And that means when I do go out, heightened cabin fever means that certain personality traits can become amplified. The first symptom is usually that I think I can see the future of rock’n’roll, comedy or, if tequila is involved, just the future.

Most dangerously of all, where investment is required, I have been known to display the chutzpah to put my money, or at least a significant portion of the family food budget, where my mouth is.

I once met a guy at a party who told me he was developing a battery-powered pogo stick. Before the night was over, I announced I would help bring his personal mobility contraption to market where it would favourably compete with electric scooters and cars. It was only in the cold light of the next morning’s hangxiety that I stopped to imagine parents trying to hold hands with their little children as they pogo-sticked along the street on the school run. Or tried bouncing down a street laden with shopping bags.

My condition goes back a long way. When I was at uni me and Harriet Peel were voted joint presidents of French Soc and we organised a weekly French Lunch where students were invited to drink wine and gnaw on baguette while practising the language. Week one: no one came. Week two: the same. Week three: the night before the lunch I drank half the allotted wine and plastered the French department lift in posters reading, “Do you like oral?” “I’ve got a big French stick going to waste,” and, “Come and have a roll with the president.” I cringe at the memory of Harriet knocking on my door the next morning telling me Women’s Soc had taken down all the posters and the faculty head wanted to see me.

That was the Eighties, though. Back then, even the worst hangxiety eventually faded. But social media and smartphone cameras mean indiscretions are now there for ever. Like marking the inauguration of President Trump with a “hilarious” drunken “Where is Lee Harvey Oswald when we need him?” on Twitter.

There are deeper circles of hell too. Critical failures of physical coordination brought on by booze mean days of hangxiety. I’m talking about falling over and dragging down a host’s curtains as one goes. All these things must be replayed at Cringe Factor 10 in the exquisite paroxysm of self-torture that is hangxiety.

But I am very glad to report my days of hangxiety ended earlier this year when the hangover pill Myrkl came onto the market. I promise I am not a salesman and I’m sure they are not for everyone. But for me, they are dignity in pill form. I slip two down and they stop me getting preposterously drunk. All those dares, accidents and investments stop happening. Or at least, they stop happening to me. I now stand back safely and watch some other maniac at the pub gig.

“Did that guy just stage-dive into the disabled area?” I’ll remark. " He’s going to feel such a knob in the morning.”

‘I’m 44 and disappointed in myself’

By Dan Rookwood

I can feel the hangxiety kicking in before I’ve fully come to. The discomforting black dog of existential dread wakes me in a hazy daze of pre-dawn confusion. Where am I? A hotel room. Ah yes, I’m in Manchester on a work trip and we had a few drinks last night. Then shots were fired, most of which I dodged. Still, it was heavy one for a lightweight like me.

I jab at my phone and crack open an eyelid. It’s just gone 5am, which means I stumbled in five hours ago – five hours of pitifully fitful sleep. Could have done without that nightcap.

There’s a goodnight text from my wife that ends “and don’t drink too much”.

The water bottle next to me is empty. I want to refill it but weigh the risk of not being able to drift back off if I get out of bed. And so I lie there listlessly, wrestling with the strange combination of sluggish brain and racing mind, my head pinballing with negative mental chatter I can’t quieten. Chastising and catastrophising, replaying regrets, adding up what I drank, vowing never to drink again.

The relentless self-admonishment continues as I hang my head under the shower. It’s not helping. FFS, I didn’t even drink that much.

Pathetic. I’m 44 years old and very disappointed in myself. Where’s the paracetamol? Google Maps shows a Tesco Metro 250 metres away. I think I can make it. I’m first through the doors when it opens at 7am and do a supermarket sweep of all known hangover remedies. The self-checkout alerts a member of store staff to approve/judge my purchases.

I am not proud of this dawn raid. Alka-Seltzer Plus, one litre of water, full-fat Coke, packet of Monster Munch – a nutritionally balanced breakfast of champions right there. “Rough night?” I sense the cashier’s knowing smirk, but studiously avoid bloodshot eye contact.

I spent my thirties living in the States where the after-work drink culture doesn’t exist in the same way it does here. Maybe it’s because many of my friends now also have kids, maybe it’s that Gen Z has decreed that alcohol is now deeply uncool, but since returning to the UK last year, I’ve noticed it’s now more socially acceptable to choose not to drink.

Nights like last night are a rarity for me because of days like today. The low of the morning after easily outweighs the high of the night before, so it doesn’t feel worth it to go out out any more. It’s not so much the thumping head that gets me down, it’s the fear and self-loathing – an insidious sense of disquiet that lingers and closes in like a foreboding fog.

My hangxiety has become so debilitating, I’ve been recently rethinking my approach to drinking. The post-booze blues can last all day and sometimes hang over into the next one. Even a couple of glasses of wine with dinner can throw the next day into disarray. And I don’t like the version of me that gets grumpy with my wife and snappy with my children.

Alcohol inhibits restorative sleep and impairs cognitive function. The boozy wooziness intensifies the malaise. Since having kids, I’ve realised how clearly sleep dictates my mood swingometer – how much better I can cope with life after a good sleep and how much I struggle when deprived of it. When my productivity plummets it only exacerbates the spiralling, self-flagellating sense of exasperation. I feel weighed down by a heavy, gnawing ache of overwhelm.

Yep, today is a total write-off. Not even the science-backed remedy of pickled onion crisps and a “red ambulance” Coke with two paracetamols can alleviate my acute middle-aged angst. So that’s it, I’m never drinking again… Until the next time.

Written by: Jane Mulkerrins

© The Times of London