When you think about the mental after-effects of alcohol, most likely you think of drowsiness, headaches and a general sense of regret. In other words, you think of a hangover. If you\u2019ve ever experienced a wicked hangover, you\u2019re not alone. No doubt, the first hangover occurred soon after prehistoric humans discovered the delightful nectar of the vine. \u00a0 Indeed, hangovers are so dreadful that humans have been seeking miracle cures going back to ancient Assyria. There those who imbibed excessively took a mixture of ground birds' beaks and myrrh to ease the after effects. In Medieval times, European doctors recommended raw eel and bitter almonds. To most modern readers, that probably sounds like it would exacerbate the nausea of a hangover tenfold.1 The Mental Effects of Alcohol Go Beyond a Hangover The pounding headache, aches and pains, vomiting and general wretched feeling are what most people associate with a hangover. However, lesser-known mental effects of alcohol are gaining more attention: \tDepression \tAnxiety \tIrritability \tFatigue \tCognitive impairment A study involving 1,410 Dutch students reported the presence and severity of 49 potential hangover symptoms. Not surprisingly, a factor analysis revealed \u201cdrowsiness\u201d (e.g. fatigue, sleepiness and weakness) and \u201ccognitive functioning\u201d (reduced alertness, memory and concentration problems) were the most important factors describing the alcohol hangover.3 However, there were others. Depression and Alcoholism Most of the research regarding depression and alcoholism has not centered on one night binges. Drinking an excessive amount of alcohol can cause an imbalance of chemicals and nutrients in the body, which can lead to depression and anxiety. These symptoms can be especially severe if someone is already predisposed to these emotions. Alcohol suppresses the central nervous system, so it not only imparts its depressive effects physiologically, but can also have an emotional after effect. It\u2019s not uncommon for individuals to use alcohol to self-medicate when they are feeling anxious or sad, which typically makes these symptoms worse.4 A high comorbidity exists between full blown alcohol use disorder and major depression. About 30% of individuals with major depression report lifetime alcohol use disorder. Conversely, more than one-third of people being treated for alcoholism meeting the diagnostic criteria for major depression at some point during their drinking life. Although drinking to the point of developing a hangover does not equate to addiction, the clear connection between depression and alcohol is reason for concern.5 Moreover, mixing alcohol with antidepressants can make depression worse and increase the side effects of some drugs, such as drowsiness, dizziness and coordination problems.4 This may be reason for those with depression or other mental illnesses to be wary of any excessive drinking. Binge Drinking Hangover If you experience a hangover and find it difficult to remember many details of the night before, you were most likely binge drinking. Drinking excessively throws off the body\u2019s natural rhythm as it is forced to cope with sudden intoxication, resulting in hangover symptoms. Alcohol temporarily inhibits cognitive and motor function, although these functions typically normalize after you are completely sober. Abnormally low blood sugar levels the next morning coupled with excessive urination (and resulting dehydration) can significantly impact mood. You may experience uncharacteristic sadness and or anxiety the morning after heavy drinking. The emotional aspects of a hangover can include depression-like symptoms, such as:6 \tSadness \tCrying \tLethargy \tFatigue \tAnxiety \tFeeling like a failure \tFears about the future Cleary, this mental effect of alcohol is not helpful to those already struggling with depression or other mental illness. Why Similar Drinking Patterns Result in Different Hangovers and Mental Effects Modern science affords us insights not available to our drunken ancestors. Many studies have examined what exacerbates hangovers, such as age, blood-alcohol concentration and other variables. One important question has remained unanswered: How can the same person can drink a specific type and amount of liquor and experience a hangover, then drink the same amount and type of liquor a few weeks later with no after-effects? In a very scientific and unsatisfying answer, symptoms of a hangover seem to be the combined result of dehydration, hormonal alterations, dysregulated cytokine pathways and the toxic effects of alcohol and acetaldehyde.7 In other words, it's complicated. Recently, researchers have pointed to ethanol in the urine as significant to understanding the mental after-effects of alcohol. A recent study was conducted on healthy social drinkers, aged 18 to 30 who consumed a minimum of five alcoholic beverages, at least three times per month. The analysis of ethanol concentration and alcohol hangover severity uncovered a clear significant relationship between urine ethanol concentration and hangover symptoms. This association was not present in hangover-free participants. Total alcohol consumed and estimated peak-blood alcohol level did not differ significantly between the hangover group and the hangover-immune group. Administration of ethanol causes the production of acetaldehyde as an intermediate metabolite. Some studies have suggested acetaldehyde levels may influence the presence and severity of hangovers. Rapid elimination of alcohol and its metabolites could explain why some people claim to be hangover immune, despite consuming the same amount of alcohol as slow metabolizers.8 Natural Hangover Remedies Thousands of years after the ancient Assyrians were looking for a miracle hangover cure, scientists are still striving to find the elusive elixir to alleviate, or at the very least, shorten the duration of symptoms. In several animal model studies and limited human tests, a few natural products appear to be useful when dealing with a hangover. Four herbs in particular were found useful: \tThe roots of Salvia miltiorrhiza \tScutellariae Radix \tThe root of Scutellaria baicalensis (a Chinese herb widely used for the treatment of liver disease and cancer) \tBerberine, derived from Rhizoma coptidis, which has the potential to modulate several neurotransmitter systems, especially in alcohol use disorder. Results of these natural plant studies showed reduced blood-alcohol levels, decreased hangover symptoms and restored biochemical marks in the liver. It appears these particular herbs have helpful antioxidative and anti-inflammatory properties.7 A Hangover Is Just the Tip of the Iceberg At the end of the day, it is wise to limit your alcohol intake. It is not only because of the risk of a hangover, but also due to its potential for abuse and addiction, fatal accidents and liver and heart disease. However, for certain vulnerable populations, the depression-like mental after-effects of alcohol could be devastating. If you suffer from depression or any other psychiatric disorder, avoid alcohol altogether. Don't risk the scary mental effects of even a single night of over-drinking. Sources: \tSuddath C. A Brief History of Hangovers. Time. January 1, 2009. http:\/\/time.com\/3958046\/history-of-hangovers\/ accessed May 25, 2017. \tSwift R1, Davidson D. Alcohol hangover: mechanisms and mediators. National Institute on Alcohol Abuse and Alcoholism. Alcohol Health Res World. 1998;22(1):54-60. doi: https:\/\/pubs.niaaa.nih.gov\/publications\/arh22-1\/54-60.pdf \tHogewoning A, Van de Loo A, Mackus M, et al. Characteristics of social drinkers with and without a hangover after heavy alcohol consumption. Subst Abuse Rehabil. 2016;7:161-167. doi:10.2147\/SAR.S119361. \tAnxiety and Depression: The Hangover Symptoms You Didn\u2019t Realize You Had. Her Campus website. http:\/\/www.hercampus.com\/health\/physical-health\/anxiety-and-depression-hangover-symptoms-you-didn-t-realize-you-had Published May 16 2014. Accessed May 25, 2017. \tNeupane SP. Neuroimmune Interface in the Comorbidity between Alcohol Use Disorder and Major Depression. Front Immun. 2016;7:655. doi:10.3389\/fimmu.2016.00655. \tEmotional Hangovers: Understanding the Feelings of Depression that Sometimes Follow a Night of Heavy Drinking. Heal Dove website. https:\/\/healdove.com\/mental-health\/Emotional-Hangovers-Understanding-the-Feelings-of-Depression-that-Sometimes-Follow-a-Night-of-Heavy-Drinking Updated on August 9, 2016. Accessed May 25, 2017. \tWang F, Li Y, Zhang YJ, Zhou Y, Li 5, Li HB. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder. Molecules. 2016 Jan 7;21(1):64. doi: 10.3390\/molecules21010064. \tVan de Loo A, Mackus M, Korte-Bouws G, Brookhuis K, Garssen J, Verster J. Urine ethanol concentration and alcohol hangover severity. Psychopharmacology (Berl). 2017;234(1):73-77. doi:10.1007\/s00213-016-4437-0.