5 Hangover Symptoms You Didn’t Know About

If you’ve ever experienced a wicked hangover, you’re certainly not alone. No doubt, the first hangover occurred soon after prehistoric humans discovered the delightful nectar of the vine. Indeed, hangovers are so dreadful, humans have been seeking miracle cures going back to ancient Assyria, when those who imbibed excessively were given a mixture of ground birds' beaks and myrrh to alleviate the after effects. In Medieval times, European doctors recommended raw eel and bitter almonds, which sounds like it would exacerbate the bouts of nausea often accompanying a hangover, tenfold.1 Fast forward to 18th-century England.2 “My first return of sense or recollection was upon waking in a strange, dismal-looking room, my head aching horridly, pains of a violent nature in every limb, and deadly sickness at the stomach. From the latter I was in some degree relieved by a very copious vomiting. Getting out of bed, I looked out of the only window in the room, but saw nothing but the backs of old houses, from which various miserable emblems of poverty were displayed . . . . At that moment I do not believe in the world there existed a more wretched creature than myself. I passed some moments in a state little short of despair . . . .” —William Hickey, 1768

The above description could have been written by countless college students over the last 250 years, albeit with a bit more flourish. Indeed, Hickey’s description fits the stereotypical symptoms of a hangover to a T. The pounding headache, aches and pains, vomiting and feeling wretched are what most people associate with a hangover, but lesser-known symptoms can occur, most notably:

  1. Depression
  2. Anxiety
  3. Irritability
  4. Fatigue
  5. Cognitive impairment

A study involving 1,410 Dutch students reported the presence and severity of 49 potential hangover symptoms. A factor analysis revealed “drowsiness” (e.g. fatigue, sleepiness and weakness) and “cognitive functioning” (reduced alertness, memory and concentration problems) were the most important factors describing the alcohol hangover.3

Depression and Alcoholism

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’s not uncommon for individuals to use alcohol to self-medicate when they are feeling anxious or sad, which typically makes these symptoms worse.4

An unequivocally 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, depressive symptoms are common in alcohol use disorder, with 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

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’s 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. Some people experience uncharacteristic sadness and or anxiety the morning after heavy drinking. The emotional aspects of a hangover can include depression symptoms such as sadness, crying, lethargy, fatigue, anxiety, feeling like a failure and fears about the future.6

Hangover Research

Modern science affords us insights not available to our drunken ancestors. Many studies have examined contributing factors in the hangover equation such as age, blood-alcohol concentration and other variables. Among the unanswered questions is how the same person can drink a specific type and amount of liquor and experience a hangover, then drink the near identical amount and type of liquor a few weeks later and be immune to its repercussions. 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

Dutch researchers analyzed 36 social drinkers and symptoms on hangover days (alcohol consumed) and a control day (no alcohol consumed). Data on alcohol consumption, demographics, sleep, next-day adverse effects and mood were compared in drinkers with a hangover and drinkers who claimed to be hangover immune. The day after alcohol consumption, the hangover group scored significantly higher on the subscales of depression, anger-hostility, and fatigue and significantly lower on vigor-activity. In contrast, the hangover-immune group only scored significantly higher on the fatigue scale and significantly lower on the vigor-activity scale. No significant effects were seen in either group on the tension-anxiety scale. Moreover, classic hangover symptoms such as headache, nausea and weakness were not reported by drinkers who claimed to be hangover immune.3

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 have shown effective protection against alcohol-induced injuries and significant alleviation of hangover symptoms. Among these were extracts from the roots of Salvia miltiorrhiza, an ancient herb, Scutellariae Radix, the root of Scutellaria baicalensis, a Chinese herb widely used for the treatment of liver disease and cancer, and berberine, 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 blood-alcohol levels were reduced, hangover symptoms scores decreased and the biochemical marks of liver injury were restored. The mechanisms of action were found to be primarily antioxidative and anti-inflammatory.7

It is wise to limit your alcohol intake, not only because of the risk of a hangover, but also due to its potential for abuse and addiction, fatal accidents, liver and heart disease and other mental and physical repercussions. And if you suffer from depression or any other psychiatric disorders, alcohol should be avoided altogether due to the potentially serious implications and repercussions.

  1. Suddath C. A Brief History of Hangovers. Time. January 1, 2009. http://time.com/3958046/history-of-hangovers/ accessed May 25, 2017.
  2. Swift 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
  3. Hogewoning 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.
  4. Anxiety and Depression: The Hangover Symptoms You Didn’t 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.
  5. Neupane SP. Neuroimmune Interface in the Comorbidity between Alcohol Use Disorder and Major Depression. Front Immun. 2016;7:655. doi:10.3389/fimmu.2016.00655.
  6. Emotional 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.
  7. Wang 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.
  8. Van 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.
Posted on June 14th, 2017
Posted in Articles, News

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