How to treat a hangover and what you should do to if you wake up with one
This Christmas means more parties, more social engagements and more eating and drinking.
Christmas is weeks away and many of us are already feeling festive. It’s been three years since we last celebrated with our family and friends, and we’re making up for lost time. We’re scheduling drinks with old friends, get-togethers with neighbours, and office parties and family dos on the days between.
But some of us take the spirit of Christmas too literally and increase our consumption of alcohol to the point where we are worse for wear the next day.
If you want to avoid that fate this Christmas, here’s everything you need to know about hangovers, from what causes them to minimising the risk of getting one and what to do if you wake up suffering the after- effects of having had one too many.
There’s an expectation that there will be a pent-up desire to party this Christmas. “We’ve just come through a crisis, and after a crisis, the tendency for many is to release, seek pleasure and adopt a ‘life is short’ mentality,” says counselling psychologist Niamh Delmar. “This can lead to overindulgence. This Christmas, with society back open, this means more parties, more social engagements and more eating and drinking.”
Drinking alcohol will inevitably be part of these celebrations for most. Alcohol helps us to relax and get in a party mood, at least initially. “It’s a very seductive drug,” says Shelia Hawkins, a consultant psychologist at One Step Clinic, an addiction treatment service in Dublin. “It starts by acting as a relaxant, giving you that buzzy feeling.”
A 2012 study by the University of California, found that endorphins are released in areas of the brain that produce feelings of pleasure and reward when we drink alcohol.
“All of this happens in the first 10 minutes,” says Delmar. “Alcohol hits our brains and makes us more relaxed, sociable, and euphoric. Endorphins and dopamine induce that characteristic feel-good effect. One drink often leads to another as we chase that initial buzz.”
This isn’t the only reason we find it difficult to moderate our alcohol intake. “Alcohol lowers our inhibitions and decision-making capabilities,” says Horgan. “So, a person may continue to drink even if they had planned on having just one or two.”
Hangxiety and other issues
Drinking at home can exacerbate the problem further. “People can be heavy-handed with their measures when drinking at home,” says Horgan. “They can drink for as long as they like, and it’s cheaper than drinking in a bar or restaurant. All of these factors mean that it’s easier to consume more than intended.”
What often happens next is that we wake up with a splitting headache, an upset stomach and crippling anxiety, a combination of symptoms commonly known as a hangover.
Dr Garrett McGovern, medical director of the Priority Medical Clinic in Dublin, says that multiple factors cause hangovers. “Dehydration is the result of alcohol being a diuretic,” he says. “It’s what causes the headache. Gastrointestinal irritation comes from acetaldehyde accumulation, a by-product of alcohol metabolism. There’s also inflammation and early withdrawal as alcohol leaves our system. And different alcoholic beverages contain additives that can add to these hangover effects.”
Hangxiety is another common symptom and one of the most debilitating. It’s the sense of fear that overwhelms after a night on the tiles.
“A hangover works much the same way as psychological stress,” says Hawkins. “Levels of the stress hormone cortisol rise, as does blood pressure and heart rate. Research also suggests that dopamine levels are reduced. And it also plays a role in depression and anxiety.”
Delmar adds that two neurotransmitters are involved too. The balance between gamma-aminobutyric acid (GABA) and glutamate helps to regulate our nervous system, ensuring it reacts appropriately.
“Alcohol attacks the body’s GABA receptors and after a few drinks, glutamate is blocked,” says Delmar. “When you stop drinking, GABA levels remain low and glutamate begins to spike, which triggers anxiety. A decrease in GABA in the brain can also worsen pre-existing mental health conditions, which means that people who already suffer from depression and anxiety are more at risk for hangxiety.”
Is there a miracle hangover cure?
A new pill developed by a Swedish firm claims to banish hangovers altogether. Myrkl (pronounced miracle) is promoted as an anti- hangover supplement. Manufacturers say the active ingredients — amino acid 1-cystine, two strains of probiotic bacteria and vitamin B12 — metabolise most of the alcohol before it reaches the bloodstream and liver, cancelling our hangover.
A 2022 study published in Nutrition and Metabolic Insights Journal appears to back up these claims. It found that test subjects who took Myrkl had 70% less alcohol in their blood an hour after two vodkas than those who took a placebo.
However, there are some caveats before we pop these pills and start slamming shots.
There were only 24 people in the study. They took the pills every day for a week and abstained from alcohol during that time. And they only drank a small amount of alcohol. Two vodkas are hardly hangover-inducing.
Dr McGovern remains to be convinced about Myrkl. “I’d be sceptical of any supplement that purports to mend hangovers,” he says.
Avoid morning-after misery
If you’re planning on kicking back with a tipple or two this Christmas, you can take steps to avoid morning-after misery. The first of these is avoiding binge drinking.
Binge drinking is the consumption of six or more standard drinks in one sitting. A standard drink could be a 100ml glass of wine, half a pint of beer, or a pub measure of spirits.
According to the Healthy Ireland Survey 2022, 32% of us regularly drink more than this on any one occasion.
“The HSE recommends that women limit their alcohol intake to 11 standard drinks a week and men to 17,” says Horgan.
“Its guidelines also state that we should have at least two alcohol-free days weekly to protect our health and wellbeing.”
Horgan suggests using a measure when drinking at home to achieve this more moderate intake. “It allows you to track how many drinks you’re having,” she says.
Try to have food with your drinks. “It helps to slow down how much you drink and how quickly the alcohol is absorbed into your body,” says Horgan.
“Don’t top up your drinks either,” says Horgan. “It makes it harder to keep track of how much you’re drinking. Finish each drink before you decide if you’d like another.”
Alternate your drinks with water or non-alcoholic beverages. “This is a good way to slow the pace of drinking and keep your body hydrated in the process,” says Horgan.
Horgan’s main advice when drinking in the pub is to stay out of rounds. “So many people end up drinking more than they intended when they buy rounds of drinks,” she says. “This is because the person who drinks the fastest sets the pace for everyone in the group. If you end up in rounds, try to alternate alcoholic drinks with non-alcoholic
alternatives.”
If you still wake up with a hangover after all your best efforts, dietitian Sarah Keogh has some tips for recovery. “Hydration is the main thing,” she says.
“If you can or if you remember, drink some water when you get home before you go to bed. Otherwise, start rehydrating in the morning with water or some Dioralyte to speed up the process. It contains water with a little bit of sugar and salt and helps you to rehydrate faster. Keep sipping throughout the day.”
Alcohol irritates the lining of the stomach, which can lead to vomiting the next day. “If it’s gone that far, you’ve really overdone it, and you may just have to wait it out,” says Keogh.
“But soft carbohydrates like mashed potato and dry toast can be soothing if you can tolerate some food. Keep it dry, as your body won’t be able to handle too much fat just yet.
“Some recommend ginger, chamomile, or even vitamins B and C, but they can irritate the stomach further. The best thing is a little food if you can take it.”
You’ll probably feel exhausted too. “Alcohol makes it harder for the body to maintain good blood glucose levels, and it messes with our sleep, so it hits our energy levels on two fronts,” says Keogh. “Go back to sleep if you can. If you can’t, some caffeine might pick you up.”
Other than that, it’s mostly a waiting game. “Your liver needs time to sort itself out, and your stomach needs time to heal,” says Keogh.
Let’s raise a glass to a merry — but not too merry — Christmas this year.
Alcohol-free alternatives
Christmas is coming, and some of us are deciding that this will be the year our festive celebrations won’t result in a hangover. We’ll drink moderately, and we’ll consume plenty of water. And we may even explore the growing range of non- alcohol drinks available in pubs and supermarkets.
However, while consuming these drinks may save us from sore heads the morning after, the jury is out on whether they all are healthy.
Many contain as least as many additives as their alcoholic counterparts and in many cases, removing the alcohol removes a lot of the drink’s taste and texture. Replacing this often requires adding sugar.
That’s why a 330ml bottle of Heineken 0.0 contains 4.3grams of sugar while regular-strength Heineken contains no sugar at all. It isn’t the only non-alcoholic beer that’s high in sugar. A 330ml bottle of Peroni larger has no sugar, while its non-alcoholic alternative Peroni Libera has 10grams.
According to GP Garrett McGovern, other drinks use sweeteners, which can have a negative impact on gut health. And because alcohol acts as a preservative, drinks that don’t contain it need to be preserved in other ways, which may include the use of artificial chemicals.
So, by swapping your alcoholic beverage for its non-alcoholic equivalent, you may simply be replacing one health concern for another.
The key, says McGovern, is to read the label. “While non-alcoholic alternatives are likely to contain as many additives as their alcoholic counterparts, I am a big fan of these drinks. They offer people a healthier option while simulating the feeling of having a drink.
Avoid anything that contains more than 11.25 grams of sugar per 100ml, and be wary of products that include multiple artificial flavourings and sweeteners.”
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