Why You Feel Hungover After An Anxiety Or Panic Attack

An anxiety or panic attack can leave you totally drained – here's how to manage that.

If you deal with anxiety, you may be familiar with the draining sensation that comes after an anxiety or panic attack. There’s the brain fog and the sluggishness. It can feel harder to focus, you may be less alert and your body might ache.

During an anxiety or panic attack, the body experiences a range of chemical changes and starts pumping out adrenaline. Your heart rate quickens and your breathing becomes shallow. Then, when the attack passes and you come down from the intense response produced by the nervous system, a new set of symptoms appear and the anxiety attack “hangover” sets in, leaving people feeling mentally and physically depleted.

“The overwhelm takes a lot of energy and it revs us up in a way, so, naturally, we’re going to feel very tired and very fatigued after it,” Jessica Stern, a clinical assistant professor in the department of psychiatry at NYU Langone Health, tells HuffPost.

What causes these after effects?

It’s important to know that panic attacks and anxiety attacks, though often used interchangeably, are two different things.

A panic attack is a physiological reaction in which the body’s fight-or-flight response is activated to help a person prepare for something dangerous. People often say a panic attack feels like they’re having a heart attack or dying – it can trigger intense anxiety along with a mix of physical symptoms, including a fast heartbeat, sweating, trembling and shortness of breath.

Anxiety attacks, on the other hand, typically occur when people no longer feel in control of their anxiety. “The anxiety sort of crosses a threshold where it’s no longer comfortable or manageable for someone,” says David Klemanski, a Yale Medicine psychologist and assistant professor of psychiatry at Yale School of Medicine.

During both types of attacks, adrenaline pumps throughout the body. When you come down from that surge in adrenaline, you may feel zapped because you just went through an intense emotional experience and, in certain cases, a taxing physical reaction as well.

When you come down from that, there’s going to be a lot of consequences. Your body is actually going to feel physically fatigued because you went through a pretty big event,” Klemanski says.

After an attack, people often feel out of it and exhausted. And if you hyperventilated, you may even feel sore – particularly within the chest muscles. Some may experience nausea, gastrointestinal issues, headaches and migraines along with flare-ups of symptoms associated with chronic conditions they have, according to Stern.

Klemanski says the after effects that come with a panic attack are likely to be more intense than those that follow an anxiety attack. And, depending on the person, the after effects can last for a couple of hours, or a full day or two.

Anxiety or panic attacks can lead to real physical depletion, like brain fog, sluggishness and body aches.
Vladimir Vladimirov via Getty Images
Anxiety or panic attacks can lead to real physical depletion, like brain fog, sluggishness and body aches.

How to cope with an anxiety or panic attack ‘hangover’

If you regularly experience anxiety attacks or panic attacks, Stern recommends learning about what you need during and after the attack, so you can have a plan in place. Klemanski said treatment methods like cognitive behavioural theory can help you learn how to manage the anxiety and panic when it sets in, so you won’t have to deal with such severe “hangover” symptoms afterward.

But if the attack already came and went, and you’re feeling pretty out of it, there are a few ways to mitigate the symptoms.

The first step is to pause and take a breather to slow down your system. “Make your environment, if you can, feel comfortable around you,” Stern says. Turn the lights off, put some calming music on – do what you need to calm down and feel grounded.

Klemanski recommends practicing mindfulness. Bring yourself to the present moment and acknowledge whatever it is that you’re feeling physically and emotionally. Engaging in some deep breathing techniques – like diaphragmatic breathing, box breathing or rhythmic breathing – to regulate your body can also help with this.

Practise all the traditionally healthy behaviours – like making sure you’re getting enough sleep and proper nutrition – and find someone to process your emotions with, whether it be a close friend or mental health professional.

Stern said it’s crucial to reach out to someone who will be grounding and calming, not someone who will rev you up even more. Stern also suggested finding a way to move when you can – whether that means going for a walk or doing some gentle stretches.

Be patient with yourself. It will take some time for the afte reffects to subside. “Realise that, hey, the worst of it’s over and as long as I try my best and am compassionate with myself, I can get through this with time,” Klemanski says.

Help and support:

  • Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
  • Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).
  • CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.
  • The Mix is a free support service for people under 25. Call 0808 808 4994 or email help@themix.org.uk
  • Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.