Experts explain hangovers that last more than a day – 05/08/2023 – Equilibrium

The margaritas you drank on Friday night have you lying in bed all Saturday. On Sunday, you wake up and you’re still dry and shaky. His head didn’t stop throbbing.

Would you be suffering a two-day hangover?

To metabolize alcohol, the body breaks it down into acetaldehyde, a chemical compound. A hangover — the racing heart, the acidic stomach — can be a by-product of this process. For the vast majority of people, in the vast majority of cases, hangovers follow a predictable pattern: They make you feel weak and tired for about 24 hours, and then they disappear. But in some cases, the symptoms may last longer.

The more alcohol a person drinks, of course, the more likely the hangover will last. However, some people are predisposed to hangovers that last longer than a day, even when they drink a relatively moderate amount, said Emmert Roberts, a Stanford University psychiatrist who studies hangovers.

Scientists aren’t sure why this happens, but they’re working to figure it out. “There has been a dearth of research on hangovers in general,” said Dr Roberts. “It’s kind of slightly uncharted territory.” Here’s what the experts know:

Who has a two-day hangover?

After a big night of drinking, those most likely to experience the side effects for several days paradoxically fall into two groups: people who drink heavily quite often and people who rarely do.

If you regularly consume large amounts of alcohol, you may be familiar with the agony that sets in as your body struggles to process all that booze. This is particularly true if you drink too much, which the Centers for Disease Control and Prevention (CDC) defines as a woman having at least four drinks on one occasion or a man having at least five.

But in some cases, what you think of as a hangover can actually be the beginning of severe alcohol withdrawal, said Lara Ray, a professor of clinical psychology at the University of California, Los Angeles, who researches alcohol use disorder. .

Hangover and alcohol withdrawal symptoms can overlap, and it’s important to know the difference, said Anthony T. March, an addiction medicine specialist at Central DuPage Hospital at Northwestern Medicine. If you persistently vomit and cannot keep fluid down, have frequent diarrhea, experience confusion or even mild hallucinations, or if your skin is turning blue, you may have a severe form of alcohol withdrawal and should go to the emergency room as soon as possible. as soon as possible.

On the other hand, if you don’t drink very often but binge one night, one hypothesis as to why you might have a longer hangover is that your liver may not be conditioned to produce acetaldehyde, Dr. Ray said. This means your hangover symptoms may persist, she explained.

Age can also be a factor: An older person’s liver can take longer to metabolize alcohol, Ray said. Additionally, she stated that medications such as SSRIs (selective serotonin reuptake inhibitors, including Zoloft) can interact with alcohol, potentially leading to longer-lasting hangover symptoms.

As for people suffering two-day hangovers even after moderate drinking, researchers have a few theories. Some people may be genetically predisposed to more severe hangovers, Dr. Roberts said; they may have an unusually strong reaction to the way alcohol raises blood sugar, which can lead to worse, lingering headaches, or their immune system may struggle to defend itself from the toll alcohol takes, which can exacerbate and prolong the general feeling of being unwell.

Other biological factors may also contribute. “Some people are very sensitive to beer because of the yeast; others are sensitive to different wines because of the sulfites,” Dr. March said. “It’s highly personal and difficult to predict.”

And because “hangover” is such a broad condition (researchers identified as many as 47 symptoms), something that looks like an alcohol-induced illness could be another problem.

People may think they’re having a long hangover when, in fact, their symptoms stem from stress or an underlying condition, Dr. Roberts said.

How to avoid the pain

The obvious guideline is to drink in moderation, as the more drunk you get, the worse your hangover is likely to be and the longer it can last. And conventional wisdom about how to avoid a hangover — drinking a glass of water between alcoholic drinks, eating too soon — can help prevent one in the first place.

The type of drink you drink also matters: tequila, whiskey and darker spirits contain compounds called congeners, which are more likely to cause longer-lasting hangovers because of the way they’re metabolized, Dr. Roberts said.

If you experience multi-day hangovers from heavy drinking, it could be a sign of problematic drinking. Dr Ray recommends a guide from the National Institute on Alcohol Abuse and Alcoholism, “Rethinking Drinking” [Repensando a bebida]which can help you assess whether drinking has become a problem.

“I think you have to step back and think, ‘If I’m deleting two, three, four times a month, I’m really stressing out my system,'” March said. “‘I’m hurting myself beyond any hangover feeling.'”

Translated by Luiz Roberto M. Gonçalves