Nothing ruins your day quite like a bad hangover. Although many people associate hangovers with a pounding headache, aching limbs and an upset stomach, excessive alcohol consumption can have a range of cognitive effects, too. While most of these are transitory in nature, continued alcohol consumption can be damaging.

#1 Increased anxiety

First and foremost, hangovers can play havoc with your levels of anxiety. Most people are familiar with the classic feeling of “hangxiety” and the sensation that they’ve embarrassed themselves the night before. Sometimes considered an urban myth, there are genuine physiological reasons for this feeling. Alcohol alters how much serotonin we have in our bloodstream, which can trigger feelings of intense anxiety. This, coupled with decreased cognitive function, makes anxiety episodes even more severe.

#2 Depression

Also linked to serotonin and alcohol-induced chemical imbalances, alcohol can leave you feeling seriously depressed the day after consumption. Alcohol works as a sedative on the brain, reducing function and causing that feeling of deflation, which quickly turns into depression. Physical discomfort like headaches and sickness are contributors, too. Feelings of post-drinking depression are one of the main reasons that people turn to hangover remedies like Hangover IV. Although there are many speculative hangover cures, IVs really work. They introduce much needed vitamins, minerals and hydration to your bloodstream, speeding up the recovery process.

#3 Decreased alertness

One of the more dangerous symptoms of a hangover is decreased alertness and nobody should get behind the wheel of a car or operate heavy machinery the night after they’ve been out drinking. As previously mentioned, alcohol is a sedative. It slows down both thinking and reaction times. That’s true both at the time of consumption and even the day after. People suffering from hangovers are markedly slower to react, which is indicative of decreased cognitive function.

#4 Confusion

It isn’t necessarily one of the most common hangover symptoms, but some people are prone to confusion that can be debilitating. It’s described by some as a kind of “brain fog.” This is caused by vitamin and mineral decencies. Alcohol depletes your body’s stores of nutrients, specifically magnesium, which plays a big role in cognitive function. With these nutrients in short supply, your brain lacks the crucial building blocks for coherent thought. While this induces feelings of anxiety and depression in most, for some it can lead to confusion and an unpleasant mental fogging.

#5 Emotional withdrawal

Emotional withdrawal is a broadterm that describes the body’s reaction to depleted feel-good chemicals like endorphins. Alcohol consumption triggers an en masse release of endorphins, which then diminish with time.

Any release of endorphins inevitably leads to a hangover because there is a natural decrease over the following days. This isn’t unique to alcohol consumption, but because drinking releases endorphins over such a short space of time, the effect can be more profound. This is especially true for those who drink regularly. Alcohol leads to a brief high, but that invariably culminates in a low.