Anxious when you wake up? Here's why anxiety is sometimes worse in the morning
Let's face it: anxiety can occur at any time of day and, when it does, it can be the actual worst. But for some, anxiety has a particular habit of rearing its ugly head in the mornings.
At the start of a new day, it’s easy for the mind to ruminate on what's ahead and become overwhelmed with negative thoughts about what you need to achieve that day. This can leave us with a “sinking feeling” and a high level of morning anxiety, says Dr Elena Touroni, a Consultant Psychologist and co-founder of London's The Chelsea Psychology Clinic.
And it turns out there's a scientific reason why anxiety can be worse in the mornings for some. "For most people, the stress hormone cortisol is highest in the first hour upon waking, helping us to stay alert and focused in the morning," says Dr Touroni. "However, going to bed feeling anxious can cause cortisol levels to spike too early, which might lead you to wake up with a racing mind."
And that's not all. "In the morning, it’s easier for the mind to ruminate on the day ahead and what you need to achieve that day," Dr Touroni adds. "Blood sugar levels are also lower first thing in the morning, which can trigger anxiety for those who are prone to it."
Sound familiar? We thought so. If you notice that your anxiety is worse in the morning, try incorporating some form of relaxation into your morning routine to help soothe the mind, says Dr Touroni. "We all have good and bad days, and starting the day with a short mindfulness meditation can provide you with a sense of what emotional state you’re in so you can be sensitive to that," she advises.
Here, three women whose anxiety was worst in the morning explain why it happened, and how they've learned to cope.
"Anxiety has always been a part of my life"
Amber, 28, content marketing executive
"Anxiety has always been a part of my life, but it wasn’t until I moved to Sheffield when I was 24 that my GP helped me take steps to manage my mental health. I was eventually diagnosed with depression and anxiety disorder.
My anxiety shows itself physically and mentally. I often suffer from an increased heart rate, tremors and rapid breathing, which used to escalate into anxiety attacks. I also struggle with sleepless nights and dark days, where I struggle to leave my bed.
When my anxiety was at its worst, my brain was full of ‘what ifs’ before I could even leave the front door for work, and I'd sometimes have panic attacks. Insomnia would drive endless self-questioning about things I had said or done and what effect they were going to have. I'd lie in a pit of spiralling darkness until it was 8am and I needed to leave for work, absorbed in anxiety and unable to leave my bed. Anxious mornings ruined my workday, if I did manage to leave for work. I'd work myself into a state on my commute and spend most of the day trying to calm myself down so that I could crunch through my to-do list.
My anxiety would be even worse in the mornings if I overexerted myself the night before, from having too many social plans, a busy day at work or too much to drink.
Eventually, in 2018, my doctor, bosses and I agreed I would take some time off work. It was a hard decision because work was the only thing getting me out of bed, but taking time off for my mental health was a necessity and I do not think I’d be here without it. I also began counselling on the NHS. I was listened to, my concerns were heard and I wasn’t just prescribed more medication. Together with my therapist, we worked on the root of the problem.
Mornings, although often still difficult, don't take over my days anymore. I haven't 'overcome' anxiety and depression but through intense counselling, medication management and relearning my own behaviours, I'm in better control of it."
"I genuinely believed everyone woke up with a sinking feeling"
Nataliya, 33, writer and digital content consultant
"Before I was diagnosed with a generalised anxiety and panic disorders a decade ago, I genuinely believed everyone woke up with a sinking feeling in the pit of their stomach every day. I'd heard people speak of anxiety, so I thought it was normal, but now I know that being anxious and having an anxiety disorder that requires medical attention aren't the same thing. Anxiety is a normal feeling in the body, like happiness, sadness, or jealousy. There's a big distinction between anxiety and anxiety disorders.
My anxiety was especially bad in the morning because I struggled to deal with the day ahead. Waking up meant I had to organise my day to ensure I didn't miss anything or say anything that would make me ruminate all night. I went through the tasks in my head over and over. If I was doing something new or unusual that day, I'd wake up too early with anxiety. Everything new spelled fear, especially when it centred around people or expectations I had to fulfil. Talking on the phone felt awful and socialising was a huge task.
At the time, I was working as an influencer, leading a NYC-based fashion blogging group. That meant socialising with many fellow bloggers and going to events. This was a nightmare and I'd sometimes prep for events weeks in advance. I found it easier to chat with a wine glass in my hand and sometimes would inadvertently have one too many drinks (not because I was having so much fun, but because I was trying to drown out the anxiety). Obviously, that created more issues.
During a particularly tough time, when I was having family issues, I woke up every day for a three months unable to catch my breath. Throughout the day I had to stop to breathe, and I often couldn't. I went to a psychiatrist and when I told her, she informed me that I was living in a state of panic 24/7 – like having a non-stop panic attack. I lost 20lbs in a month and started taking medication. At first, meds didn't work for me, but then I switched to some which worked better.
So what helps me? Well, routines. Anxiety is anticipating the unexpected, so eliminating the unexpected from any situation helps. My anxiety doesn't wake me up anymore but I feel it throughout the day in pangs when thinking about what to do next – or doing anything sociable. But my routine keeps the evenings and the mornings consistent. In the mornings, I wake up and stroke my cat while catching up on emails, then I make coffee, feed my animals and start on my to-do list. I consistently follow the list and add tasks throughout the day.
In the evenings, I always make a cup of tea, meditate, do 15 minutes of Japanese practice, and listen to an audiobook. These routines lower my anxiety because I always know what I'm tackling ahead of time. If my experience sounds similar to yours, don't self-diagnose or try to cope with it alone. See a doctor. I didn't realise how different life could be on medication that actually works for me."
Nataliya is the founder of Styletomes.com.
"Even the smallest of things can tip me over the edge"
Leanne, 36, marketing executive and blogger
"I was diagnosed with depression when I was 19 and suffered with my mental health in my twenties, even overdosing after a difficult break-up.
My anxiety manifests itself as a feeling in my tummy that just won’t go away. It isn’t hunger, or being poorly. It’s like a deep pit in my stomach. I also feel like my chest is tight and get short of breath. Sleeping is always an issue as my brain goes into relentless mode. Even the smallest of things (like not having recycling bags, for instance) can tip me over the edge and make me feel powerless. My menstrual cycle also drains me and makes my outlook on life change quite dramatically for a few days each month. Money is probably my biggest stress: I never feel like I have enough and, in turn, tell myself that my kids don't have enough either.
My anxiety is worst on Mondays. I reflect on the weekend and make myself feel guilty for eating or drinking the 'wrong' things, not being more productive, and not exercising as much as I 'should' have. It's when I feel most overwhelmed by everything I need to do throughout the week for my blog, part-time job and family. As soon as I get out of bed, I feel like I'm on a treadmill without a 'stop' button.
I have three sons, age 14, 12, and four. My eldest son is autistic and if I know he has something going on at school or in his social life that will affect him, it'll get to me in the mornings and I'll worry about it all day.
Every night, even now, I stir at 3am and a million things race through my mind. Feeling so anxious in the mornings made me feel like I was setting myself up for failure every single day. I'd become convinced that the day would hold a bump in the road, that something would go wrong. Even if I'd had what might be considered a 'perfect day' the day before, a grey cloud would rush over and change everything.
Things are better now and I've learnt a few coping strategies: I use the Headspace app. Taking ten minutes per day to just focus really brings me back down to normality. I also use an app called Yoga Studio. Gentle stretching and listening to how my body feels makes me feel so much more in tune with myself."
Tips to manage morning anxiety
What is anxiety?
"What causes us to feel anxious varies from one person to another," says Stephen Buckley, head of information at Mind. "Anxiety is a normal reaction to a stressful situation, but if feelings last a long time or keep returning, you might be experiencing an anxiety disorder. Anxiety and depression are common and treatable, but it’s best to speak to your GP as soon as you can."
What are the symptoms of anxiety?
According to Dr Touroni, some of the most common anxiety symptoms to look out for include:
Strong, fast or irregular heartbeat (called palpitations)
Trembling or shaking
Digestive issues and diarrhoea
Feeling of panic or dread
Ruminating or obsessive thoughts
Shortness of breath
Difficulties sleeping (not being able to fall asleep/waking up very early and not being able fall back asleep again/waking up multiple times throughout the night)
What should I do if anxiety is disrupting my sleep?
“For some people, the symptoms of anxiety may feel stronger at night without the usual distractions of the day," advises Buckley. "It’s not uncommon for people with anxiety disorders to wake up during the night having a panic attack, which can be really scary. Lots of people will find they experience other physical symptoms such as headaches, clenching their jaws and grinding their teeth at night – all of which can disrupt our sleep. If you’re struggling to sleep, you might find that your mental health becomes worse as a result, and it can become a cyclical pattern."
But there are things that can help: "Only get into bed when you are tired, rather than at a set time," continues Buckley. "Relaxing before bed, such as having a bath, or reading a book, can also be helpful. Some people use meditation techniques like focusing on their breath. Technology can also prevent you from sleeping well, so make sure you step away from screens at least an hour before you want to sleep.”
How should I manage my anxiety?
“There are various things you can do to manage anxiety," says Buckley. "Talk to someone you trust about what is making you anxious. If you experience depression and anxiety, you might benefit from a talking therapy, such as Cognitive Behavioural Therapy, which is available on the NHS. Speak to your GP about treatment options as soon as you can.
"If you aren't able to open up to someone close to you, call a confidential helpline such as those run by the Samaritans, Anxiety UK or Mind’s Infoline (open Monday-Friday, 9am-6pm). Breathing exercises and other relaxation techniques can also help manage anxiety. Keeping a record of what triggered the anxiety (such as noise or crowds) and what helps it to pass (such as focusing on slowing our breathing or getting outdoors) can also help you understand and spot patterns early.”
Plus, exercise and diet both can both affect mental health. "Physical activity is beneficial to our mental health as it releases ‘feel good’ endorphins and reduces levels of cortisol," says Buckley. "Eating regularly, keeping your blood sugar stable staying hydrated and managing caffeine can all help to keep us mentally well."
When to seek help
"If your anxiety has begun to interfere in your everyday life and relationships and it's leaving you feeling overwhelmed, it's important to seek professional help," Dr Touroni emphasises.
For information, support and advice about mental health and where to get support, visit Mind’s website at www.mind.org.uk or call Mind’s Infoline on 0300 123 3393 (Monday to Friday, 9.00am to 6.00pm).
This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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