Falling asleep when your head is whirling with anxious thoughts is hard enough. But waking up with anxiety? That can be just as difficult. If “jumping out of bed” feels more like dragging yourself out of bed, know that you’re not alone. There are things you can do to help ease those early morning (or even middle of the night) worries.
Anxiety is a feeling of physical, mental, or emotional stress. When you’re anxious or stressed, you might feel physical or mental sensations like:
These sensations can feel uncomfortable and downright annoying, but any of these feelings are a completely normal, even protective, reaction to a stressful situation.
And of course, there’s some science behind it: when you encounter a stressor (environmental or psychological), your body releases chemical messengers (the stress hormonescortisol and adrenaline) that help your body prepare to face a dangerous situation. Blood flow increases; blood pressure rises; sugars are released into the bloodstream; your digestive system slows.
The result? A boost in energy, stamina, and focus—exactly what you need to face a temporary stressor like say, prepare for an exam or fend off a mountain lion. Unfortunately, some of us feel the effects of stress and experience anxiety even when the stressor isn’t there.
Feelings of anxiety (also known as stress) typically go away once the external cause is resolved.
Anxiety disorders, on the other hand, are characterized by persistent anxious thoughts and symptoms that happen even in the absence of a stressful event or out of proportion to the stress at hand. They are common (roughly 40 million Americans, or 18.1% of the population, will experience an anxiety disorder in a given year) and treatable.
There are five major types of anxiety disorders:
While symptoms may vary depending on the type of anxiety, they can generally be characterized as physical, mental, or behavioral:
Physical symptoms:
Mental symptoms:
Behavioral symptoms:
While some anxiety in daily life is to be expected—and beneficial, even, since it helps us recognize and respond to potentially threatening situations—anxiety disorders are marked by symptoms that can negatively impact one’s overall well-being, impact professional and personal relationships, and make it difficult to function and get through the day.
Morning anxiety isn’t a medical term, and it can occur in people with or without an anxiety disorder. For most of us, morning anxiety is caused by an upcoming stressor like a hard day at work, a big presentation, or a social/romantic engagement.
There may also be hormonal culprits behind early-morning anxious feelings—remember the stress hormonecortisol that’s behind our fight or flight response? Scientists think there’s also a link between anxiety and cortisol levels upon waking. Cortisol levels ebb and flow over the course of a 24-hour period and seem to increase dramatically within the first 45 minutes of waking.
This morning spike in cortisol is known as the cortisol awakening response or CAR. Scientists are still figuring out exactly how CAR affects our health, but some studies have found that individuals who experience more daytime stress will see a higher spike in morning cortisol than those who have less stress.
It’s important to remember that regardless of the cause, if anxiety levels start to interfere with your daily life, it’s time to seek help from a mental health professional.
Fortunately, there are various treatment options in our mental health toolkit to help ease symptoms of morning anxiety.
Regular exercise
Exercise isn’t just good for your heart and muscles, it’s also good for your brain. Scientists have found that regular exercise is linked with positive changes in your brain and nervous system that ultimately protect against and reduce the negative effects of stress and anxiety.
How can you reap the stress-relieving benefits of exercise? Choose a routine that you can stick with. Whether it’s a high-intensity workout like running sprints, a brisk walk, or even yoga—aim for about 30 minutes of exercise a day.
Diet
While diet alone won’t cure anxiety, good nutrition can help support your energy levels and brain health, both of which are beneficial for coping with anxiety and negative thoughts (not to mention supporting your physical health, too).
Here’s what’s recommended:
Mindfulness and self-care
There are various mindfulness tactics that can help support healthy cortisol production. And remember, there’s no need to commit to them all.
In fact, we recommend starting small—try just one item from the list below for a few weeks and see how you feel.
Therapy
The idea that there are better ways to think about our feelings is the core concept behind cognitive behavioral therapy (CBT), which focuses on how thoughts, feelings, and behaviors influence each other.
The goal: recognize when thoughts might become troublesome and be able to employ techniques to effectively redirect those thoughts.
Medication
If diagnosed with an anxiety condition, your healthcare professional will perform bloodwork to rule out any other medical conditions (e.g., hypothyroidism) that may be contributing to your symptoms. You’ll also receive a psychological evaluation from a mental health specialist to discuss family history of anxiety or depression, symptom severity/frequency, and other social stressors.
If diagnosed, your psychiatrist may prescribe anxiety medications to help manage your symptoms.
At Talkiatry, our psychiatrists focus on long-term treatment success, which is why anti-anxiety medications that provide temporary relief are only recommended as a short-term measure to alleviate symptoms when starting the treatment process. We instead utilize medications that have demonstrated long-term success in treating anxiety symptoms, including SSRIs, SNRIs, and tricyclic antidepressants.
Not all of these medications will be appropriate for everyone with anxiety. Some people may require just one medication, while others may manage their symptoms best with two complementary medications. If you don’t respond to one medication, it’s possible you’ll respond to another, which is why it’s important to work with a provider, like a psychiatrist, who can tailor your treatment to your specific needs.
The first step in treating anxiety is getting a proper anxiety disorder diagnosis from a qualified mental health professional, like a psychiatrist. Unfortunately, many people with anxiety disorders don’t take this critical first step. They don’t realize that they have a medical condition for which many treatment options exist.
With Talkiatry, you can see a psychiatrist from the comfort of your home and you can schedule your first appointment in a matter of days.
If you believe you have an anxiety condition (or are not sure), start by taking our free, easy assessment and see if Talkiatry is a good fit and get matched with a psychiatrist that meets your needs and takes your insurance.
The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
Sources:
NIMH » I’m So Stressed Out! Fact Sheet | NIMH
Table 3.10, Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5 | NCBI
Table 3.10, Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5 | NCBI
Anxiety Disorders: Types, Causes, Symptoms & Treatments | Cleveland Clinic
Cortisol on Circadian Rhythm and Its Effect on Cardiovascular System | PMC.
Effects of Exercise and Physical Activity on Anxiety | PMC
Coping with anxiety: Can diet make a difference? | Mayo Clinic
Generalized Anxiety Disorder and Hypoglycemia Symptoms Improved with Diet Modification | PMC
Associations between Nature Exposure and Health: A Review of the Evidence | PMC
Dr. Nidhi Sharoha is a double board certified psychiatrist in Psychiatry and Consultation Liaison Psychiatry. She completed her undergraduate training at Stony Brook University followed by medical school at New York Institute of Technology College of Osteopathic Medicine. She has completed both a Residency in Psychiatry and Fellowship in Consultation Liaison Psychiatry at Nassau University Medical Center.
Dr. Sharoha has held academic appointment at Stony Brook University Hospital, practicing as a consultant psychiatrist as well as the Associate Director of Consultation Liaison Psychiatry Fellowship Program. She has been deeply involved in teaching throughout her years
She has a genuine interest in treating a vast array of psychiatric disorders including depression, anxiety, bipolar disorders, post traumatic stress disorders and obsessive compulsive and related disorders. She also has experience in treating patients with medical comorbidities and has training in issues related to women’s health.
Patients looking for a psychiatric provider will find that Dr. Sharoha has a gentle approach to diagnosis and management of her patients. She believes in the principle that body and mind are interconnected which allows her to provide comprehensive care to all of her patients.
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