If the start of your day is also the most anxiety-provoking, listen up.
“It’s normal to have morning anxiety once in a while,” said Reena B. Patel, a licensed educational psychologist, board-certified behavior analyst and author of “Winnie & Her Worries.” “Presentations for work, new job interviews, tests for school, or even meeting a new date for breakfast can all lead to morning anxiety.”
But if it’s more than a “once in a while” thing, it may be time to investigate. Whether you’re managing general anxiety disorder or just feeling a bit frazzled, experts weigh in on why you might be on edge — and what you can do about it.
Why Are You Anxious In The Morning?
To be clear, not everyone feels anxious when they first wake up — but it’s not uncommon to feel that way, either.
“In my experience [as a practitioner], anxiety tends to be higher in the morning,” said Alex Dimitriu, a sleep medicine physician and founder of Menlo Park Psychiatry & Sleep Medicine in California. “The data is mixed ... with some studies showing more anxiety later in the day.”
Here’s what could be happening:
1. Cortisol spikes in the morning.
Some of the anxiety could be attributed to cortisol, which is higher when you first wake up, Dimitriu said.
“Serum cortisol levels are higher in the morning; this is part of the brain ‘booting up,’ like a computer, after a night of sleep,” he explained, adding that this boot-up is “to jolt us awake from sleep.”
And while it’s “totally normal,” it may be a challenge if you’re already facing general anxiety or stress. “If someone has anxiety or stress, the baseline level of cortisol can already run higher, and peak higher yet in the mornings,” he said.
2. Your sleep habits can also be a factor.
It’s incredibly important to pay attention to your sleep schedule.
“The circadian system can play a huge role in anxiety as well as panic symptoms,” Dimitriu said. “In some analyses, people have been shown to have more panic symptoms in mornings and afternoons. Part of the increase in anxiety and the stronger version of anxiety — panic symptoms — being worse in mornings and afternoons may be due to circadian-driven increases in cortisol, and possibly other alerting hormones.”
Dimitriu added that the “fight or flight” stress response gets to rest at night while you sleep, but it may not get as much rest in individuals with higher levels of anxiety. “This may suggest that there is a built-up inertia of stress that extends into the night.”
The ongoing stress (without respite) is what can lead to that feeling of panic when your alarm clock sounds at the start of the week. “Mornings, especially Monday mornings, are considered to be a particularly high likelihood time to experience a heart attack for this same reason,” Dimitriu said.
The combination of business, arriving to work, and potential jet lag from “an altered sleep pattern on the weekend,” he said, leads to a “higher likelihood of adverse cardiovascular events, [which] has been detected and found to be increased in mornings.”
In fact, research published in 2018 shows “the occurrence of stroke, myocardial infarction, and sudden cardiac death all have daily patterns, striking most frequently in the morning.”
3. Your baseline mental health plays a role.
Lyndon J. Aguiar, a licensed clinical psychologist and clinical director at Williamsville Wellness in Virginia, said your mental health state may sometimes determine what time you feel anxious. While social anxiety and obsessive-compulsive disorder may be correlated with morning anxiety, “generalized anxiety or PTSD tend to have more anxiety at night and at bedtime,” and a patient recovering from addiction “would likely feel anxiety at times that they formerly engaged in their addictive behavior.”
In addition to these particular mental health conditions, “vivid dreams, night terrors, PTSD symptoms, the person’s schedule, and stress levels” all can “play a big part in morning anxiety,” Aguiar said. “Poor sleep, poor nutrition, and limited stress management skills could all lead to high morning anxiety as well.”
How To Manage Morning Anxiety
If you’re waking up with anxious feelings, a pit in your stomach or even a panic attack, it’s time to see a mental health care provider (or your general practitioner). This phenomenon can have a serious impact on your well-being, and your “ability to think calmly and have a realistic plan for the day,” Patel said.
Aguiar suggests beginning with a journal to log your experience. “Track successes, challenges and interpersonal interactions through the day to see if a pattern emerges right before days with high anxiety in the morning,” he said. This can also help your health care provider gain better insight into your condition.
Another quick tool he recommends for in-the-moment anxiety: diaphragmatic breathing. Practice this by “inhaling for four seconds by nose, holding it for four seconds, and breathing out by mouth with a small opening for six seconds.”
Patel and Aguiar also stressed the importance of implementing calming lifestyle activities to mitigate morning anxiety. Practices like guided imagery, yoga, using affirmations or trying progressive muscle relaxation can all contribute to lower stress levels, Aguiar said. They also both recommend exercise — outdoor or otherwise — to give yourself a mood boost.
Patel suggested keeping up both a morning and evening routine. “Structure helps alleviate the unknown,” she said. At bedtime, to maximize the potential for more restful and de-stressing sleep, she advises trying the following:
- Go to bed at the same time every day
- Get off your screen 30 minutes before bed
- Do a “negative brain release” of negative thoughts in your journal
- Use a weighted blanket to sleep
Lastly, consider cognitive behavioral therapy (CBT), Patel said, adding: “CBT therapy can help you learn how to shift and reshape your thinking, and how you react to stress.”