We asked experts in clinical psychiatry, sleep and anxiety the reasons why some people wake up anxious and tense – and what someone can do to work past the early-morning wave of emotion.
What is morning anxiety?
Morning anxiety isn’t a technical term or a clinical diagnosis, said Wolitzky-Taylor. But she said many of her patients with generalised anxiety disorder say they wake up feeling anxious. However, not all of them – many say their anxiety is more likely to keep them up at night, she said.
Anxiety can peak in the morning, but also in the midafternoon and evening, depending on the person, said Rebecca Cox, an assistant professor of psychological and brain sciences at Washington University. Cox has found one reason may be individual differences in circadian rhythms.
People who are “early birds” tend to feel the most anxious in the morning and less so later in the day, according to Cox’s research. Whereas, “night owls” – people who naturally fall asleep later in the evening – tend to report more feelings of anxiety in the evening.
It might seem logical to blame the rise and fall in anxiety on cortisol, the so-called “stress hormone,” which tends to go up in the morning and declines throughout the day. But it’s not that simple. Experts say the relationship between the hormone and the emotion is more complex.
“The research literature on cortisol is really quite mixed and messy. Some studies show a higher cortisol awakening response is associated with higher in-the-moment anxiety,” said Cox. “But other studies don’t show that effect.”
People who are anxious can also have an increased cortisol waking response but cortisol doesn’t cause morning anxiety, according to Doug Mennin, a professor of clinical psychology at Teachers College Columbia University.
“It’s not causal – it’s an index,” he said. “It shows an indication of something being dysregulated.”
What to do if you have morning anxiety
Anxiety can also turn into a habit that you may unconsciously foster over time, said Judson Brewer, a professor at Brown University’s School of Public Health and the author of the book Unwinding Anxiety.
Brewer offers three steps to break the habit.
1. Recognise you’re in an anxious loop. Then, think about what might be causing you to feel anxious.
2. Ask yourself: ‘What am I getting from this?’ This question helps people recognise the anxiety and realise worrying isn’t rewarding or beneficial.
3. Approach your anxiety with curiosity. Instead of reacting to anxiety with alarm, reflect on how the emotion makes you feel.
“Don’t underestimate the power of curiosity in helping to break free from that habit of morning anxiety,” Brewer said. “That is a game changer.”
Although it’s often easier said than done, researchers say one of the most important ways to reduce morning anxiety is to get enough sleep the night before.
“Sleep is medicine,” Cox said. “Of the things that we’ve talked about that are associated with morning anxiety, sleep is the factor people have the most control over.”
If you do wake up with anxiety, get out of bed and occupy yourself with a task so you don’t associate the bed (and the morning) with worrying, Cox said.
What happens the night before and the day prior does matter, Mennin said. If you’re up late working, or “you’re really fired up,” even if you have no trouble falling asleep, you’ll likely be asleep for less time. Mennin said he works with patients to really change “the nature of the night,” reducing the amount of screentime and light exposure, to ease into bed.
“Anxious people are very good at sensing when dawn is happening. They also have very good biological clocks,” Mennin said. “So trying to reduce [light exposure] can create sleep.”
Breathing exercises help, as well, he said. It can consist of counting your breaths or deep breathing. Imagine you’re turning down a dial or pulling down a lever to relax the body.
“There is also progressive muscle relaxation work you can do to relax each of your muscles,” Mennin said. “That can feel more grounding and take people out of their minds.”
Anxiety is just another human emotion, Wolitzky-Taylor said. It’s not harmful or dangerous to feel anxious, she said. But the emotion can become a problem when it becomes pervasive, out of proportion to the threat, and it impairs your day-to-day life.
Around 3% of the US population have generalised anxiety disorder, which is defined as having a difficult-to-control amount of daily worrying for at least six months, with three or more symptoms, like having a sense of impending doom, fatigue, irritability and trouble sleeping. People may overestimate the likelihood something bad is going to happen, which is known as catastrophising.
Just because you have morning anxiety for a period of time, doesn’t mean you have an anxiety disorder. But if your anxiety starts to affect your day to day, or your quality of life, that’s a sign you might want to seek help.
“There’s nothing wrong with going just to talk to someone,” Mennin said.
Where to get help:
