Why Do I Keep Waking Up Anxious?

Medically reviewed by Julie Dodson, MA
Updated April 22, 2024by BetterHelp Editorial Team

If you have ever woken up in the night or at the start of your day with intense fear and dread, you might feel confused about why it happens. If you frequently experience high anxiety levels in the morning, you are not alone, and there are strategies you can try to manage it. In addition, speaking to a licensed therapist may be beneficial for understanding your feelings upon waking.

Waking up with anxiety can be frustrating

Understanding anxiety

Anxiety is a feeling of intense worry and fear that can occur during real stressful situations or perceived events. Experiencing occasional anxiety, such as feeling anxious before an interview, can be common. However, some people experience more chronic and debilitating forms of anxiety, which might be a symptom of an anxiety disorder. There are several anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including the following:

  • Panic disorder
  • Generalized anxiety disorder (GAD)
  • Specific phobias
  • Social anxiety disorder
  • Separation anxiety disorder
  • Selective mutism
  • Agoraphobia
  • Substance or medication-induced anxiety disorder
  • Anxiety disorder due to another medical condition
  • Other specified anxiety disorder

People with different anxiety disorders may display a different set of symptoms, both physical and mental.which can affect their physical health and mental health. However, there are several similar symptoms of these persistent anxiety conditions that many people report, including the following:

  • Feeling weak and fatigued
  • Difficulty breathing
  • Mental confusion and fear
  • Nervousness or a feeling of impending doom
  • Restlessness
  • Insomnia or difficulty sleeping
  • Tingling or numbness in the hands or legs
  • Excessive worrying
  • Racing heart
  • Sweating and chills
  • Tight chest
  • Trouble sleeping
  • Upset stomach or diarrhea
  • Muscle tension

Possible causes of waking up with anxiety

Consistently waking with anxiety can be uncomfortable and have a range of negative impacts on a person's well-being, as the anxiety symptoms may affect how they move through the day and their sleep quality at night. Sleep is vital for physical and mental health, so sleep disruptions may cause a range of challenges. Below are some potential causes of morning anxiety or waking up fearful. 

Anxiety disorders

Any anxiety disorder may contribute to the symptoms of morning anxiety. Symptoms may contribute to anxiety in the morning if you have a specific phobia or social anxiety. If you are already diagnosed with an anxiety disorder, talk to your therapist or doctor about why your symptoms may occur when you wake. You might be able to take medication, such as anti-anxiety drugs, or start a new therapeutic modality for support. However, consult a medical doctor before starting, changing, or stopping medication. 

Other health conditions

If you don't have an anxiety disorder, another health condition could be causing your morning anxiety. Severe medical conditions, including diabetes, heart disease, and thyroid problems, may cause symptoms that cause you to wake up with anxiety. Therefore, if you have one of these health conditions or another medical concern, talk to your doctor to determine if they are causing your anxiety.

Negative morning habits

If you aren't waking up with anxiety but experiencing it soon after, you might observe your morning routine to see if it affects your mental health. For example, listening to chaotic music, eating an unhealthy breakfast, or consuming significant amounts of caffeine may worsen your symptoms of anxiety. If this is the case for you, you may be able to ease anxiety in the morning by swapping your habits for more positive ones, such as eating a healthy breakfast or spending time listening to calm music. 

Stressful life events

If you are feeling anxious about particularly stressful events in your everyday life, those may be causing your sleep problems and be part of the reason you are waking up with anxiety. Whether it be financial, job, or family stress, life events that prompt anxiety throughout the day can also affect your morning stress levels.

Stress hormone levels

Cortisol is one of the key stress hormones in the body. As part of the body’s stress response, it is released by the adrenal glands and helps you detect threats. However, many people don't experience life-or-death threats on a daily basis, but they may experience an increase in cortisol in typical, everyday situations. 

People who frequently experience waking up with anxiety experience increased stress hormone levels within the first hour of their day, called the cortisol awakening response. Though all people can have this natural response, people with anxiety disorders like generalized anxiety disorder or panic disorder may be particularly susceptible and feel increased morning anxiety.

Sleep disorders

In some cases, sleep disorders may be the cause of anxious waking. Some people have insomnia and wake up in the night. A disrupted sleep schedule might cause feelings of unease, exhaustion, and concern, which could contribute to anxiety. In addition, sleep disorders like sleep apnea can cause a restriction of breathing, which might cause panic when you wake up and feel like you can't breathe. If you think you might be experiencing a sleep disorder, talk to your primary care doctor to get a referral to a sleep specialist. 

Post-traumatic stress disorder (PTSD)

If you've experienced a traumatic event or multiple repeated traumatic events in your life, you might have symptoms of post-traumatic stress disorder (PTSD). PTSD symptoms include flashbacks, nightmares, and distressing memories. 

For people who have experienced ongoing trauma, sleeping might feel unsafe, even if you are safe in your own home. You might subconsciously stay hyper-alert throughout the night and morning, waking up feeling in danger. Certain situations or locations might worsen this feeling, such as sleeping in a new location, at a friend's house, on your own without your partner, or without a blanket. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

If you are experiencing symptoms of PTSD, you're not alone. According to the Anxiety and Depression Association of America, more than 8 million adults in the US are living with PTSD. Reach out to a therapist for support in these symptoms, as there may be treatment options to help you. 

Tips for reducing  morning anxiety 

If you're experiencing excessive anxiety in the morning or when you wake up during the night, you may be looking for ways to take control of the situation. Below are a few strategies you can try to reduce your morning anxiety symptoms. 

Make lifestyle adjustments

Physical health and mental health are often connected. Therefore, taking care of your body can be vital to taking care of your mind. Self-care can involve eating healthy food, exercising regularly, and implementing healthy sleep habits (part of good sleep hygiene). For people experiencing an excessive amount of anxiety, physical activity may be a practical option to help reduce stress levels and blood pressure. 

People with generalized anxiety and other anxiety conditions often experience sleeping problems that keep them from getting the rest they need. A lack of sleep can cause you to feel anxious, worsen anxiety, and cause physical symptoms such as headaches and muscle tension. If this is the case for you and you are having trouble managing it on your own, talk with your doctor about professional treatment options to help you fall and stay asleep.

Change the environment

Your surroundings may impact your mood and trigger anxiety. Listening to loud music, watching dramatic and stressful shows, and having a chaotic environment may contribute to negative and anxious thoughts.

Try to ensure that your environment promotes calm feelings and that you have a relaxing evening or morning routine. For example, you can minimize consuming stressful media before bed, fill your home with relaxing music and calming colors, or take a relaxing bath before bed.

Meditate

Many people have found practicing mindfulness and meditation effective ways to relieve anxiety. Over 200 studies, many of them medically reviewed, have shown the effectiveness of meditation for various mental health conditions, including anxiety and depression. If morning anxiety overwhelms you, you might try incorporating a guided meditation or deep breathing exercises into your routine. You might also try a guided meditation to fall asleep at night.

Talk to a therapist about generalized anxiety disorder or other anxiety disorders

In addition to the strategies listed above, talking to a mental health professional for further support may be beneficial. You can contact a therapist, psychiatrist, or other healthcare provider for support and discussions on health topics, anxiety, and potential treatments for generalized anxiety disorder or other anxiety disorders.  

If you have a health condition related to your anxiety or are experiencing painful physical symptoms, speak to a medical doctor. They can work with you to understand your symptoms and provide treatments to help with the physical symptoms. In some cases, they may suggest specific medications for anxiety. Talk to your doctor about the most up-to-date information on anxiety medication to identify the best option for you. 

For further help in working through anxiety, therapy can be valuable. A therapist can work with you to try to unpack the causes of your morning anxiety and stress and develop a treatment plan with strategies to offer relief. They may also recommend support and treatment facilities for individuals experiencing anxiety. 

Waking up with anxiety can be frustrating

Try alternative counseling options 

Some aspects of seeking help through therapy may feel intimidating for individuals with anxiety, like traveling to a new place, waiting in a busy office, and interacting with strangers. In such cases, online therapy may feel less intimidating, as you can match with a therapist online and have therapy sessions wherever you have an internet connection. Online therapy may help you reduce anxious or negative thoughts not only in the morning but also throughout the day.

There is a growing body of evidence demonstrating the effectiveness of online therapy for a range of concerns, including anxiety. Whether you experience panic attacks, health anxiety, social anxiety, or another form of anxiety, talk therapy can be a useful tool. For instance, one study conducted a meta-analysis to compare the effectiveness of internet-delivered cognitive behavioral therapy (ICBT) and face-to-face CBT for treating anxiety disorders. Researchers concluded that ICBT and face-to-face CBT had equivalent overall effects in treating anxiety disorders. 

Takeaway

You might wake up with high levels of anxiety for several reasons, such as an anxiety disorder, a health condition, a stressful life event, or negative morning habits. If you're experiencing this phenomenon, consider trying the above strategies to find relief. You might also benefit from speaking to your doctor or a therapist for support and more mental health resources. 

If your anxiety makes it difficult to attend in-person therapy sessions at this time, you might consider online therapy. With BetterHelp, you can be matched with a therapist who has experience helping people overcome anxiety, whether it’s morning anxiety or anxiety in general. Take the first step toward relief from morning anxiety and reach out to BetterHelp today.
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