Why do I feel restless? Restlessness and mental health

Possible causes of restlessness

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists restlessness as a symptom of several mental illnesses. Although you don’t have to have a mental illness to experience distressing amounts of restlessness, below are a few potential causes you can discuss with your doctor or therapist. 

Anxiety disorders

Various anxiety disorders are associated with restlessness. Anxiety disorders are among the most frequently experienced mental health conditions in the United States. In addition to physical restlessness, a person with an anxiety disorder might also experience mental turmoil, such as racing thoughts or excessive worry. 

Anxiety disorders like social anxiety disorder and generalized anxiety disorder (GAD) often cause restlessness due to fear or a desire to avoid stress. Anxiety disorders can affect people of all ages and backgrounds, and they are highly treatable. Mindfulness, journaling, and talking to a therapist are a few ways to decrease anxiety-related restlessness. 

Attention-deficit hyperactivity disorder (ADHD)

A person with ADHD may primarily experience inattentive or predominantly hyperactive or impulsive symptoms. They may also experience ADHD with a combined presentation of physical and psychological signs. Symptoms like restlessness, fidgeting, and feeling like you are “driven by a motor” are signs of primarily hyperactive or combined type ADHD in adults and children. 

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) features hyperarousal symptoms like restlessness, hypervigilance, feeling “on edge,” and startling easily. Treatment for PTSD, like psychotherapy, can help individuals manage or reduce their symptoms. 

Not everyone who experiences trauma develops PTSD, but some do. Even if someone does not have PTSD, trauma can still affect a person’s life and well-being, which may cause restlessness. 

Depression

As with anxiety disorders, restlessness is a potential symptom of depression. Depression may not cause restlessness for everyone, but it is possible. Several types of depression can include restlessness, including major depressive disorder (MDD) and premenstrual dysphoric disorder (PMDD). It is also common for people with depression to experience a co-occurring anxiety disorder. 

In addition to feeling physically restless, a person living with a depressive disorder may experience sleep disturbances, including poor sleep quality, sleeping too much, sleeping too little, and irritability.

Bipolar disorder

Bipolar disorder is characterized by alternating periods of mania or hypomania and depression. In some cases, a person with bipolar disorder may be at a baseline state, meaning they do not have excessively high or low moods. 

Bipolar disorder may cause unusual restlessness, increased energy, agitation, irritability, and a decreased need for sleep, among other symptoms, such as impulsivity and engaging in risky behavior. These symptoms commonly occur during a manic or hypomanic episode of bipolar disorder.

In addition, substance use disorders, eating disorders, obsessive-compulsive disorder, and restless leg syndrome (RLS) can also cause or contribute to restlessness.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

How do I know if restlessness is caused by a mental health condition?

Below are a couple of steps you can take to understand the causes of your restlessness. 

Talk to a doctor 

Talk with a medical or mental health professional to understand whether your restlessness is a symptom of a mental illness. You can also develop a treatment plan for this symptom, whether due to mental illness or not. 

When you meet, you can discuss your concerns and ask for physical or psychological testing to determine the cause. Even if a doctor or therapist cannot decide on a diagnosis, they may be able to refer you to a specialist who can provide you with an adequate assessment and diagnosis. Since symptoms of physical and mental health conditions sometimes overlap, consulting with a professional can be vital. You may be able to determine if your restlessness is caused by a mental health condition or a physical health condition such as a movement disorder or rheumatoid arthritis.

Log your feelings and symptoms

Consider keeping a daily thought and feelings log in which you take brief notes on how you feel throughout the day. You can also include a number rating system for how restless you feel. Over time, you may reflect on your notes to determine if there are any patterns or identifiable causes of your restlessness. If so, these observations can be helpful to talk about with your doctor or therapist as you seek a solution.

How to cope with restlessness

You can take several steps to cope with your restlessness and find support, including the following. 

Notice what heightens symptoms

Certain stimuli may worsen the symptoms of restlessness. For example, stress and caffeine can cause a racing heart and shallow breathing, which might contribute to anxiety, which can cause restlessness. Awareness of what exacerbates your symptoms may help you manage or prevent these symptoms. 

Address lifestyle factors

Poor stress management, insufficient sleep, drinking caffeine or alcohol, an inadequate diet, and other lifestyle factors can impact restlessness. A daily routine that supports your overall health, including time to de-stress, practice sleep hygiene, prioritize physical activity, or ensure dietary changes, can be beneficial for your body.

Build a toolkit of coping skills

Consider developing coping skills to use when restlessness occurs. The coping skill may vary based on where you notice the symptoms, so having various tools can be helpful. Coping skills include breathing exercises, grounding, mindfulness activities, going outside, and physical activity, among others. You can also develop a list of these skills with a therapist. 

Find support with others

Whatever the cause of restlessness, you may find a support group where you can speak with others who experience the same symptoms. For example, a support group for anxiety disorders, ADHD, or PTSD might be helpful, depending on other underlying mental health conditions. For some, it can feel like a relief to meet others who understand their experience. 

Get professional help

Establishing a relationship with one or more professionals who know you and your history can be crucial in finding help for restlessness. The decision to find a doctor to work with on an ongoing basis, including a therapist, psychiatrist, or medical specialist who works with physical health conditions, may be valuable. 

If you haven’t reached out to a therapist due to barriers in receiving care, like cost, distance, or availability, you might find online counseling through a platform like BetterHelp beneficial. You may find that online therapy can make the process of finding a therapist more straightforward, with thousands of cost-effective providers available. You can also choose between phone, video, or live chat sessions, which gives you the flexibility to attend therapy in a way that works for you.  

Studies have found that internet-based therapy is an effective treatment option for a wide range of mental health concerns that can have restlessness as a symptom, including anxiety disorders, depression, and PTSD.