Why Do I Feel Restless? Insights Into Mental Health And Anxiety

Restlessness may be a common symptom of several mental and physical health conditions. Whether you’re feeling restless daily or occasionally, discovering the cause of this state and finding ways to reduce it can be beneficial to your overall health and well-being.

What is restlessness? 

Dictionary.com defines restlessness in multiple ways, depending on whether it manifests physically, mentally, or both. Restlessness might indicate difficulty sitting still or a persistent urge to move, often characterized by fidgeting and pacing. As a mental state, it might describe a sense of anxiety, discontent, or worry. Situationally speaking, restlessness may manifest as an overall feeling of agitation due to boredom or anticipation. While being restless isn’t always a negative thing (such as when we’re anticipating something exciting or joyful), it can cause discomfort when we can’t moderate or control it.  

What does restlessness feel like?

Sensations of restlessness may vary in intensity, frequency, and complexity. As such, it isn’t always easy to label. For example, we might feel restless emotionally without the physical sensations we often use to identify it. Restlessness also often works bi-directionally, with physical symptoms causing mental health challenges and vice versa. The following are some common signs of restlessness.

Physical sensations

You might feel physical symptoms of restlessness if you’re anticipating something, you’ve had too much caffeine, from medication side effects, or from certain medical issues like hyperthyroidism or restless legs syndrome. Physical manifestations of restlessness include: 

• Inability to sit still, muscle tension, pacing, difficulty relaxing

• Pacing, walking back and forth, or an inability to sit still

• Tapping feet, shaking legs, wringing hands, or playing with objects

• Tightness in the body, clenched fists, or muscle twitching

• Difficulty falling asleep, staying asleep, or sudden awakening

• Feeling "jittery," trembling, or experiencing "creepy, crawly" sensations

• Increased heart rate, shallow breathing, or sweating 

Emotional and cognitive experiences

Although it may appear in physical form, such as difficulty sitting or excessive fidgeting, restlessness can be attributed to mental health issues that can interfere with your emotions and how they’re regulated. Emotional and cognitive signs of restlessness include:

• Feeling constantly uneasy, "on edge," or overwhelmed

• Sudden mood swings, impatience, or being easily annoyed

• Difficulty “turning off” the brain or inability to concentrate

• Acting abruptly or exhibiting hostile, uncooperative behavior

• Mentally fixating on specific ideas or worrying 

Why do I feel restless? Possible causes of restlessness

The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) lists restlessness as a symptom of several mental illnesses, including generalized anxiety disorder (GAD). Although you don’t have to have a mental illness to experience distressing amounts of restlessness, you may want to discuss a few potential mental health-related causes of the condition 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 chronic worry. 

Anxiety disorders like social anxiety disorder and GAD may cause a stress response leading to symptoms of 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)

ADHD is classified in the DSM-5-TR as a neurodevelopmental disorder, often with a combined presentation of physical and psychological signs. Symptoms like restlessness, fidgeting, and sensing that you are “driven by a motor” can be signs of primarily hyperactive or combined type ADHD in adults and children. 

Post-traumatic stress disorder (PTSD)

Some people with post-traumatic stress disorder (PTSD) experience hyperarousal symptoms like restlessness, hypervigilance, being “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 and other mood disorders 

Depression and anxiety are commonly co-occurring conditions. Like anxiety, several types of depression can include restlessness as a symptom, 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, which can exacerbate restlessness symptoms.

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

Bipolar disorder

Bipolar disorder is another chronic mood disorder typically characterized by alternating periods of mania or hypomania and depressive episodes (although some people with bipolar II or cyclothymia do not experience mania). During a manic episode, an individual may find it challenging to control or ignore impulses, have trouble concentrating, exhibit excess energy, and, in some cases, experience feelings of euphoria. Additionally, an estimated 29–32% of people with bipolar disorder experience agitated depression, a severe form of depression often described as a "mixed state" of mania combined with the emotional despair of depression. This state often poses a higher risk of suicide.

Other mental health conditions associated with restlessness 

Other mental health conditions can lead to the experience of restlessness, although it may not be as predominant a symptom as in the conditions described above. These conditions include:

• Substance use disorders 

• Eating disorders

• Obsessive-compulsive disorder 

Restlessness and sleep problems

Like mental health conditions, restlessness and sleep problems share a bidirectional, often cyclical, relationship where poor sleep causes stress and irritability that leads to insomnia. While many assume adults need at least eight hours of sleep, the American Academy of Sleep Medicine recommends that adults aim for at least seven hours per night to get enough sleep. Conditions such as insomnia, restless leg syndrome (RLS), and other sleep disorders may cause difficulty falling asleep or staying asleep, interfering with an individual’s ability to get enough restful sleep.

Lifestyle factors that can worsen restlessness

Restlessness in the body and mind can be caused or worsened by a combination of factors. However, lifestyle changes, including better sleep hygiene and plenty of rest as noted above, can help. Below are some common underlying issues that may contribute to restlessness, and the lifestyle changes you can make that might lessen it

Nutrition 

Research, including a 2021 review of 110 studies, has repeatedly shown a connection between what we eat (or don’t eat) and mental health. In the review, the researchers highlighted that poor diet and nutrition affect several biological mechanisms that can directly influence mental states, including neurotransmitter production, inflammation, oxidative stress, and the gut-brain axis. They noted that a diet high in refined sugars, processed carbs, and caffeine can cause blood sugar crashes and nervous system stimulation, leading to restlessness, anxiety, and poor sleep. Conversely, consuming nutrient-dense foods—like magnesium-rich leafy greens, iron-rich foods, and complex carbohydrates—promotes relaxation, stabilizes energy, and supports better sleep. 

Stress and overstimulation

Not only can ongoing stress cause restlessness, but sensory overload from things like noise, lights, or screen time can cause anxiety and an inability to sit still, too. Heavy workloads can become overwhelming when unmanaged, leading to heightened stress and restlessness. Reducing sensory input, prioritizing rest, and using techniques like meditation might help you reduce stress and manage symptoms. Support from family, friends, or a therapist may help, too.

Daily habits and movement

Sedentary routines or prolonged periods of inactivity might increase the urge to move for some people. Additionally, a lack of physical activity and higher body weight are associated with more severe restless legs syndrome (RLS), which may disrupt sleep and cause daytime restlessness. To manage restlessness, consider incorporating regular, gentle physical activity, such as walking or yoga. Additionally, caffeine and nicotine can overstimulate the nervous system, while alcohol can disrupt sleep, causing increased awakenings and restlessness. Limiting or eliminating caffeine, alcohol, and nicotine from your daily routines may help calm the nervous system.

When restlessness may signal something more serious

While occasional restlessness or agitation are normal for many, when these develop into more persistent or severe symptoms, they may indicate a mental health issue. It might be a red flag when restlessness interferes with your daily life and relationships, as well. Signs such as suicidal behavior or ideation, mania, or intense emotional distress might indicate restlessness as tied to serious mental health conditions like bipolar disorder. 

When symptoms emerge, consider reaching out to a friend, family member, or healthcare professional for support. Connection can provide emotional support, but others may also offer practical advice for next steps. Early intervention often makes a significant difference, helping to prevent symptoms from worsening.

How do I know if restlessness is caused by a mental health condition such as anxiety or depression?

There 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. Your doctor can also help you develop a treatment plan for your restlessness, regardless of its cause. 

When you meet with your doctor, 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 how you feel when experiencing restlessness

Consider keeping a daily thought-and-feeling 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.

Therapeutic methods for treating restlessness

Therapeutic approaches for treating restlessness as a mental health symptom often focus on identifying underlying causes, calming the nervous system, reframing thought patterns, and utilizing in-the-moment skills to cope with stress and anxiety. Common treatments include cognitive behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and somatic techniques. Your therapist may construct a personalized treatment plan depending on coexisting symptoms, your mental state, and your long-term therapeutic goals.   

How to cope with restlessness

There are several coping strategies you can try when restlessness becomes overwhelming, but it may help to first notice what heightens symptoms. Certain stimuli may worsen restlessness. For example, stress and caffeine can cause a racing heart and shallow breathing, which might contribute to anxiety and make it challenging to rest. Awareness of what exacerbates your symptoms may help you manage or prevent these symptoms. You may also build a toolkit of coping skills to reduce stress. In this toolkit, you might include: 

• Mindful breathing techniques
• Body-based mindfulness techniques
• Meditation
• Yoga
• Stretching
• Spending time in nature
• Prioritizing restful sleep
• Leaning on a support system

Finding professional help for restlessness

Establishing a relationship with health professionals who know you and your history can be crucial in finding help for restlessness. A mental health professional can help you uncover the root causes of restlessness, such as anxiety, depression, or sleep-related restlessness, and offer a treatment plan tailored to your needs. They might also teach coping skills to use in daily life when depression and anxiety symptoms become overwhelming. 

If you haven’t reached out to a therapist due to barriers to care, such as cost, distance, or availability, you might find online counseling through a platform like BetterHelp beneficial. You may find that online therapy can make finding a therapist more straightforward, with thousands of cost-effective providers available. You can also choose between phone, video, or live chat sessions with an online therapist, which can offer 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 cause restlessness, including anxiety disorders, depression, and PTSD. For example, one 2022 meta-analysis of randomized controlled trials found that internet-based CBT produces significant reductions in anxiety sy