What to know about morning anxiety

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Overview

It’s not unusual to wake up feeling worried about something. Maybe you’re stressing about a presentation at work or just feeling overwhelmed that a new week is about to begin.

But regularly experiencing anxious feelings in the morning may be a symptom of generalized anxiety disorder (GAD).

This article reviews the symptoms of morning anxiety, its causes, and treatment and prevention options. 

Morning anxiety symptoms

About 40 million adults in the United States live with anxiety. GAD can cause:

• restlessness
• constant worry
• a sense of dread or fear
• constantly feeling “on edge”
• difficulty concentrating
• irritability

Anxiety can also cause physical symptoms like:

• fatigue
• headache 
• chest tightness
• muscle tension
• sweating
• irregular breathing
• shaking and trembling 
• stomach pain 

Morning anxiety causes

Your morning anxiety might result from the following:

• Life stressors and triggers: Whether positive (starting a new job or moving into a new house) or negative (financial and relationship woes), the stress of daily life can affect your morning and leave you with worried and anxious thoughts. 
• Sleep problems: People with sleep problems may be more likely to develop anxiety and depression, and vice versa, according to a 2019 study.
• Substance and alcohol use: Alcohol and substance use and anxiety commonly occur together.
• Health conditions: Having a chronic health condition, like high blood pressure, heart disease, and diabetes, may cause health anxiety.
• Mental health conditions: Mental health conditions, like depression, can also lead you to have anxious feelings when you wake up.
• Morning happenings and routines: Cortisol naturally increases in the first hour after you wake up, which may put you on higher alert than at other times of the day. Additionally, having coffee or sugar in the morning can leave you feeling jittery and restless.

Risk factors

Anxiety disorder risk factors can be genetic or environmental. A 2017 research review and a 2015 study suggest that anxiety links to specific genes.

Environmental factors that may increase your risk of developing an anxiety disorder include:

• traumatic experiences
• life stressors like divorce or illness
• socioeconomic circumstances

Medical treatment for morning anxiety

If your anxiety interferes with your daily activities, it may be time to get professional help. Available treatments include medication and therapy.

Medications that can help with anxiety symptoms include:

• Serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI): Healthcare professionals prescribe SSRIs and SNRIs to treat depression and anxiety. These include medications like sertraline (Zoloft) and duloxetine (Cymbalta).
• Tricyclic antidepressants: Tricyclic antidepressants can help treat depression and anxiety. These include medications like clomipramine (Anafranil), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil).
• Benzodiazepines: Benzodiazepines can help you manage anxiety symptoms. However, they have a high potential for dependency. Some of these drugs include diazepam (Valium) and lorazepam (Ativan).
• Beta-blockers: Medical professionals typically prescribe these medications to treat people with heart disease and high blood pressure, but they can also help with the physical symptoms of anxiety. Prescriptions may include propranolol (Inderal) and acebutolol (Sectral).
• Buspirone: Buspirone (BuSpar) can provide short-term relief of anxiety symptoms and has a lower risk of dependency than benzodiazepines. However, doctors typically use this as long-term anxiety treatment.

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Talking therapies and morning anxiety

The following types of therapies can help you with anxiety in general and anxious feelings in the morning:

Talk therapy or psychotherapy

Talking therapies, like counseling and psychotherapy, can help you understand what triggers anxious feelings in the morning and how to better cope with anxiety.

Cognitive behavioral therapy (CBT)

CBT can help you identify and change harmful thought patterns that may be causing morning anxiety.

Learn more about CBT for anxiety.

Preventing morning anxiety

The following lifestyle strategies may help you manage and prevent morning anxiety:

• eating a balanced diet that includes whole grains, fatty fish, fruits, and vegetables
• exercising regularly, about 30 minutes for 5 days for a weekly total of 150 minutes
• practicing stress-reducing activities, such as yoga, meditation, mindfulness, and journaling 
• doing breathing exercises to reduce stress
• getting enough sleep
• avoiding alcohol or limiting its consumption

Summary

Waking up with feelings of worry isn’t uncommon. After all, life stressors, like financial issues, health concerns, and professional woes, can make some mornings overwhelming. However, regularly experiencing morning anxiety may be a symptom of a mental health condition.

If you experience frequent anxiety, consider talking with a mental health professional. They can help identify what may be causing your symptoms and recommend a treatment plan that works for you.

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