“I woke up before the alarm went off with a feeling of inexplicable anxiety. Even before I got out of bed, I already felt deeply tired. Shoulders cramped with tension. Fear nestled under tightly closed eyelids. I desperately wanted to burrow deeper under the covers, close my eyes and not think about the day ahead. But even if I had the opportunity to do it, nothing would have happened. The cycle of disturbing thoughts would have kept me awake. The day was hopelessly ruined again. Familiar situation? It can happen to anyone, even if at first glance he has a stable, orderly life without any problems.
Where anxiety attacks come from in the morning and how to deal with them, Healthyinfo figured out.
Anxiety after waking up
This condition is manifested by the following characteristic symptoms that appear immediately after waking up:
a feeling of anxiety, restlessness, nervous excitement;
increased irritability, often inexplicable to itself;
fatigue despite a night’s sleep;
trouble concentrating, feeling empty in the head;
general nervousness that is difficult to control;
symptoms of a panic attack: tense muscles, increased heart rate, rapid breathing, a feeling that “blood is knocking at the temples”, etc .;
gastrointestinal symptoms may appear.
What reasons can cause such an unpleasant condition?
Morning cortisol surge and insomnia
Recent studies have shown that the release of the stress hormone cortisol in our body is subject to circadian rhythms. Normally, in a healthy person, the level of cortisol drops to a minimum at 19–20 hours. At night, it gradually begins to rise and the peak of its production falls on the pre-morning hours — this phenomenon is called the “cortisol awakening response” (cortisol awakening response, CAR).
What happens in the body of a person suffering from insomnia or an anxiety disorder? His so-called “stress” system is constantly active — the hypothalamic-pituitary-adrenal axis, which provides the production of cortisol, that is, his nervous system is in a state of constant excitement. It is difficult for such people to fall asleep in the evening due to increased cortisol in the blood. Then they finally fall asleep, but as soon as the pressure of sleep weakens, the person wakes up again and can no longer sleep further, since his cortisol is again at its peak.
The CAR phenomenon is considered one of the causes of premorning and morning complications of cardiovascular diseases. Elevated levels of cortisol in the blood increase blood clotting, which increases the risk of blood clots. Not surprisingly, strokes, heart attacks, and angina attacks most often develop between 6 am and 12 noon.
Another important fact: with a lack of sleep, the activity of the areas of the cerebral cortex that are responsible for regulating emotions decreases. It also increases anxiety in the morning.
Anxiety neurosis and its triggers
This is a mental disorder in which a person is almost constantly in a state of pathological stress, anxiety and fear, and without a specific reason. This condition is also called generalized anxiety disorder (GAD, as it is spelled out in the International Classification of Diseases, ICD-10).
Anxiety neurosis, despite its systemic nature, generalization, can have very specific triggers: problems at work, conflicts with loved ones, frightening news, a pandemic in the yard and fear of illness, etc.
In 2010, psychologists from Pittsburgh (USA) analyzed how relationships within a married couple affect sleep. The experiment involved 29 heterosexual couples who spent the night together. It turned out that the better the relationship within the couple was during the day, the stronger the sleep of both partners was and the better they felt in the morning. The reverse was also true: bad relationships during the day worsened sleep and waking in the morning.
Triggers can also be physiological: hormonal storms (during pregnancy or during the menstrual cycle, disruption of the thyroid gland or adrenal glands), abnormal loads, both intellectual and physical, chronic diseases, especially with a poor prognosis, etc.
Any of these triggers, and many more, can cause sleep disturbances and severe, disturbing awakenings.
Heavy drinking the day before can lead to acute feelings of anxiety the next morning, especially if the person has already been diagnosed with anxiety disorder. Anxiety is part of the hangover syndrome.
Sleep and Awakening Disorders in GAD
For an anxious character neurosis, the so-called paradoxical drowsiness: a person wants to sleep very much, but as soon as he touches the pillow with his head, the dream disappears, as if by magic.
Other sleep disorders associated with GAD include:
Interrupted superficial sleep with frequent awakenings
Such a dream is filled with nightmares, and the awakening is incomplete, giving a feeling of unreality of what is happening. A person seems to hang between heavy dreams and reality, unable to fall asleep soundly or fully wake up. Such sleep does not bring rest and leads to early awakening in a state of anxious excitement.
Short nap after getting up early
A person constantly wakes up between 4–6 am in a state of affective-emotional tension with a feeling of anxiety. He has a chance to continue the dream if he can focus on this task. But if this did not work out right away, the dream will not be returned. Lack of sleep will add to anxiety a feeling of lethargy and weakness, chronic fatigue.
Psychiatrists distinguish the so-called borderline stage: a person can get a full sleep with all its phases and good quality. However, in the morning, he has disturbing doubts — did he sleep at all? It may begin to seem to him that the sleep was not strong, short, while he will not experience drowsiness throughout the day. Doctors point out that often this condition with disturbing awakening is associated with diseases of the heart, gastrointestinal tract, as well as disorders in the intimate sphere.
What to do before bed?
Get rid of gadgets
Today it is one of the main causes of increased anxiety. Alert for a message, tweet, post, letter, comment, etc. pulls a person out of work, rest and even sound sleep. However, the really important messages rarely arrive at 2 am or 6 am. Therefore, at night, turn off the sound of all gadgets and put them away where even the light of the screens will not be visible to you. Moreover, blue light inhibits the production of melatonin, a hormone responsible for quality sleep.
Prepare things and clothes for the morning
Morning bustle can even make a neurotic out of a Buddha. Therefore, it is better to prepare for it in advance. Documents, things, clothes — everything should be collected in the evening, so that in the morning you can get dressed without thinking and go out quickly.
Relieve the stress of the day
Somnologists and psychotherapists recommend stopping all intelligent and digital activities an hour before bedtime (at least half an hour!). Relaxing yoga poses, a warm bath, deep breathing, meditation — any method that relieves nervous tension and brings a calm, sound sleep will do.
“Relax” the mind
Relaxing games of the mind and memory help well: you can try to remember all the known breeds of dogs or mentally walk around a well-known room. You can also remember only the good moments of the day, relive them, feel them. If there are no good memories of this day (anything can happen!) — remember in detail any other positive joyful moment.
What to do immediately after waking up?
Don’t rush to gadgets
You will have time to read important work letters during the working day, or at least closer to its beginning. Waking up in the morning, forbid yourself to look at the phone and read the mail and messages that appeared while you were sleeping. Everything has its time.
Breathing techniques for relaxation and stabilization of the internal state have been known to mankind for a long time. Deep slow breathing with the diaphragm — inhale for 4 counts and exhale for 4 counts — helps to reduce anxiety. This method can also be used during bouts of stress during the day.
For some, morning workouts are a good help to “return to yourself”. But not everyone has the time and energy for physical activity in the morning. Therefore, you can simply stretch from the heart on the rug, allocating yourself 10 minutes for this. If possible, it would be nice to take a walk before work, putting your thoughts in order.
Accept your anxiety
Fix the moment of anxiety, anxiety and admit that it exists, accept the very fact of the presence of such an emotion, without trying to drive the understanding of this into the farthest corner. This reduces the intensity of the struggle with one’s own anxiety, which, when trying not to pay attention to it, flares up more and more.
When should you see a doctor?
You can contact a psychotherapist immediately, as soon as disturbing awakenings have ceased to be isolated cases. At a minimum, their presence indicates the existence of unresolved problems, and a psychotherapist can help find an approach to them.
If the mental disorder progresses, then psychiatric help and medication may be needed.
Finally, during the examination, it may turn out that the matter is not “in the head” of the patient at all, but the cause of the anxiety disorder is a disease that should be treated by an appropriate specialist.
Chronic insomnia and stress system. / Basta M, Chrousos GP, Vela-Bueno A, Vgontzas AN. // Sleep Medicine Clinics. - June 2007 - 2(2)
Daily life stress and the cortisol awakening response: testing the anticipation hypothesis. / Powell DJ, Schlotz W. // PLOS One. - 2012 - 7(12)
Couples’ nighttime sleep efficiency and concordance: evidence for bidirectional associations with daytime relationship functioning. / Hasler BP, Troxel WM. // Psychosom Med. - 2010 - 72(8)