Why do i have panic attacks in the morning

Tips for Coping with Morning Anxiety

Given the stress of living through a pandemic, moderate anxiety is common. Waking up in a panic every morning is more troubling, as it sets in before coping mechanisms can be deployed. Morning anxiety has a biological cause: Cortisol, often called the “stress hormone,” is higher during the first hour after waking for people experiencing stress. Sometimes people feel a measure of control when they worry, so they have trouble stopping the cycle.

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Symptoms of and Myths About Anxiety

Many people conflate stress and anxiety, but they’re different. Webster’s defines anxiety as “being uneasy, apprehensive or worried about what may happen,” whereas stress is “mental or emotional tension or strain characterized by feelings of anxiety, fear, etc.” Stress can also be defined as not having the resources to complete a task, while anxiety is usually tied to a perceived threat, real or imagined. Stress may be alleviated by accomplishing the task, but anxiety sticks around, producing a host of physical and psychological symptoms.

Symptoms of Anxiety

Some of the symptoms commonly associated with anxiety are internally physical in nature, which can range from nausea and headache to rapid heart rate and tight chest. Other symptoms are outwardly physical, such as sweating, shaking or having difficulty breathing. There are also symptoms tied to behavioral or emotional tendencies, such as a sense of panic, difficulty concentrating, restlessness and diminished sex drives. Other potential symptoms are fatigue or problems sleeping.

Common Misconceptions About Anxiety

Unfortunately, there are several myths regarding anxiety and how it’s handled. Some prominent misconceptions include worrying is genetic and incurable, anxiety medication is addictive, using distractions or avoiding stressful situations can help minimize the threat of anxiety, and being around supportive people can cure anxiety.

Prevalence of Anxiety

Anxiety has been on the rise the last few years, as 32% of Americans say they’re more anxious than they were the year before. In 2019, two-thirds of Americans were worried about the safety of themselves and their families as well as their finances. Nearly two-thirds had anxiety about their health, and around half were worried about the effects of politics and had anxiety over various interpersonal relationships.

Ongoing anxiety can cause a variety of physical ailments, such as hypertension (high blood pressure), kidney and heart damage and arrhythmia. It can also exacerbate other conditions, such as depression, irritable bowel syndrome, asthma, heart disease, stroke and chronic pain.

General Anxiety Disorder

While occasional worry is a part of life, frequent excessive anxiety about tasks or situations that most people don’t find threatening could be an indication of generalized anxiety disorder (GAD). Nearly 7 million adult Americans experience GAD annually, per the Anxiety and Depression Association of America. Studies also indicate GAD affects women about twice as often as it affects men. Additionally, people with serious or painful medical conditions or substance misuse problems are more likely to have anxiety disorders.

Everyday Anxiety vs. GAD

An individual experiencing everyday anxiety will spend time worrying about a specific event, assignment, or task. They’ll also have trouble sleeping or concentrating during stressful times, and they’ll experience physical aches and pains from specific situations.

An individual with GAD will experience ongoing general worry about vague, often imagined threats that interfere with daily life. They’ll also experience frequent trouble sleeping or concentrating and experience physical aches and pains for more than six months without a specific cause.

Tips for Reducing Morning Anxiety

If a racing heart or upset stomach greets you first thing in the morning, you can do a few things to help ease your everyday anxiety. For instance, you can engage in exercise, which increases endorphins, improves mental focus, and elevates mood. You can also practice meditation or mindfulness, which can improve ability to calm the mind and stop the cycle of anxious thoughts.

Another tip involves limiting stressors, such as waiting to check news or social media, using an alarm clock instead of a smartphone, or taking the time to self-care. Additionally, you can use tactics designed to exert a sense of control, such as daily planning or writing down and “fact-checking” nagging fears. Finally, resources like meditation apps or podcasts focused on decreasing feelings of isolation can be valuable.

Reaching Out Can Help

If anxiety is impacting your sleep, work, relationships or ability to focus, seek professional help. The National Alliance on Mental Illness connects people with professionals in their area. Call 800-950-NAMI or text “NAMI” to 741741. If anxiety is causing suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).






https://www. frontiersin.org/articles/10.3389/fpsyg.2019.01684/full









Why Do I Feel Anxious When I Wake Up in the Morning?

Do you ever experience racing thoughts or anxiety in the morning before you even have a chance to hit snooze on your alarm? If you do, you’re not alone.

While some anxiety is considered a normal part of life, excessive worrying about daily tasks or situations that others see as nonthreatening may indicate an anxiety disorder.

Although not a medical term, morning anxiety refers to waking up with feelings of stress and worry. If you are dealing with excessive anxiety, worry, and stress in the morning, there’s a good chance you may also have generalized anxiety.

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrolled worry that pervades daily life and occurs frequently for at least six months. People with GAD typically worry about everyday actives such as work, money, family, and health.

The symptoms of morning anxiety often mimic those of generalized anxiety disorder. If you are struggling with anxiety upon waking, you may be experiencing:

  • feeling restless, “on-edge,” or “wound up”
  • irritability
  • fatigue
  • signs of a panic attack, such as tight chest,
    tense muscles, higher than normal heart rate, or difficulty breathing
  • difficulty concentrating and finding your mind
    goes blank
  • difficulty controlling the worry or nervousness

Morning anxiety can be caused by many factors that may also contribute to an anxiety disorder. Since morning anxiety is a reaction to excess stress and worries, there are several potential causes that may contribute to your symptoms.

The “stress hormone” cortisol is released by the adrenal glands in response to fear or stress. Researchers have studied the cortisol awakening response (CAR) and have found that cortisol is highest in the first hour of waking for people with an increased level of stress in their lives. This helps explain why you may experience an increase in anxiety in the morning.

What you eat and drink first thing in the morning can also contribute to higher levels of anxiety in the early hours of the day. Caffeine and sugar can increase anxiety symptoms. But low blood sugar due to a lack of food can make anxiety symptoms worse.

If you go to bed worrying or wake up during the night with anxious thoughts, you are likely to feel anxious and concerned about your day in the morning.

Living with an anxiety disorder can feel like a never-ending cycle of worry. But it doesn’t have to take over your life. With the right treatment, you can learn ways to cope with your symptoms. Some of the more common ways to treat morning anxiety include:


Otherwise known as “talk therapy,” psychotherapy can help you understand how anxiety affects your life. Your therapist will also work with you to develop strategies that decrease the severity of your symptoms. Cognitive behavioral therapy (CBT) looks at the important role of thinking in how we feel and what we do. CBT teaches you new ways of thinking, acting, and reacting to situations that cause anxiety.


Medications such as antidepressants and anti-anxiety drugs can help relieve the symptoms associated with anxiety.

Lifestyle changes

Many lifestyle changes can help you manage morning anxiety, including:

  • getting enough sleep
  • limiting alcohol and caffeine (both can trigger
    anxiety and panic attacks)
  • eating a healthy diet that limits processed food
    and sugar
  • reducing stress at work and home

There are also self-care strategies you can use right when you wake up feeling anxious. This includes:

Physical activity

Exercise is one of the best things you can do for yourself in the morning, especially if you are dealing with an excessive amount of worry when you wake up. Any physical activity, such as taking a walk, can:

  • lift your mood
  • reduce anxiety symptoms
  • improve your body’s ability to handle stress
  • help you relax

Aim to exercise at least five days per week for 30–45 minutes each session.

Practicing mindfulness and meditation

The goal of meditation practice is to be aware, and to observe and notice thoughts, feelings, and body states without reacting to them or believing them to be true.

While it may take practice to get into a mindful state when you wake up in the morning, it can help to reduce anxiety symptoms.

Deep breathing exercises

Deep breathing done first thing in the morning can help take the focus off of your negative and anxious thoughts and turn your focus and energy toward your body.

Challenging negative thoughts

If you wake up with negative thoughts about your day (often called “awfulizing”) challenge them and focus on what you can control. You can keep a journal by your bed and write down what you are grateful for. It’s also a good idea to list at least three things you are looking forward to.

If you’re new to these techniques and you’re finding that managing morning anxiety is a lot harder than you thought, try setting a worry timer. Give yourself a time limit of 10 minutes to experience those feelings. When the timer goes off, move on to your self-care strategies. Though you can’t expect to simply “turn off” your anxiety, this approach allows you to acknowledge your worry and gives you a concrete point at which to move on to self-care.

Even though the symptoms of morning anxiety can feel overwhelming and permanent, they are highly treatable. When you combine professional treatment along with the self-care strategies listed above, you can experience relief from the racing thoughts and worry that invade your mind.

Panic attack

Panic disorder affects a large number of people in every country in the world. Many researchers believe that at least 10 percent of citizens have experienced panic attacks at one time or another in their lives, and anxiety disorders in general are familiar to at least a quarter of the world's population! Where are these people, you say? The fact is that many, and perhaps you, hide their frustration from others. This is due to fears of being rejected by society as crazy, getting into a "psychiatric hospital" and "perishing there" and other catastrophic scenarios. Therefore, many people suffering from panic attacks are afraid to go to specialists and even share their experiences with relatives. So they suffer "in silence", experiencing their own fears with themselves and considering their illness and "trouble" a unique phenomenon, little known to modern medicine. True, Internet resources have somewhat corrected the state of affairs with education in this area. But even here, to put it mildly, not all information options are equally competent and useful.

Concerning the common fear of going crazy when experiencing panic disorder. A panic attack does not lead to insanity, since panic is a natural, albeit peak, emotion of fear. If fear, even very strong, could drive one crazy, there would be no mentally healthy people around. Although some psychiatrists suspect this, let's not rely on private opinion, but follow the scientific interpretation. Insanity is a limited list of severe mental illnesses that are caused by biological causes and are called "endogenous" (that is, "generated inside"), or conditions that manifest as a violation of mental processes and are associated with chemical, traumatic, infectious, organic, and the like damage to the brain. character that is physical rather than psychological. Neurosis, including panic disorder (panic disorder), is a functional disorder of higher nervous activity. If we take a computer as a metaphor for the human psyche, then with neurosis, a “program crash” occurs, and not a “breakdown” (like, for example, a “burnt out” hard drive). By what you experienced, you did not "burn" your brain, and did not encode your genome in a different way. Otherwise, using this logic, you would have to be afraid that after strong experiences you might wake up in the morning and find that you suddenly changed gender, nationality or even race (which at one time was determined precisely by the chromosome set inherited from your parents) .

Panic disorder is definitely manageable! Strategically, you need to complete a full course of psychotherapy. The most effective in the world practice for such disorders is recognized as the cognitive-behavioral direction of psychotherapy. Tactically, antidepressants with anti-anxiety effects and tranquilizers can be used for situational relief of a panic attack, anxiety or fear. However, it should be understood that in most cases, medications will only act as a “crutch” and a temporary outlet, they are not able to change your attitude and the habit of scaring yourself already formed at the level of complex reflexes. Behind a variety of external symptoms, your fear of death and anxiety of losing control require more thoughtful analysis and a deeper study and transformation of the existing system of relations.

before bedtime, during sleep, after sleep.

A sudden panic attack can occur at night - before bedtime, during, and also in the early morning after sleep. Panic attacks during sleep accompany the same symptoms as daytime vegetative crises: in addition to a strong sense of fear, a person experiences suffocation, as if he does not have enough air, his heart rate increases, tremors appear in the limbs, less often - numbness, chills run through the body, and cold sweat, often against the background of an attack, an upset stomach occurs, and the feeling of anxiety increases. A person has a desire to go out into the air to “breathe”, call an ambulance, or even remain motionless under the covers, waiting for an attack of “horror”.

Often, panic attacks during a night's sleep are confused with a heart attack, with a normal reaction to a nightmare, or even with a slight clouding of the mind. However, the fact that a person cannot fully rest and sleep during a night's sleep is clear evidence that the balance between the mechanisms of excitation and inhibition, for which the vegetative part of the nervous system is responsible in our body, is disturbed. At the chemical level, this process in the human body is manifested by an imbalance between the production of adrenaline, norepinephrine and acetylcholine. The production of the latter becomes insufficient to “extinguish” the exciting effect of adrenaline on the body, which is why the above-described state occurs.

It should be noted separately that caffeinated drinks consumed in the late evening or early morning also often cause a panic attack in patients with impaired functioning of the autonomic nervous system.

Panic attack before sleep

Panic attack at night is often manifested by insomnia. The patient cannot sleep for hours, experiencing ever-increasing anxiety. This state develops into a feeling of intense fear up to the fear of going crazy and even dying.

Anxiety can occur for no apparent reason, but more often it is caused by important events of the day ahead: a significant meeting, speech, exam, trip, etc. The attack is accompanied by obsessive thoughts: what if something does not work out? What if I get into an awkward situation? suddenly I feel bad?

Any stressful factors can serve as an additional catalyst that triggers the mechanism for the development of a panic attack at night. Thus, an unstable psycho-emotional state caused by problems in the family, at work, with money or health also creates favorable conditions for the development of night attacks. In this case, the patient is visited by obsessive thoughts related to the current state of affairs.

The patient himself may associate his “nervousness” and irrational behavior with increased emotionality and anxiety characteristic of him “in life”, and for a long time ignore his painful condition or alleviate it with the help of sleeping pills or antidepressants.

Undoubtedly, the personal qualities of a person, such as increased anxiety or emotional sensitivity, become the soil on which a disorder of the autonomic nervous system can develop. However, this is not a reason to ignore such manifestations of this disorder as panic attacks, since by letting the disease “take its own course”, we exacerbate its harmful effects on our entire body.

Thus, with a milder form of autonomic disorder, the patient may experience stomach problems only directly during the moments of his nightly "experiences". However, in a patient whose disease is already at a more advanced stage, gastrointestinal upset is observed constantly, including in the daytime, even with the slightest mental, emotional or physical stress. That is, the body cannot withstand the systematic load at night and the lack of proper rest during the night's sleep, the “spring” of the ANS, which is responsible for excitation and inhibition in our nervous system, eventually completely fails and autonomic nervous disorder progresses. Therefore, it is important to prevent the development of a disorder of the autonomic nervous system as early as possible.

Panic attack in sleep

In the middle of the night, people with disorders of the autonomic nervous system are often disturbed by sudden awakenings, which seem to “throw” a person out of sleep - “as if from a push”. Abrupt awakenings can be accompanied by so-called "nightmare" dreams, which are often perceived by the patient as the main cause of fear, increased heart rate, chills, sweat and other symptoms, which are actually direct symptoms of a panic attack at night.

"Nightmares" often accompany a panic attack in a dream and are direct evidence of an autonomic disorder of the nervous system. This phenomenon is also associated with excessive production of adrenaline in the blood even at a time when our body is trying to tune in to rest: the harmonious unity of the chemical processes occurring in our body is disrupted, and sleep is abruptly interrupted.

Panic attack after sleep

Panic attack may occur in the early morning. Long before the alarm should go off, a person suddenly wakes up from a strong sense of unreasonable anxiety and can no longer sleep. The attack is accompanied by obsessive thoughts and feelings of "brokenness", fatigue. The person does not feel rested, but can no longer fall asleep. Symptoms of a panic attack after sleep: a person wakes up abruptly in a strong agitation, reaching the fear of death, feels chills or, conversely, a flush of heat, a rapid heartbeat, trembling in the body, headache, nausea or diarrhea are possible.

A person who has suffered a panic attack before, during or after a night's sleep experiences a breakdown in the morning and throughout the day, loses interest in life, he has a fear of leaving the house, going to work or school, that is, new panic attacks. In parallel, an additional burden is placed on the entire body, the psycho-emotional background worsens, and, as a result, the disease progresses.

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