Anxiety is a normal human emotion, which encompasses feelings like worry, apprehension, and nervousness. Some people are prone to anxiety because they have a naturally anxious temperament. For others, their anxiety is so intense that they may have a mental health condition known as General Anxiety Disorder or GAD. Anxiety can be either temporary, chronic, or even cause people concern for their whole lives.
Anxiety disorders can be debilitating to the point where a person is unable to work or function comfortably in society. However, a number of modalities exist which are commonly used to manage anxiety successfully and for treating anxiety disorders.
Many people find their anxiety worse at night. During the day, they have work, family duties, and chores to attend to, which helps keep their mind off their anxiety. By keeping constantly busy, they can keep their anxious feelings at bay. But at night, with fewer distractions, and when it's dark outside, anxiety may come rushing back, into the space left by the absence of intense activity.
When people experience more anxiety in the evening hours, they find it very hard to fall asleep. They may experience racing thoughts, with their mind on overdrive. People may find themselves replaying an entire day's worth of worries and concerns, which seriously disrupt their sleep routine.
If people ultimately manage to fall asleep, it is a step in the right direction, but they are still not guaranteed a restful night's sleep. Many people find they wake up in the early hours of the morning filled with dread. If their anxiety levels are high, they may find themselves getting night sweats - the body's physiological reaction to stress. If they feel under threat or start imagining dreadful events awaiting them, they may even experience an adrenaline rush. This is the body's fight or flight response to a perceived danger. These dangers, however, are almost never there in reality and exist entirely in the person's mind.
Nocturnal panic attacks are another, quite a dramatic symptom of severe anxiety at night. They occur most frequently between around 1:30 and 3:30 am. People wake up suddenly and abruptly, in a state of alarm and heightened anxiety. This often happens for no apparent reason, and in response to no clear trigger. Panic disorder is when panic attacks become recurrent. As a result, they may also begin to happen at times other than the middle of the night.
Panic attacks generally peak within a few minutes, and pass within ten. It can take time for the strong emotions to abate - falling asleep again can be difficult.
Thankfully, there are ways to manage evening anxiety, primarily by implementing lifestyle changes and establishing a healthy bedtime routine.
Aside from the contributing factors mentioned above, a number of other parameters can cause people to experience anxiety at night, and in general also.
At night, the body begins to prepare for rest and restorative sleep. It is a transition time between being fully active in the daytime, and fully at rest when sleeping. When a person's mind is still in overdrive and they are restless and wound-up, the body will generally respond by being tense also.
If the sympathetic nervous system is all fired up from stress and worry, it will prepare the body to respond to perceived danger - real or imagined. A person's heart rate may increase, and their breathing becomes shallow. Even when such physical signs are absent or mild, a person's body is preparing for action if required - the exact opposite of what is required to calm anxiety and return to a relaxed state.
Sleep disorders refer not only to sleep deprivation, but also to difficulty getting adequate sleep - in terms of duration and quality, and at suitable times. Sleep disorders are known to be a major contributor to anxiety, in particular nighttime anxiety. Over time, they worsen anxiety at any time of day, because the body, mind, and nervous system are constantly tired. This is no doubt why so many measures taken to manage anxiety focus on helping people get a restful night's sleep.
Furthermore, if sleep deprivation can worsen evening anxiety, the reverse is also true. Anxiety in general, and in particular nighttime anxiety, make it hard for a person to fall asleep, and then remain asleep until they have taken sufficient rest. It's a bit of a vicious cycle.
Recent traumatic experiences can make anxiety worse. It can take time for a person to process trauma. During the day, painful memories or images can seem less frightening. At night, when the shadows fall, they can return and appear far more menacing. Also, the mind is liable to think less rationally in the late evening or middle of the night, and anxiety at night can get blown way out of proportion.
Memories of difficult experiences, in childhood, adolescence, or early adulthood, are likely to be more deeply ingrained. A common example is physical or emotional abuse. These memories can cause long-term anxiety, and again, the demons of past pain can resurface more intensely when the day is ending in the form of nighttime anxiety.
There is a close connection between the gut and anxious or fearful feelings. If you've ever experienced butterflies in your stomach or felt it churn from apprehension or stress, you'll know that food is the last thing on your mind. Conversely, chronic indigestion and recurrent digestive problems can worsen anxiety. Nighttime anxiety can be worse if a person has not been able to eat a proper dinner, or if their body is too tensed up to process food properly.
Some people get anxious far more often, and more intensely than most of us, and this can significantly affect their life. An anxious temperament can be genetic - if a person develops anxiety in their youth, there is most likely a hereditary component to it.
A condition is considered pre-existing if it is already present when a person seeks advice from a mental health professional. Often, they consult a doctor to help manage stress because they find their anxious symptoms persist or get worse. A medical professional will acknowledge the anxiety issue already present prior to the consultation, and suggest treatment options and tools for reducing anxiety.
Depression is another of a number of mental health conditions that vary in intensity. It, too, can be worse at night, particularly after dark, all the more so in regions where winter nights are long. In general, research indicates a definite connection between depression and anxiety.
In some individuals, anxiety can be secondary to depression; that is, depression occurs first, and anxiety is a consequence. In others, both conditions develop at the same time - this is known as comorbidity. In the latter case, professional help is highly recommended, as it can be hard for a person to manage these two simultaneous medical conditions unassisted.
Anxiety can be triggered by a gradual build-up of negative experiences or a one-off unpleasant event. Stress, frustration, insecurity, and so on can accumulate inside a person to the point where their anxiety levels disrupt their life. Recent trauma is also a common cause of anxiety. And anxiety at night, when a person has more time to worry and imagine terrible outcomes, makes a person less emotionally resilient. Small things, for example, a minor disagreement, an easily rectified mistake at work, being cut off in traffic, forgetting things, and so on, can cause vexation and worry.
Other common triggers are:
Everyone experiences anxiety differently. The foundations for treating nighttime anxiety are proper sleep, rest and relaxation, and nutrition. Of these, sleep is possibly the most important, as the only time a person can escape from compulsive, racing thoughts, and enable their mind to rest, is when asleep. Sound sleep requires a healthy lifestyle too.
Peer-reviewed studies, such as those conducted by the NIH, conclude that there is a strong connection between sleep disturbance and anxiety.
A healthy bedtime routine before sleep should begin with relaxation exercises of some kind, to allow the mind and body to begin to unwind. A long, warm bath, chamomile tea, or other caffeine-free infusions, are a good start for many people. Herbal supplements such as magnolia bark are also known to promote sound sleep.
Exposure to blue light should also be avoided two hours before sleep. Blue light is a natural frequency in sunlight but is also emitted by TV screens, laptops, tablets, phones, and so on. The brain - tricked into thinking it's time to be wide awake - responds by producing less melatonin. Low melatonin is an obstacle to falling asleep.
Anxiety, particularly at night, can severely disrupt your life. Not only are constant anxious feelings burdensome and hard to manage, but stress, lack of sleep, and other consequences of the condition can also make you miserable.
At GIA Miami, we provide a highly comprehensive treatment service, combining advanced technologies and the compassionate support of our experts, to help you regain vibrant and lasting mental health. We work with you to create a tailored recovery program that best suits your individual needs. Contact us today to find out more.
How to Take Care of Your Mental Health
How To Think Positive When Depressed
How Do I Know If I Have Postpartum Depression?