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Waking Up With Anxiety: Causes & Calming Techniques

Bisma Anwar, LMHC — Tue, 15 Mar 2022 18:39:54 +0000

Waking up anxious in the morning, or waking up at night with anxious thoughts or feelings is common for many people. Nearly everyone experiences feelings of anxiety and stress periodically. However, if your anxiety is affecting you daily when you wake up or causing incessant sleeping problems or other physical symptoms, it might become overwhelming to the point that you can’t perform routine activities like work and interacting with your family.

Here, we’ll look at some of the common symptoms of morning and sleep anxiety. We’ll explore some of the causes that can be contributing to you waking up early with a sense of dread about your day. We’ll also offer various calming techniques that you can use, beginning tomorrow morning, to decrease the frequency and intensity of waking up with anxiety every morning.

Why Do I Wake Up With Anxiety?

Waking up with anxiety can put a real strain on your day. Right from the jump, you’re stuck feeling that heavy weight of stress and dread. Some common symptoms of morning anxiety are:

Feeling like your day is doomed right from the beginning
Feeling fatigued, even though you just woke up
Feeling like you just can’t get out of bed
Difficulty focusing and concentrating
Rapid, shallow breathing
Rapid heartbeat
Perspiring

So what causes anxiety in the morning?

The natural response

The most common theory about waking up with anxiety has to do with a stress hormone called cortisol. As a defense mechanism designed to protect us, our brain and body will naturally react to stress by raising our cortisol level. Although we no longer face the types of threats our ancestors once did, stress results in our bodies and brains reacting as if we’re under attack.

Thus, when we’re stressed, we release more stress hormones, including adrenaline and cortisol. Adrenaline causes the heart rate to increase, boosts blood pressure, and spikes energy supply. Cortisol is the primary stress hormone in the body. It acts to release more glucose into the blood and enhances the brain’s usage of those sugars to enhance alertness and prepare us to defend ourselves.

Research has shown that cortisol levels already surge in the morning for the first 30 – 45 minutes after waking. This is known as Cortisol Awakening Response (CAR) and may increase morning anxiety.

Stress

The common demands of life, like taking care of your family, accomplishing a huge workload, paying the bills, and preparing for the future, are all stressors. The limbic system of your brain perceives stressors as threats, and that can make you feel anxious from the moment you wake up each morning.

Substance abuse

If you’re using or abusing drugs and/or alcohol, waking up with anxiety can be common. While substance abuse may not have direct links to anxiety, it is known to increase anxiety symptoms.

Relationship struggles

Some studies show that the energy in a relationship may affect how well you sleep at night and how rested and calm you wake up in the morning.

Physical health problems

If you’re dealing with a chronic health condition, it’s natural to be stressed. Anxiety is common for those who have heart disease, diabetes, cancer, asthma, hypertension, and other serious health-related issues. Waking up with anxiety in the middle of the night or in the morning can be common when you have a serious medical condition.

Financial stress

Worrying about money is a normal stress for many adults. Especially if you’re financially insecure, waking up with anxiety about how or when you’ll be able to pay rent, buy groceries, or cover bills is not unreasonable.

Mental health conditions

Like our physical health, mental health conditions can weigh heavily on our psyches. Living with bipolar disorder, depression, or another mental health disorder can result in heightened anxiety or anxious thoughts at all times of the day, even in the mornings.

“If you find yourself waking up feeling anxious, ask yourself what happened the night before? What were you thinking about before you went to bed? These questions can help you identify the cause of your anxiety.”

Talkspace therapist Bisma Anwar, LMHC

Fortunately, there are various techniques you can employ, beginning right now, that are known to alleviate morning anxiety symptoms. You can practice these daily upon waking and decrease the frequency and intensity of morning stress.

6 Calming Techniques to Avoid Waking Up with Anxiety

Wondering how to stop waking up with anxiety? You’re not alone. Let’s review some techniques that have been found to help many people wake up more confidently, calm, and energetic, ready to face their day.

Though you might not be able to totally prevent the feeling of anxiety or panic you experience when you first wake up, you can help lessen the physical symptoms and severity with natural remedies for anxiety. Try using any or all of these methods right away.

“There are many ways to help calm your anxiety. You can do a guided meditation, do yoga or a workout, engage in a deep breathing exercise, have a healthy breakfast, listen to relaxing music, take a walk, or write a journal.”

Talkspace therapist Bisma Anwar, LMHC

Change your diet

The foods and beverages we choose to consume have an effect on our mood and functioning. Neurotransmitters, hormones, and other biological chemicals are all synthesized in our bodies based on the nutrients (or lack thereof) we get through our diet.

Studies show certain foods are associated with anti-anxiety effects. These include:

Brazil nuts
Eggs
Pumpkin seeds
Chamomile
Yogurt
Turmeric
Dark chocolate
Fatty fish like mackerel and salmon

Consider adding more of these foods in your daily diet to help your anxiety levels.

Also, you might want to watch your intake of caffeine and other stimulating substances. If you’re already prone to anxiety, caffeine might exacerbate those symptoms. A glass of warm lemon water or decaf tea with honey in it may not be as exciting as that strong cup of coffee, but it can definitely be more calming.

Meditation & deep breathing (pranayama)

Mindfulness meditation offers many benefits to improve emotional and mental health. You can do it anywhere, without any equipment or memberships. Most communities have group meditation courses and support available. There are several different meditation styles, each having benefits for generalized anxiety disorder. Even just five minutes of meditation or deep breathing exercises for anxiety daily can have measurable benefits.

Leave the television off & opt for music

Repetitive exposure to negative stories like what we see and hear in the mainstream media these days has been linked to increased anxiety. If you don’t like the silence in the morning, try putting on some calming music to create a more relaxing environment. Remember, “calming” doesn’t have to be the same for everyone. You might prefer classical music, jazz, acoustic…try whatever is soothing to you.

Exercise

There are several various ways that daily exercise helps to alleviate a high anxiety level, including:

Diverting your attention from what’s making you anxious
Activating executive functions in the brain
Decreasing muscle tension
Altering brain chemistry

Regular exercise builds up resources in the body that help increase resilience to erratic emotions. Exercise actually changes your brain chemistry by increasing the availability of neurochemicals that work against anxiety, including gamma-aminobutyric acid (GABA), serotonin, various endocannabinoids, and brain-derived neurotrophic factor (BDNF).

Journaling

Taking a few minutes each morning or at night just before bed to jot down your anxious feelings or thoughts can help to calm your mind and focus your thoughts. If you’re journaling in the morning, try tracking your dreams from the night before.

Solidifying your relationship with yourself is an excellent way to decrease nighttime anxiety. Doing so can help you stay in touch with your goals and aspirations and spot negative emotions creeping up on you as they occur.

Create a morning routine

Develop a realistic routine for your mornings, and then stick to it. Having a schedule helps you stay focused on your goals and avoid distracting thoughts and actions. It can also let you feel more steady, which can reduce anxious feelings that might stem from a feeling of being out of control. Additionally, knowing you have a routine to wake up to in the morning might help you stop waking up with anxiety in the middle of the night.

Learning How to Manage Anxiety Day-to-Day

If you’re waking up with anxiety every morning, cognitive behavioral therapy (CBT), exposure therapy, and other types of therapy for anxiety and techniques can help. Working with a therapist, you’ll learn new coping skills for how to treat anxiety that can work to decrease your morning stress.

You might also consider taking prescription medication for anxiety like benzodiazepines, anti-anxiety drugs, beta-blockers, or antidepressants, but note that these are often associated with adverse side effects and do little to solve the core problem causing your anxiety. If you and your doctor do decide to try medication for generalized anxiety disorder, it likely will be a short term solution that’s coupled with effective, proactive strategies like those we’ve discussed here today.

Focusing on holistic approaches like mindfulness meditation, taking a relaxing bath, setting and being committed to goals, and showing gratitude are all simple, effective ways to combat waking up with anxiety every morning.

Each of them can help to reduce morning anxiety symptoms so you can have calmer, happier days. If you’re ready to start your journey and take steps to learn how to stop waking up with anxiety, Talkspace can help. Our approach to online therapy makes the process as easy as possible. Get started by connecting with a therapist for a possible anxiety diagnosis.

Sources:

1. Powell D, Schlotz W. Daily Life Stress and the Cortisol Awakening Response: Testing the Anticipation Hypothesis. PLoS One. 2012;7(12):e52067. doi:10.1371/journal.pone.0052067. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527370/. Accessed February 13, 2022.

2. Hasler B, Troxel W. Couples’ Nighttime Sleep Efficiency and Concordance: Evidence for Bidirectional Associations With Daytime Relationship Functioning. Psychosom Med. 2010;72(8):794-801. doi:10.1097/psy.0b013e3181ecd08a. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950886/. Accessed February 13, 2022.

3. Liu C, Liu Y. Media Exposure and Anxiety during COVID-19: The Mediation Effect of Media Vicarious Traumatization. Int J Environ Res Public Health. 2020;17(13):4720. doi:10.3390/ijerph17134720. https://www.mdpi.com/1660-4601/17/13/4720. Accessed February 13, 2022.

4. Audiffren M, André N. The exercise–cognition relationship: A virtuous circle. J Sport Health Sci. 2019;8(4):339-347. doi:10.1016/j.jshs.2019.03.001. https://www.sciencedirect.com/science/article/pii/S2095254619300298. Accessed February 13, 2022.

5. Brellenthin A, Crombie K, Hillard C, Koltyn K. Endocannabinoid and Mood Responses to Exercise in Adults with Varying Activity Levels. Medicine & Science in Sports & Exercise. 2017;49(8):1688-1696. doi:10.1249/mss.0000000000001276. https://www.ncbi.nlm.nih.gov/pubmed/28319590. Accessed February 13, 2022.

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Cognitive Behavioral Therapy for PTSD Treatment

Ashley Ertel, LCSW, BCD — Wed, 22 Sep 2021 18:20:15 +0000

Cognitive behavioral therapy (CBT) is a popular form of psychotherapy that starts with a basic premise: if we can change how we think, we can change our behavior patterns.

CBT has proven to be an effective treatment for a number of mental health conditions, and it’s thought to be one of the most effective options for treating post-traumatic stress disorder (PTSD). Considering the fact that almost 9 million adults in America have PTSD, it’s critical to look at effective treatment options like cognitive behavioral therapy to see how they can help. CBT for PTSD encourages those struggling to adopt skills that help treat, and in some cases even eliminate, PTSD symptoms.

Does Cognitive Behavioral Therapy Help With PTSD?

There are several CBT techniques that are effective in treating individuals with chronic PTSD. CBT for PTSD can make it possible for a person to benefit from:

Association shifts: The memories of traumatic events can be triggered by any number of situations, including news headlines, conversations, and physical locations. CBT helps people change how they process these associations so they can protect their core emotions.
Improved social cognition: CBT challenges an individual’s own harmful beliefs. For instance, if someone thinks their trauma occurred because they somehow deserved it, a therapist can use cognitive behavior therapy to help them work through those thoughts so they can better understand the reality of what happened to them.
Education: Educating someone about common PTSD reactions helps them to begin to learn how to manage stressful situations and work on having a plan of action for any known triggers.

Many of our belief patterns are based on shortcuts that help us make sense of our world. When someone feels like they need to find a reason for their trauma, doing it alone (without the guidance of a therapist) can result in solutions that aren’t always helpful in terms of mental health. Cognitive therapy for PTSD makes it possible to accurately view trauma in the context of the bigger picture.

“Trauma can change how we view ourselves, other people, and the world. CBT techniques can support clients in developing a realistic and beneficial perspective.“
Talkspace therapist Liz Kelly, LICSW

Core Components of CBT

While there are a number of CBT techniques widely used, there are two core components of CBT for PTSD that are known for their efficacy in reducing PTSD symptoms. In general, all subsequent techniques will fall into one of these two overarching categories.

Cognitive restructuring

Cognitive restructuring is a technique that helps someone make sense of a traumatic experience or memory. It’s normal (and actually very common) to recall a trauma slightly to significantly different than how it actually happened. For example, some people will remember a traumatic experience in a disjointed way. Or they may completely block out certain parts of what happened to them. They also may have feelings of shame or a sense of guilt associated with their trauma, despite it not being their fault.

Exposure therapy

Exposure therapy is an intervention geared towards helping people face and then conquer their fears. It works by reliving a traumatic memory in a safe space. This type of therapy often uses writing, mental imagery, or even visits back to places where a traumatic event occurred. It can also include discussions and visits with actual people who were involved as well.

CBT incorporates a number of specific beliefs that work together, including:

Psychological disorders are based on faulty thought patterns, which can then lead to faulty behavior patterns.
If a person can learn how to recognize these thought patterns, they can reevaluate whether there’s any truth to them.
Once someone gains a better grasp of their own thoughts, they can begin to understand their own behavior and the behaviors of others.
Specific problem-solving skills can be taught and implemented for better coping both in times of crises, as well as in everyday situations.
A person can grow in confidence if they confront their worst fears and work towards conquering them.

Types of CBT Techniques for PTSD

CBT for PTSD is typically approached with one or more of the following types of CBT:

Cognitive Processing Therapy (CPT): CPT asks individuals to confront both a traumatic event, as well as the effects they feel as a result of it. This can be effective for those who feel stuck in one way of thinking, and thus are unable to recover from their chronic PTSD. CPT is a trauma focused therapy that helps break these patterns and helps people to move on.
Prolonged Exposure Therapy (PE): PE relies more on behavioral therapy techniques to help people approach specific memories, situations, and emotions that bring out the worst of their symptom severity. Exposure can be done through imagination, virtual reality, or real-life scenarios.
Stress Inoculation Training (SIT): Stress inoculation training focuses on teaching those with PTSD specific coping skills. Some of these skills can include breathing techniques, muscle relaxation, and cognitive restructuring. This can help someone react differently to scenarios that increased their stress and anxiety at one time due to their PTSD.

“Trauma symptoms can often be physical as well as mental and emotional. CBT for PTSD incorporates education, coping strategies, as well as challenging and reframing unhelpful thoughts and beliefs.”
Talkspace therapist Liz Kelly, LICSW

CBT for PTSD: Different strategies for different people

CBT is not just one strategy or treatment plan. Therapists must work with individual clients to develop a system that works for effective treatment. The goal of cognitive-behavioral therapy for PTSD is for the treatment to be a collaboration between therapist and client. In general, prolonged exposure therapy has been found to be incredibly successful when dealing with post-traumatic stress. Because of that, prolonged exposure therapy is often used in a number of situations when it comes to trauma treatment with positive results.

Regardless of the tactics used though, CBT for PTSD is not always done solely in-session. Those who are suffering from trauma may be asked to do homework as a part of their recovery, too. Reinforcing and strengthening skills between each session can help speed up the therapy process and result in a more effective treatment plan.

Getting Help for PTSD

No matter what the trauma was, or how significant symptom severity is, it’s important that to understand there is help available for those recovering from PTSD. CBT and PTSD go hand-in-hand with one another because ultimately it’s often thoughts and fears resulting from a traumatic experience that lead to the worst symptoms.

By adjusting those thoughts on an incremental basis, many people find they can leave a large portion of a traumatic event in the past without ignoring its significance. Cognitive therapy for PTSD doesn’t seek to discount your lived experiences. Nor does it attempt to minimize the impact or severity of what’s happened to you. Recognizing your experience is an essential part of your healing, so it’s worth noting this aspect upfront. This way you can set healthy expectations about what your therapy will entail.

At its core, cognitive behavioral therapy was founded on the basis of respect for an individual’s feelings. It centers around meeting you where you are mentally. By challenging negative thoughts (for example, the fact that bad things happen to bad people) and offering exposure to situations that were once believed impossible to handle, people with PTSD can start to see their lives from a very different perspective.

Is CBT the right PTSD treatment for you?

There are several treatment options for those looking for help with their PTSD. For example, one such technique, eye-movement desensitization and reprocessing (EMDR therapy), is considered an effective form of treatment.

Other options include problem-solving therapy, supportive psychotherapy, psychodynamic therapy, and present-centered therapy, to name just a few. When looking at all of the therapies out there, CBT for PTSD seems to be associated with better remission rates in comparison overall.

If you have PTSD and are looking for help, traditional therapy settings, where you meet with a therapist face to face is one option. But there are other opportunities for you to seek treatment, too. Online CBT sessions with a trusted, licensed Talkspace therapist can be a first step toward improving your life and reducing your PTSD symptoms.

Cited Sources:

Cognitive Behavioral Therapy (CBT) for Treatment of PTSD. https://www.apa.org. https://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy. Published 2017. Accessed August 18, 2021.
PTSD Facts & Treatment | Anxiety and Depression Association of America, ADAA. Adaa.org. https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/treatment-facts. Published 2021. Accessed August 20, 2021.
CBT for PTSD: Basics and Rationale – Psychotherapy Academy. Psychotherapy Academy. https://psychotherapyacademy.org/pe-trauma-training-ptsd/cbt-for-ptsd-basics-and-rationale/. Published 2020. Accessed August 19, 2021.
What is Cognitive Behavioral Therapy?. https://www.apa.org. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral. Published 2017. Accessed August 20, 2021.
Ioannis Syros. Cognitive behavioral therapy for the treatment of PTSD. https://doi.org/10.1080/20008198.2017.1351219 Published 2017. Accessed August 20, 2021.
Posttraumatic Stress Disorder | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder. Published 2017. Accessed August 18, 2021.

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7 Effective Thought-Stopping Techniques for Anxiety

Melissa Stanger — Thu, 11 Apr 2019 14:15:50 +0000

Anxiety is one of the most common issues I hear about from my clients, one that many people have on a regular, sometimes daily, basis. Of course, anxiety is a normal part of the human experience, and it can be a healthy, biological reaction to environmental stressors.

The problem is when that reaction switches from one of manageable, temporary worry or stress to heightened, intolerable panic. The latter can interfere with work, social activities, and personal relationships. Sometimes anxiety can make it incredibly difficult to function as we normally do, and this is a very scary and uncomfortable feeling.

How do I stop worrying so much?

It is important to understand that overcoming anxiety is an incremental process that won’t happen overnight. Avoiding your worries will only reinforce your fears, so try and manage them instead. One thing you can start doing is trying to think about the facts rather than worrying about the possibilities. This adjustment in thought will simplify your angst and inform your action. Your goal should be to tolerate your anxiety rather than eliminate it, learning to cope with your worries will deduce them to actionable issues.

One of the most effective ways to curb anxiety in the moment is thought-stopping — a strategy that interrupts catastrophic thinking to allow our minds a few moments of clarity to think through the anxiety. Here are seven ways to do it:

1. Scattered Counting

Counting up (or down) to 10 is a great way to handle anger, but it’s not as effective for anxiety because the process is so automatic. While we’re counting chronologically, our minds still have the capacity to ruminate on whatever is causing our anxiety. A better technique is scattered counting. Start with any number and then jump around — 14, 89, 30, 57, etc. It takes more concentration to come up with the next number when you have to think about what it will be, and this helps take your mind off the thoughts that are troubling you.

2. Verbal Interruption

The traditional way to stop thoughts in their tracks is with a verbal interruption. This could be literally spoken out loud, if you feel comfortable doing so, or spoken to yourself in your head. Shouting “stop!” or “enough!” or “not now!” when your worries begin to take over, forces you to take a pause. This can be done as many times as you need to calm your mind.

3. Positive Self-talk

If your thoughts are particularly negative or scary, try restructuring them into ones that empower you. Instead of thinking “I’m so nervous about bombing this presentation at work,” try thinking “it’s okay to be nervous and I can deal with this.” Coach yourself through each anxious thought until your anxiety subsides, and then congratulate yourself on getting through it.

4. What’s the Worst that Could Happen?

Anxiety often takes us to the worst-case scenario. We go from feeling nervous about a presentation at work to worrying about performing badly to worrying about losing our job entirely. If you’re able, imagine going to that worst-case scenario. What would happen if you did lose your job? How would you handle it? What kind of plan would you make to revamp your resume, network with other people in your industry, and apply for new positions? Picturing yourself tackling the imagined worst possibility often gives us confidence that even if the worst were to happen, we would still be able to handle it.

5. Auditory Distraction

Our obsessive thoughts can be so loud in our head, and one great way to drown them out is by listening to something else. Put on your favorite song, your favorite podcast, or an audio book you find interesting and let the sounds coming out of your headphones squash the sounds of your anxiety.

6. Muscle Isolation

Anxiety clogs our minds with unwanted thoughts and obsessions, and keeps us stuck in our heads. By feeling our body intentionally through muscle isolation, we can draw the attention away from our brain and into different parts of our body.

First, sit comfortably in a chair or on the edge of your bed. You can close your eyes if that feels natural to you. Then, starting with your toes, squeeze and hold those muscles and count to five slowly. At “five,” release the muscles and feel your toes completely relax. Repeat this process up your body from your feet to your calves to your thighs to your abdomen, all the way up to your head and back down to your arms, hands, and fingers. An exercise like this relieves some of the tension in your brain by releasing it from your body.

7. Meditation (It Really Does Work!)

Maybe you’ve had a friend or a therapist recommend meditation to alleviate anxiety. Maybe you rolled your eyes at the idea thinking that it would never work for you. Science has proven that it does! Regular meditation changes the structure of the brain and strengthens your ability to combat strong emotions like anxiety. Start by practicing mindful breathing for five minutes a day. You can picture your anxious thoughts like clouds, drifting by you, or like cars passing on the road. Over time, you can work up to 10 minutes, 20, or even an hour of meditation.

When anxiety strikes, it can be difficult not to give in to the obsessive “what-if” thoughts that consume your attention. It’s an uncomfortable experience that is hard to ignore, but with a little practice using thought-stopping exercises, those worries might seem a little less frightening.

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