Why Is Anxiety Worse in the Morning?

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Many people--including those who suffer from anxiety disorders--report that they feel most anxious in the morning. This morning spike of anxiety has been linked to a surge in the stress hormone cortisol, which peaks shortly after awakening.

Cortisol, Arousal and Anxiety

  • The hormone cortisol is released by the medulla of the adrenal gland as part of the body's physiological, biochemical, emotional and behavioral preparation for physical and mental exertion. Cortisol activates the sympathetic branch of the autonomic nervous system, which then prepares the body for action by increasing heart rate, blood pressure, respiration and more. Anxiety often accompanies this stress response.

Daily Fluctuations in Cortisol Levels

  • According to various studies, cortisol levels increase two- or three-fold within 30 minutes of awakening. Then, over the course of the day, they slowly decrease. This pattern is consistent throughout the week, including days when people don't work.

Morning Anxiety

  • The term "morning anxiety" appears on websites and blogs to describe the heightened anxiety that many people experience in the morning. As of November 2009, the prevalence of "morning anxiety" in the general population is not known.

Morning Anxiety and Anxiety Disorders

  • Studies, including the 1977 study by Knorring, Perris and Strandman, indicate that, on average, people who are diagnosed with all classes of anxiety disorders experience their highest levels of anxiety in the morning.

Other Causes of Morning Anxiety

  • In addition to heightened cortisol levels in the bloodstream, other potential factors causing morning anxiety include the presence of anxiety disorders, hypoglycemia and cognitive factors such as expectations of anticipated events.

Treatment

  • Treatments for morning anxiety can include addressing underlying anxiety disorders, eating complex carbohydrates shortly after awakening, waking up slowly and gently and practicing relaxation, yoga or meditation shortly after awakening.

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