Learn that Early Morning Anxiety is just Arousal in your Body

The symptoms of anxiety are often worse in the morning and improve throughout the day. Why? Simple answer. When you’re feeling anxious or stressed, cortisol is released by the adrenal glands, along with other stress hormones, such as epinephrine. As it turns out, cortisol is highest in the hour after you awaken, something called the “Cortisol Awakening Response.” The function of cortisol is to increase arousal. Think of it as your body’s way of helping you wake up and focus your attention. Early morning anxiety is just arousal in the body getting you ready for the day.

When you’re already anxious, however, the extra arousal brought on by cortisol accelerates your anxiety. Physically, you feel keyed up, on edge, tense. Psychologically, your thoughts race as sensations of threat impel you to escape. Think of it as waking up with your fight or flight response chronically activated.

Case Example

A client, a retired physics professor reported he’d been anxious literally his entire life. He believed it to have some kind of genetic component. His mother had been hospitalized with anxiety several times during his childhood. At times during his life his anxiety had been very difficult. Nevertheless, he had always managed and did well during his academic career. There was also an overlay of depression secondary to his anxiety. He often felt helpless and hopeless to ever escape the anxiety.

We worked on his anxiety with mindfulness meditation. This allowed him to intercept catastrophic thoughts and respond with self-affirmation. Mindfulness taught the client “observing mode,” as opposed to “experiencing mode.” Even though the client was anxious each morning, he learned to see the consistency across mornings. He eventually understood his early morning anxiety as a hormonal fluctuation, rather than as a feeling caused by some threat in the world, which he had to identify. This gave him some distance from the anxiety and contributed to emotional stability.

We also spent some time working on guilt. Although retired, the client felt that he should continue to be productive every day. We finally decided that because the client is an adult, he’s empowered to both make the rules and changes the rules. If he wants to work on a project, he can. If not, that’s okay, too. But what he absolutely should not do is succumb to a should or must, because that’s not what being an adult is about. Obedience puts him in the role of a child.

Treatment Result

The client improved slowly during the months of the pandemic, during which he was isolating due to his age. His daytime and evening anxiety dissipated, but his early morning anxiety stubbornly refused to disappear. During the early morning hours, I asked him to meditate by bringing his attention to his symptoms, not his breath. He should immediately accept the symptoms in whatever form he found them. He should become aware that the issue is cortisol, not any external threat. Early morning anxiety is just arousal in the body getting him ready for the day. In time, he managed to extinguish any anxiety about anxiety. In particular, he learned that the anxiety would reliably abate as the morning went on. He no longer felt hopeless and helpless, and no longer experienced the bodily arousal as threatening. His anxiety was now predictable, too predictable to make his anxious.