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Q
Anxious in the Morning?

Can you explain why anxiety is worse when waking up than at any other time of day? This has been my wife's pattern for years.

A
Answer (Published 10/29/2010)

Morning anxiety appears to be common, but many people suffer from anxiety at other times of day as well. I have a friend who gets anxious at sundown. Unless there is a particular set of circumstances that occurs every morning your wife may suffer from generalized anxiety disorder (GAD), which is different from feeling stressed out and anxious about specific situations.

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With GAD, individuals can't seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They also seem unable to relax and often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating or hot flashes, lightheadedness, and feeling out of breath.

As an alternative to drugs for managing anxiety, I recommend a number of lifestyle changes that may help. Chief among them are my breathing exercises, which I find to be very effective. Many people experiencing anxiety tend to hold their breath or hyperventilate without being conscious of their actions. Controlling breathing can offer immediate relief as well as a sense of empowerment. The relaxing breath is perhaps the best tool to use in addressing GAD, and the exercise I recommend as the cornerstone of any relaxation program.

Other worthwhile measures include exercise, meditation, eliminating caffeine (from all sources), cognitive behavioral therapy, journaling and taking a "news fast" by avoiding the daily onslaught of (mostly bad) news online, on television and in newspapers and magazines.

Andrew Weil, M.D.

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