There’s a good explanation for why your mental health tanks during a certain period. Thankfully, there’s also a way to fix it.
Anxiety has been a constant, if unwelcome, companion for as long as I can remember.
Therapists, meditation and self-help books have given me tools to cope with my racing thoughts and mental spirals for the most part. But lately, I’ve noticed a sudden increase in anxiety at the same time every afternoon — no matter what I’m doing. This recurring anxiety spike happens when I’m working, spending time with my kids or relaxing on the weekends. Usually, it’s around 4-6 p.m.
It feels like my mood plummets. Sometimes it’s accompanied by a racing heartbeat and an intense fight-or-flight feeling. Other times it feels like a slow sense of dread, where I just want to curl up on the couch and disappear. Because it’s been happening so frequently, I have begun to feel anxious thinking about this part of my day, trying not to schedule anything important during these hours, and just hoping to get through it.
If you have an anxiety disorder — which is the most common mental illness in the U.S., affecting 40 million adults every year — then you know what it’s like to feel debilitated by anxiety. In fact, the Mayo Clinic says people with anxiety disorders “frequently have intense, excessive and persistent worry and fear about everyday situations.” And the American Psychological Association notes that those with anxiety disorders “usually have recurring intrusive thoughts.”
So why does this recurring anxiety happen at the same time every day, and more importantly, what can we do to stop it?
Luckily, just because it’s common doesn’t mean you have to suffer. There are many ways to cope with anxiety ― even the kind that occurs at the same time every day for seemingly no reason.
What causes recurring anxiety
Despite how annoying this particular anxiety issue can be, it isn’t exactly uncommon.
“Anxiety is defined as a feeling of worry and nervousness that is often accompanied by physical symptoms of sweating, heart palpitations, stomach pains or nausea,” said Desreen Dudley, a licensed clinical psychologist for Teladoc. “Anxiety is often triggered by an upcoming event or an unknown outcome to a circumstance, in which a person worries about what to expect or anticipates a negative outcome, respectively.”
Because our brains can learn anxiety, “our bodies and brains often learn to react with anxiety at a certain time of day or in certain situations,” Dudley said. “For example, I treat many patients who experience onset anxiety in the morning when they get ready for work, especially if their job is a great deal of stress for them.”
It’s possible to condition ourselves to have anxiety at the same time every day, albeit subconsciously, added Suraji Wagage, a licensed clinical psychologist and director of the Center for Cognitive Behavioral Therapy and Mindfulness.
“We are constantly making connections between seemingly unrelated stimuli each day, which can become ingrained associations,” Wagage said.
If you have insomnia, then you might suddenly feel wide awake when you lie down to sleep. “Some patients have paired being in bed and being awake by repeating the experience of being awake in bed over and over, so now even if they are sleepy when they lie down, lying in bed actually elicits wakefulness,” Wagage explained.
Similarly, we can associate something anxiety-provoking that happened in the past with a time of day in our present. This could happen after experiencing a trauma at a certain time of day in your past (or a certain time of year or certain type of weather). So, you continue to feel anxious at the same time every day or when the forecast shows the same type of weather.
Experiencing a lack of distractions that normally keep your anxiety at bay can also be a major cause of recurring anxiety. That’s why it can crop up on the weekends or in the evenings.
“We often don’t have time to worry when our day is filled and busy, and anxiety can creep in when we have unstructured time,” Wagage said. “This is why many people report that they feel suddenly anxious at night when everything else is taken care of and it’s time for bed.”
Recurring anxiety could also be a sign of having generalized anxiety disorder or metabolic and hormonal imbalances, according to Sanam Hafeez, a New York-based neuropsychologist, director of Comprehend the Mind and a faculty member at Columbia University.
“Suppose your anxiety seems to increase at night,” Hafeez said. “In that case, the amount of caffeine you had during the day, medications and certain medical conditions can contribute to the increased anxiety at night.”
Other factors that can contribute to recurring anxiety also include environmental factors, stress, genetics and brain chemistry. “Even skipping meals, health issues, medications, or personal triggers that remind you of a traumatic event or bad memory can cause anxiety at the same time every day,” Hafeez added.
“Our bodies and brains often learn to react with anxiety at a certain time of day or in certain situations.”– DESREEN DUDLEY
Recurring anxiety in the afternoon happens frequently
Peaking anxiety every afternoon may be attributed to what you may be associating with that particular time of day, according to Dudley.
“If your afternoons are usually filled with many tasks that need to be done — child care, transportation or afternoon meetings for work — you may subconsciously associate afternoon with a past or anticipated stressful event, which would trigger your anxiety around this same time of day,” she said.
After you’re triggered, your anxiety takes over. “Anxiety tends to have a cascading effect,” Wagage said. “First, even subconsciously, we pick up on something like our heart beating a bit faster for no particular reason, which then leads to a thought of ‘uh oh, something is wrong with me,’ which then leads our heart to beat even faster and sweating and shaking to start, which leads to even more catastrophic thoughts and so on.”
“This is to say that even if something very minor, or nothing in particular, triggers the initial anxiety symptom, anxiety can self-perpetuate into a spiral,” Wagage continued. “This spiral can then get paired with the time of day when it happened.”
Additionally, a physiological trigger could be to blame. You could be under more stress in the afternoons, or it could be related to a drop in blood sugar.
“Some individuals may experience more stress or demands at a specific time of the day, or their glucose levels may fluctuate as the day progresses, which may trigger or exacerbate fatigue or mood and anxiety changes,” said Leela Magavi, a Johns Hopkins-trained psychiatrist and regional medical director for Community Psychiatry and MindPath Care Centers.
Magavi said afternoon anxiety could also be triggered by feeling tired, especially when you feel you still have so much to finish. Of course, “frequent rumination and negative thinking could worsen mood and energy,” Magavi noted.
How to overcome or prevent recurring anxiety
Start by doing a little research. Over the next few days, gather as much information on your recurring anxiety as you can.
According to Wagage, some questions you should ask yourself include:
- What time of day do you experience sudden anxiety?
- How high would you rate the anxiety on a scale of 0-10?
- What accompanying thoughts and physical sensations did you notice, including thoughts about your anxiety?
- What did you do or want to do when you felt anxious?
- Is there any context that might be worth noting? (e.g., Did you sleep poorly the night before? Did you have a stressful day at work? When did you drink coffee? Did you take any medications?)
She said that even the act of observing your anxiety in this way “transforms the experience fundamentally.” Now, you are on the outside looking at your anxiety, which can “lessen the intensity of the emotion.”
Next, you can start to change the pattern. “Try being somewhere else at that time of day and doing something else, like watching a movie with a friend, taking a swim, or going for a hike,” Wagage said. “If the anxiety arises while doing this activity, practice recognizing it and then continuing what you were doing. Exercise may be particularly helpful because there is overlap between the physical sensations during and after exertion and anxiety — we can start to reinterpret these uncomfortable sensations as part of exercise rather than anxiety.”
One important thing to note: You shouldn’t try to avoid the anxiety. “Anxiety is part of life and challenging, fulfilling things often come with anxiety,” she said. “Rather, you want to be able to do the things that are meaningful without being held back by anxiety.”
Hafeez recommended being present in the moment when your anxiety occurs. “Be aware of the moment that you are in when these anxious thoughts appear,” she said. “Once you are aware of the present moment, close your eyes, and take a few deep breaths into your low belly.”
“Learn to accept that not every thought signals a sensible reason to worry, and not every thought is true,” Hafeez continued. “Instead of believing the thought, arguing it, or trying to fix it, let the thought come, label it (such as ‘judgment’ or ‘worry’) and replace your negative thought with a positive one.”
Another thing you can try is to identify what is triggering your anxiety and tackle those things accordingly. For example, if you are “experiencing anxiety due to caffeine consumption, it may be helpful to dilute [your] coffee or switch to tea,” Magavi said.
If you “experience burnout around this time, it may be helpful to take a break to walk or stretch,” she added. “Healthy distractions can decrease the activity of the amygdala, which is the fear center of the brain.”
If you find that ruminating on negative thoughts is contributing to your recurring anxiety, Magavi recommended listing your accomplishments, including small victories, and meditating on those. She also said to repeat positive affirmations, write gratitude letters to yourself, visualize success, and imagine victories in order to “alleviate anticipatory anxiety and negate negative feelings associated with rumination.”
You could also set aside the time you normally feel anxious to read, relax, spend time with family, create lists, journal, pray, do art or travel. Seeking help during these times is also a good idea.
“Some of my patients schedule to see me during these recurrently stressful times,” Magavi said. “Scheduling an appointment with a therapist or psychiatrist during these times could help pinpoint triggering and alleviating factors, and consequently, expedite the healing process.”
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