Ah yes. The conundrum that most insomniacs are dealing with. Is it the chicken or the egg – do you have anxiety that causes insomnia, or insomnia that causes anxiety?
When you have an anxiety attack at night, it probably doesn’t feel like it matters much what order it came in. All you know is anxiety and sleep don’t mix, and it makes treating insomnia so much more difficult.
Either way, if you have anxiety and insomnia, you are probably dealing with both.
So let’s dive in.
Anxiety vs. an Anxiety Disorder
Let’s first make a distinction: anxiety and anxiety disorders are not the same thing.
Anxiety is a normal part of life and there are many situations where an anxious response is warranted. In fact, if you weren’t anxious at all, there would be something wrong.
Anxiety is an appropriate emotional response to some situations and can even be useful. You need to experience “negative” emotions like anxiety from time to time because it’s a signal from your brain that something needs to change.
It seems that “anxiety” is the word du jour in North America. We self diagnose and say we have generalized anxiety disorder (GAD) because sometimes anxious feelings arise. It’s almost trendy and chic to identify as an anxious person.
I think it’s because we’re so desperate to find ‘X’ disease to blame for our uncomfortable feelings so we can squash it out like a bug and feel ‘good’ or ‘back to normal’.
However, we have adapted to experience our lives through our diverse range of emotions including anxiety. Imagine if you were just happy all of the time. You wouldn’t even know it because there’s nothing to compare to. How can you have the sweet without the sour? The light without the dark? The heat without the cold, and all those other cliches?
If you have insomnia, this might be part of the equation that you should be cognisant of. But there may be something deeper going on.
Symptoms of an anxiety disorder
An anxiety disorder is more than just the feeling of anxiety. An anxiety disorder is an inappropriate and/or exaggerated response to situations, and affects how you live your life. It is a very real thing – in Canada and the US, approximate 1 out of every 5 of us has some type of anxiety disorder.
There are many causes of anxiety disorders. If you are asking “why do I have anxiety”, here are some of the possibilities that you should discuss with a psychologist or psychiatrist:
- Obsessive-Compulsive Disorder
- Generalized Anxiety Disorder
- Social Anxiety
- Childhood circumstances
- An accumulation of stress
When you experience an anxiety disorder, you may have some (or all) of the these symptoms:
- You feel out of touch with yourself
- Excessive worry
- Painful muscle tension
- Shortness of breath
- The need to go to the bathroom frequently
- Trouble sleeping
Theeere it is! Anxiety can cause the symptom of insomnia.
There are many other symptoms specific to the type of anxiety disorder (e.g., only people with social anxiety disorder experience a fear of being in public). Also, for reference, anxiety disorder symptoms are the same in women as they are in men.
Sleep Anxiety: When Anxiety and Insomnia Cause One Another
When anxiety and insomnia meet, it means that you reinforced that sleep = bad. You have conditioned yourself to equate sleep with a negative experience. No longer is the initial anxiety disorder (like generalized anxiety disorder or traumas) causing insomnia – now sleep and insomnia itself is the stressor.
The thought of going to sleep now causes the same symptoms. Chest tightness, shortness of breath, excessive worry are now associated with sleep.In what feels like the biggest slap in the face, anxiety caused insomnia and now insomnia was causing anxiety.
Sleep anxiety is a whole new beast.
Getting over anxiety and insomnia kind of feels like this:
It’s a lot to unravel.
But it’s time to dive into the heart of the beast.
What caused your anxiety in the first place?
Write down your answer to these questions. It doesn’t matter if it looks ridiculous, let your brain flow onto the page.
- What part of your life are you living because you felt like you had to do it, rather than wanted to?
- How do you define yourself?
- What are your values and beliefs? Are you living them every day?
- What are your strengths? Are you using them, or did you decide to adopt a more socially acceptable strength?
- How do you recharge? Are you regularly taking care of yourself so you don’t burn out?
- What makes you wake up with a spring in your step?
Anxiety and insomnia: a different side of the same coin
If you can’t sleep, I would bet that you have some negative self-talk going on. Do any of these ring a bell?
- I won’t be able to work/exercise/(insert activity) tomorrow if I don’t sleep.
- It’s such a normal human function but somehow I can’t sleep.
- Why can’t I sleep? What’s wrong with me?
- This will never end.
- I know I won’t sleep well tonight.
- If I wake up in the middle of night, I’ll never get back to sleep.
This self-depreciating internal dialogue perpetuates chronic insomnia. You have an expectation that you will be unable to sleep so it causes you enough anxiety to not sleep.
Give yourself an hour per day to write these down. Even if logically it looks ridiculous. Write it down.
Then write down thoughts that counteract the negative ones.
- I have slept before, and I’ll sleep again.
- If I don’t sleep as much as I’d like, that’s ok. I’ve survived before.
- When I sleep, I feel rested and ready for the day.
- Sleep is enjoyable
- If I get anxious, I can do ‘X’ (meditation, visualization, etc.) to relax and come down from my anxiety so I can sleep.