Dear Therapist:

I am someone who has occasionally had trouble with my moods. I have gotten help in the past with anxiety and depression. While I am currently doing really well, I still have a rough time in the morning. I wake up with a lot of anxiety and it takes time for me to get out of bed. Once I get out of bed I generally do ok and have a good day. There are no noticeable "triggers” for me in the morning so there is no obvious reason to me. I guess I can learn to live with it if I need to but perhaps you can offer some understanding or advice.  Is there a reason that anxiety could be worse in the morning? Is there anything I can do either before going to bed, or in the morning to prevent it from acting up this way?



Without more detailed information, it is difficult for me to venture guesses as to the source of your anxiety. Perhaps there are triggers that are not obvious to you. Triggers can be viewed simply as things that cause an emotional reaction. When a trigger is conscious (or noticeable), there is a clear sense that the trigger led to the resultant emotion.

Often, however, triggers are unconscious in nature. Although they are every bit as powerful as conscious ones (and often far stronger), we are by definition unaware of their existence.  We all have unconscious triggers to one degree or another. These affect us in various ways. Some of us anger easily, or are easily embarrassed or insulted. When they occur, these triggers make us feel something that often does not seem to fit the situation.

One therapeutic goal can be to identify some of our most powerful unconscious triggers. One reason for this is the fact that conscious triggers can typically be more easily resolved. When a trigger is unconscious, we will often have a negative reaction without being able to fully explain the reason for it. This can leave us spinning our wheels trying to resolve an emotional issue that has no logical explanation—and therefore no logical resolution. Once we become more aware of a trigger, we are able to begin understanding it, challenging it, and ultimately resolving it.

Think of the unconscious mind as a vast ocean of unregulated and unorganized emotions. These emotions are free-floating in that they are not attached to any conscious thoughts. When an emotion is triggered and the person becomes aware of the feeling, sometimes the emotion remains free-floating (as with generalized anxiety). At other times the emotion attaches itself to an event, experience, thought, belief, or other conscious factor. This can cause us to assume that this factor is what caused the emotion when this is not necessarily the case.

When we sleep, our unconscious mind is more obviously in control than when we are awake. This means that our sea of emotions has free reign over us without the limiting effect of our conscious (awake) mind. To get a sense of what the unconscious mind is doing on a constant basis, think of how dreams allow us to feel and “believe” illogical and weird things. Waking from a state of essentially pure emotion can place people in a precarious emotional state until the conscious mind takes a more prominent role.

Upon waking in the morning, you can try focusing your conscious mind. This can be done through any manner of mental exercise. Rather than dwelling on the emotional vestiges of your unconscious sleep mode, consciously focus on something like a crossword puzzle or an interesting book. This can help to push your conscious mind into gear, thus moderating the effects of the unconscious mind.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer / 516-218-4200