Night Anxiety

Question: “What keeps triggering these attacks to happen especially when I'm in bed or relaxed at night?”

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Matthew’s response:

You cannot think your way out of anxiety and panic attacks merely by locating the cause of them although at some level you believe that if you locate the one cause it will put an end to them. 

Why say this?

Because continuously thinking about what particular things cause your anxiety will only serve to heighten your anxiety and feed your circular thoughts that are contributing your anxiety. 

HOWEVER, there are definitely options if you suffer from night anxiety and these options produce positive results:

You can use your brain to work through panic attacks and anxiety by restructuring and replacing thoughts which contain cognitive distortions.  That is precisely why we have focused so much on this process throughout my free newsletter.  Often many people are aware of this fact but don't think to apply it to night anxiety.

Yes these thoughts are at the source of your anxiety; however it is not necessarily a simple event, circumstance or genetic defect causing your anxiety but rather patterns of thoughts which contain cognitive distortions.  The problem is that the anxiety sufferer accepts these thoughts as true.

You’ve also likely heard that anxiety issues are control issues.  Although typically anxiety sufferers do not appear controlling to other people, it’s certainly true that anxiety sufferers are afraid of losing control, losing their mind, but it’s when they start to buy into the notion that they can become very anxious.

But, as you can see, merely knowing that fear of losing control and thoughts that contain cognitive distortions cause panic attacks doesn’t in itself solve your problem with anxiety and panic attacks.

However, once you can learn to talk back to your negative thought patterns and replace them with alternative thoughts that make you feel better you can be on the road to recovery.   We have worked through many examples in this newsletter.

Let’s do so now with the above subscriber’s question.  Again the question is: “What keeps triggering these attacks to happen especially when I'm in bed or relaxed at night?”

As usual, you can click here and access a list of Cognitive Distortions (don't worry a new window will open) so that you can refer to them and see what might be behind the thought and work through the process with me.

One of the tricks to really making the entire process of CBT effective is to be a good detective with your underlying thoughts.  In other words, you will need to locate the thought(s) behind the thoughts.  At first they might not be obvious but over time you’ll get better at this.

With the above example, I would suggest that there is a thought behind this statement that panic attacks should not occur when one is in bed or relaxed at night time. Does this sound like should thinking?

Yes because a should rule suggests that things should or should not happen, in this example panic attacks at night time or what I am calling night anxiety.  Obviously if one holds this belief he/she will become very upset when the rule is broken i.e. when they have a panic attack at nighttime or when in bed.

Now that we have identified the distortion, we need to generate some alternative thoughts that are more accurate that can make us feel better.

One alternative thought is that panic attacks can happen at various times and while night anxiety is not the most convenient thing, we can learn to let the night anxiety pass.  We can learn to ride it out. 

Another cognitive distortion likely at the basis of the above statement is disqualifying the positive.  The mere fact the subscriber is asking this question about night anxiety suggests that he/she is likely quite alarmed at what might happen when he/she has panic attacks at such odd times such as at night or when in bed.  In reality the outcome at night is no different than in the day.

While he/she may feel anxious and scared during an attack, the night anxiety will eventually pass, just like it does in the day time.  Moreover, if the subscriber really thinks about it, he/she has likely had attacks during the day and the night and nothing really bad has happened to them. 

Picking up on this point, the distortion of fortune telling is also likely at the root of this statement. In other words, the subscriber is making a prediction that something bad will happen (at least on some level in his/her mind)and that produces anxiety. 

Dr. Jack Singer, Psychologist, writes that Fortune Telling is a frequently used distortion, and an entire scenario is developed in our minds, based on what we believe will happen and the end result is negative. A clue to this distortion is beginning a thought with “What if…”¹ 

With the actual scenario we are looking at experience likely demonstrates for this subscriber that he/she has had panic attacks in the past, and despite them being scary, the attack has passed and no harm has come to him/her.

The trick to the process of reviewing your thoughts and finding your underlying thoughts and their cognitive distortions to substitute more accurate thoughts can be very effective but it is a practice that needs to occur on a regular basis.

I would suggest that you go about detecting the Fortune Telling distortion by watching for thoughts that are prefaced with "what if.." and then carry on with the rest of the CBT process.

CBT, like any technique, it improves with practice. 

Additionally you can continue to generate more and more positive thought and continue to feel better, perhaps slowly, but consistently.  If you take “baby steps”, as many psychologists say, you can improve your life in countless ways!

My suggestion is that whenever you come across an upsetting situation or thought, write it down (even if you just have time to write down the upsetting event). 

Then at a scheduled time during the day or night, complete the process we just described.  Remember that night anxiety need not parlayze you with fear.  For more great tips on anxiety, panic attacks, and agoraphobia, please join my newsletter for free.

1. Singer, J.N. (2007, July 12). Remarkable Resiliency Skills for The Uncertain Times Pt 3. 

Retrieved November 28, 2010 from The Health Podcasting Directory website:

http://healthpodcastingdirectory.com/articles/?p=12