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How does anxiety affect our nervous system?

No matter how many therapy sessions I've had, I can't always remember how anxiety affects our nervous system. Kelsey Thompson said, "Anxiety, much like trauma, causes the flight, fight or freeze response to be activated. Cortisol and adrenaline flood our system and cause our heart to race, breathing to speed up, muscle tension, energy is moved from the stomach to more needed areas — such as the muscle and heart — causing stomach issues such as IBS, constipation, stomach aches." It's clear that the list goes on and on.

Dr. Poffenroth further elaborated on the muscle tension that's often caused by anxiety. "Studies have shown that even when at rest, people with anxiety disorders constantly have more tense muscles. Constantly tense muscles can cause physical discomfort, which can make anxiety symptoms worse. The body's 'fight or flight' response is being repeatedly triggered, which is causing this tension." Unfortunately this leaves bodies in a constant state of believing it has to be ready to respond to threats.

So, what are the long-term effects of being in a state of 'fight or flight?' "Research suggests that long term this can lead to more chronic issues such as high blood pressure, insulin resistance, inflammation and chronic stomach issues," Thompson said.

Why does it feel like all of our anxious thoughts occur at night?

This leads to the looming big question — why does it feel like our minds race at night? Thompson said, "Often we are so distracted and so busy throughout the day that we are able to push away our anxious thoughts. In American culture we are so wired to do a million things each day, work, clean, cook, sometimes take care of children, that there is often not a lot of time to let ourselves process or thoughts and emotions."

It's one of the things I realized after becoming a mom. You'd think I'd be used to the impossible juggling act that comes with that, but I'm often reminded that no one is able to do everything. It's one of the reasons both Thompson and Dr. Poffenroth said our anxiety goes haywire at night.

Thompson said," When you aren’t distracted by tasks and you slow yourself down and lay in bed trying to get to sleep, you start processing through things, often this is when anxiety can flood in which makes it difficult to fall asleep or stay asleep if you wake up in the middle of the night."

What's the science behind it? "In low light, the brain's fear center, the amygdala, becomes more active. Studies suggest that there was a decrease in activation in the amygdala and an increase in functional activity in the dark. This increased susceptibility may result in a rise in thoughts that make one anxious," Dr. Poffenroth said.

This has everything to do with the survival tactics that kept our ancestors alive. "When it's dark outside, the brain is more sensitive to possible dangers, even when none exist. Even though it was originally necessary for survival, this evolutionary adaptation can now cause increased anxiety at night," Dr. Poffenroth continued.

What are signs that someone's mind is racing at night?

It's likely you're able to recognize when you're having anxious thoughts at night after the fact, but sometimes you're not always aware in the moment. According to Thompson, some of the thoughts you could be having are:

• Having spiraling thoughts and repeating them for prolonged periods of time
• Ruminating about the past, present or future,
• Thinking about what you may have said to someone that day
• Worrying about what people think of you,
• Worrying about the future or others

She said this could physically show up as you being unable to wind down or relax. "You may feel the need to continuously do something or even scroll on your phone as a distraction technique," she mentioned.

Guilty as charged.

To add to that, Dr. Poffenroth said your "inability to 'switch off'" your thoughts is the most common indicator that your anxiety is running the show at night.

"This cognitive hyperarousal can seriously obstruct one's capacity to go asleep and stay asleep through the night. The 'what if' scenarios or reflections on past events that frequently accompany the racing thoughts can lead to a vicious cycle of worry that can be challenging to break on one's own," she noted.

I've found that I don't experience bouts of insomnia like I used to, but there are nights where I wake up every few hours instead of sleeping soundly. If my anxiety spiral is really bad, I even have a series of weird dreams that wake me bolt out of bed to make sure I'm not fighting some terrible monster who has a personal vendetta against me.

Is there a way to stop the anxious spiral that happens when we're trying to get rest?

If you're trying to figure out if you'll ever learn how to stop anxious thoughts at night, know that you're not 'broken.' Just like in Inside Out 2, anxiety wants to keep us safe and will employ any tactic it can so we can plan for possible threats. To help your anxiety understand that you're not being harmed, Thompson suggested utilizing grounding techniques.

She said this can look like:

• Using guided meditation
• Listening to sleep sounds music
• Keeping your environment cold and dark for sleeping
• Burning energy before bed by going on evening walks, to the gym after dinner or taking hot baths for relaxation before bed
• Practicing mindfulness and learning challenging and cognitive restructuring skills from CBT (Cognitive Behavioral Therapy)

Dr. Poffenroth said, "Cognitive restructuring is an effective method to stop the anxious spiral that occurs when trying to sleep. This method is questioning and rephrasing nervous thoughts. The procedure entails recognizing negative thought patterns, assessing their veracity, and swapping them out for more realistic, balanced ideas."

This is another tool I use when I'm still a little anxious after choosing a grounding technique to focus on. It feels silly to ask yourself, "Is ______ true in this situation," but Dr. Poffenroth said it helps you reassess things so your perceived fear about something can eventually stop disrupting your sleep.

What's the worst thing someone with anxiety can do before going to bed?

Now that we know why we have anxious thought at night, it's time to discuss changing some of our nighttime habits. The first thing Thompson wants you to stop doing is relying on caffeine after 12 or 1 p.m. This sounds like punishment for those of us who love our midday coffee runs, but that extra caffeine may be causing more harm than good.

Also, she doesn't want you to scroll on social media or check your to-do list before going to bed. This is something my work bestie has advised me against doing, but I haven't quite tricked my mind into putting my phone down before going to sleep.

The last thing she says you should avoid doing is getting into a huge argument with someone that goes unresolved. "These are all things that will make it difficult to sleep if you have anxiety at night," Thompson said.

Additionally, Dr. Poffenroth wants you to leave your work emails in your inbox until the next day. "It can be extremely difficult to de-stress and go asleep after engaging in these activities because they raise stress levels and stimulate the sympathetic nervous system."

I know we like to trick ourselves into believing we can work ahead, but the work will always be there. I learned this the hard way when I thought it would be a good ideas to tackle five projects one night only to have more tasks to complete the following day. In addition to missing out on valuable sleep, I was even more anxious the next day.

Dr. Poffenroth said, "Taking up work-related topics right before bed can set off a chain reaction of ideas about outstanding work or impending difficulties, resulting in a restless night's sleep. Setting up a distinct boundary between work and play is essential for encouraging improved sleep hygiene and lowering anxiety."

What are helpful ways to induce a proper night's rest that's void of anxious thoughts?

Therapy is where I started learning how to be aware of my anxious thoughts and it's something Thompson recommends. She said you can also, "Use exercise as medicine, take hot baths at night for relaxation, and make sure you get morning sunlight because this helps with sleep issues." For more information about how to improve your sleep skills, she suggests you listen to the Huberman Labs podcast on sleep skills).

Other helpful things she believes you can do to avoid having anxious thoughts at night are:

• Journaling after dinner before you start your wind down routine
• Focusing on progressive muscle relaxation skills like yoga or stretching to get connected to your body and out of your mind
• Discussing medication options with your doctor (non addictive sleep medications can help)

Dr. Poffenroth also believes you should focus on your breathing. "Deep breathing exercises are a very powerful tool for helping you get a good night's sleep free from worrying thoughts (via Cleveland Clinic). The parasympathetic nervous system, which is in charge of the body's rest and digest processes, is triggered by deep breathing. This activation aids in mitigating the effects of the sympathetic nervous system, which is frequently hyperactive in anxious people."

She said some of the benefits of deep breathing are:

• Decreased blood pressure and heart rate
• An induced relaxed state that's optimal for having a good night's rest

"In addition to being a mindfulness exercise, this method helps to focus attention on the here and now rather than on worrying thoughts," she added.

Can anxious thoughts be completely avoided?

This is a question I've asked myself before, but Thompson has some news for anyone us who want to banish anxiety for good. "Anxious thoughts are a natural part of the human experience, but you can learn to manage them, get skilled at mindfulness and learn to not spiral or ruminate," she said.

Dr. Poffenroth actually advises against in trying to get rid of your anxious thoughts, too. "Attempting to repress them may make them worse. Because of the way the brain functions, thoughts become more present the more we attempt to suppress them," she says. "It's more important to recognize anxiety, accept it as a normal aspect of life, and develop healthy coping mechanisms."

The moment I accepted my anxiety instead of trying to douse lighter fluid on it is when I started making a breakthrough in therapy and my everyday life. It's silly, but I like to check in with my anxiety to see why it's on edge. This is a huge nod to the cognitive restructuring Dr. Poffenroth mentioned earlier.

What can someone tell themselves if they can't stop thinking about past or present situations at night?

I'm one of those people who writes everything down. I have a list of affirmations prayers I refer to when I'm feeling anxious

• Thoughts are just thoughts-you don’t need to give them meaning.
• Things to not always go according to plan--- and that is ok!
• You CAN change the way you think.
• Don’t feed your fears- avoidance makes things worse.
• Remember your strengths- they are so much stronger than your fears.
• Your physical health is entirely linked to your mental health.
• Managing your anxiety is a skill—you must practice it like any other skill.
• Everyone makes mistakes, failure is a part of life and is inevitable.
• Don’t take life too seriously.
• You deserve to be happy.
• Everything changes and ends, that is part of life --- change is uncomfortable but that’s how you grow.
• Pain is a part of life, suffering is optional.
• And will this matter 5 years from now? If yes, then ok. It's valid to spend some energy thinking about this. If not then it’s not worth being anxious about this.

Another phrase Dr. Poffenroth wants you to say to yourself when you're having anxious thoughts is, "I am safe in the present moment." She believes this can be a useful reminder if you're truly struggling with your thoughts at night.

"By anchoring attention in the present reality, this statement acts as a grounding technique, helping to divert attention from thoughts about the past or future that cause anxiety. This strategy is in line with mindfulness exercises, which have been demonstrated to be successful in easing the symptoms of anxiety," she shared.

By reminding yourself that you're safe in your bed, your thoughts won't have as much of a big impact on you like they usually do.