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For Some People, Relaxing Makes Anxiety Worse

Kelsey Tyler

If you feel a little panicky a lot of the time, you’re hardly alone. Nineteen percent of American adults have an anxiety disorder, and almost one-third will be diagnosed with one at some point in their lives.

As we’ve collectively become more anxious, we’ve also embraced a growing list of activities to help us block out worries and just relax: We’re signing up for goat yoga, squeezing in subway meditation sessions and going on digital detoxes. For many people, these calming pastimes supply much-needed moments of relief. Yet, for others, efforts to unwind actually trigger more anxiety.

An estimated 17 to 53 percent of adults report having what’s called relaxation-induced anxiety. Although psychologists have known about this paradoxical phenomenon since at least 1983, they’ve only recently begun to investigate why it happens. Given that relaxation is so valuable for our health, researchers are hoping to develop treatments for anxiety caused by it — so that everyone can reap the benefits of, say, sunset vinyasa classes. For now, though, there are steps to take to make relaxation less scary. 

The traditional antidote to anxiety

Anxiety is a state of heightened alertness. When you start to feel on edge — even about nothing in particular — your brain sends out a distress signal to trigger your stress response. Your body responds by amping up levels of stress hormones and spiking your heart rate and blood pressure, among other physiological changes. Essentially, you go into survival mode.

“Chronic worry or chronic muscle tension creates wear and tear on your body and psyche,” says Michelle Newman, professor of psychology and psychiatry at Pennsylvania State University. Chronic anxiety has been linked to a wide variety of physical and mental health problems, including heart disease, gastrointestinal symptoms, insomnia and cancer.

The yin to anxiety’s yang is the relaxation response. When you no longer feel like you’re in harm’s way, your parasympathetic nervous system takes charge, facilitating vital processes that don’t take place in survival mode, including sleep and digestion

Learning relaxation techniques has been a standard part of treatment for chronic anxiety since the 1970s. One technique is called diaphragmatic breathing, a deep-breathing exercise during which your chest remains fairly still while your stomach expands on inhale and slowly falls on exhale. There’s also progressive muscle relaxation, which involves tensing up a group of muscles for a few seconds and then relaxing it for longer. Working your way from your toes to your head, or vice versa, and tense and then relax every muscle group in this way. 

In the 1980s, researchers noticed that although relaxation techniques helped many people achieve a sense of calm, or at least feel less anxious, they had the opposite effect for others. In a small 1983 studyabout half of participants said their tension grew during a deep-breathing exercise, while almost one-third felt increased anxiety while practicing progressive relaxation. 

“We assume that when some patients [with relaxation-induced anxiety] try these exercises, they feel their bodies begin to relax, and that’s a trigger for more anxiety,” says Sandra Llera, associate professor of psychology at Towson University. “Their bodies start to let go of tension, relax and calm down, and they react to that as if it were a threat” and tense up again.

Some people with relaxation-induced anxiety may be able to fully relax at times, Newman says. For others, any relaxation might be a temporary sensation.

When worry brings comfort

Newman recently ran an experiment to investigate the basis of relaxation-induced anxiety. She hypothesized that contrast avoidance, a concept she developed in 2011 with Llera, played a role in the issue. 

People who experience contrast avoidance have a hard time shifting from positive or neutral emotions to negative ones. In other words, they really don’t like feeling content one second and then unexpectedly becoming scared or sad the next, so they try to protect themselves against the possibility of that happening.

“If they’re fully relaxed,” Newman says, “it feels like they are more vulnerable and less in control, and if something bad happens, they’re more likely to experience a strong spike in anxiety.”

For Newman’s study, published in the Journal of Affective Disorders in December, 96 participants practiced a relaxation technique and then watched a video that, unbeknownst to them, was designed to elicit either fear or sadness. Next, they answered a questionnaire to measure contrast avoidance; i.e., researchers wanted to figure out whether the relaxation exercise made it easier or harder for participants to cope with emotions triggered by the video. Participants then did a second relaxation exercise followed by a questionnaire. This time, the goal was to measure how anxious they felt while trying to relax.

As Newman suspected, contrast avoidance was strongly linked to relaxation-induced anxiety.

“The worry and chronic anxiety might actually feel protective to them,” Llera says. “That sense of already being upset, worked up, or anxious makes it less surprising — there’s less emotional contrast — to then have a bad thing happen. It’s the thought that, ‘If I keep myself in this negative emotional state all the time, then I can’t be caught off guard if a negative event happens.’”

They may associate worry and physical sensations like muscle tension with the sense that they are “ready” for unexpected threats, like someone sneaking up on them. Whereas, Newman explains, “if they stop worrying, relax, let their down guard, or are just in the moment enjoying it and not anticipating what could go wrong, they can feel as though they’re setting themselves up for being more vulnerable if something happens.”

Practicing relaxing

We all know people who find it difficult to lie on a beach, sit down and read, or otherwise just be. Newman says these can’t-sit-still types would benefit from learning how to enjoy downtime: “The take-home of all of this isn’t that people should not try to relax.”

Both Newman and Llera believe that relaxation-induced anxiety is treatable. Llera sees potential in exposure therapy, which hasn’t yet been studied as a treatment for people with a clinical aversion to kicking back. Exposure therapy entails gradually exposing yourself, under the guidance of a therapist, to whatever makes you scared until you overcome your fear of it. The method could be used, Llera believes, to help patients make that transition from feeling calm to experiencing a negative emotion.

“Over time they may realize it’s not so scary and they don’t need to walk around all the time with this emotional armor on,” she says. “They see that they are capable of handling these emotional shifts.”

Another option, Newman says, might be to practice relaxing, either with a therapist or on your own: “Over time, you can become habituated to the anxiety if you continue to try to relax despite the anxiety, and with repeated practice you can learn to do it.”

The bottom line is that everyone needs to find ways to let go of stress, anxiety and worry. “You need to get out of the habit of holding onto muscle tension and practice letting go across your day,” says Newman. “It’s better for our mental, physical and emotional health.”

Research shows that a lot of what people worry about doesn’t happen, you may be missing out on the joys of life — or even making yourself miserable — in an attempt to head off situations and feelings that will never come to pass. 

“Start to trust yourself,” Llera says. “You could be in a perfectly good mood, and even if something bad did happen, you would still be capable of coping with it in the moment.”


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Show Comments (4)
  1. Michelle

    Really interesting article. I feel like this may apply to me, and never knew it was so common!

  2. Eleene Hoskins Upchurch

    I believe this is happening to me and no doctor takes me seriously about this issue and now have hardening of the arteries and I believe this has something to do with my anxiety when I go see a doctor and it runs in my family. Good cholesterol is high bad is OK

  3. C.A.

    Fascinating! I can relate to the bracing for something bad to happen, so one walks around with baseline tension and nervousness as preparation for the worst, but didn’t know about the concept of contrast avoidance and that that might be something I’m doing or I have. Glad for this article!

  4. sara

    wow. super interesting, totally new and it’s not easy for me to find an idea new 🙂 I can relate. In fact, it makes me anxious when my other people relax. It somehow seems irresponsible! Going to really think about this. Thank you

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The Paper Gown, a Zocdoc-powered blog, strives to tell stories that help patients feel informed, empowered and understood. Views and opinions expressed on The Paper Gown do not necessarily reflect those of Zocdoc, Inc.

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