Anxious People Also Get Anxious From Relaxing

Is there anything more stressful than relaxing? The abject terror of a friend bringing you to a meditation class; the restless, sinister feeling of savasana during yoga; the panicky confusion of trying to “breathe from your diaphragm.” And don’t get me started on the boundless, meaningless abyss that is vacation.

There is a name for such feelings: relaxation-induced anxiety.

For a subset of people, and often, people with anxiety disorders, the very activities that are supposed to make you relaxed can actually trigger more feelings of anxiety. (If you don't know what I'm talking about, I'm happy for you, and can't wait to hear how soothing your new mindfulness app is.)

Researchers have known about relaxation-induced anxiety since at least 1983, when a paper found that, in people with chronic tension, around 31 percent who tried progressive muscle relaxation (in which you focus on tensing and relaxing one set of muscles at a time, from head to toe), and 54 percent who tried meditation, ended up having high levels of anxiety instead. An up-to-date estimate is that anywhere from 17 to 53 percent of all people have experienced this phenomenon.

Relaxation-induced anxiety isn't the same as not being able to relax. People who deal with this can initially relax in various ways, but that relaxation morphs into feelings of moderate or intense anxiety, said Tina Luberto, a psychologist at Massachusetts General Hospital who created a measure of the fear of relaxation in 2012. “Once they achieve a relaxed state, they suddenly become anxious or afraid and may notice things like their heart rate increasing or their breathing becoming more shallow,” Luberto said.

Relaxation-induced anxiety isn’t a mental health disorder on its own, it's more a symptom. There hasn't been a lot of research on it, so the reasons why it happens are still unclear. Clinicians have guessed that since many relaxation methods ask people to focus on internal cues, it might make people more sensitive to the tension they’re feeling. Or maybe they’re afraid of losing control, or concerned others think they're lazy.

In a new study in the Journal of Affective Disorders, Penn State psychology professor Michelle Newman provided evidence for another potential explanation: Anxious people don’t like to relax because it makes the next time they’re anxious feel so much worse.

It’s related to something Newman calls the contrast avoidance model, which says that people with anxiety are fearful of sharp spikes in negative emotion, or the contrast of feeling good to suddenly feeling very bad. If you continually worry or feel anxious, you don’t have to experience those spikes.

In a 2014 study, Newman and her colleague Sandra Llera asked people with and without generalized anxiety disorder (GAD) to either relax or worry before watching a fear-inducing video. The control group said that relaxing helped them cope, while the anxious subjects said the exact opposite: The worrying helped them deal with the fearful video. In a 2017 paper, Newman also found that people with GAD were more likely to say they preferred negative moods over feeling good.

Newman's new study uses a similar set up: asking people to relax right before watching a video that provoked negative emotions, and then measuring how they responded to the intense contrast in emotions. In a separate step, they asked participants to relax and asked about their levels of relaxation-induced anxiety. They found that people who reported more sensitivity to the emotional shift were also more likely to have higher relaxation-induced anxiety—further strengthening the association.

“It all goes back to this idea of comfort with anxiety, being more comfortable in an anxious state than a relaxed one," Newman said.

That's a tough mirror to look into, that those of us with anxiety are somehow wrapping it around us like a security blanket. “It’s ironic, because what you’re doing is you’re making yourself feel bad all the time,” Newman said. “It doesn’t actually protect you from anything. This aversion to being in a relaxed state, ultimately, is going to hurt you because it lowers your quality of life.”

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Deciding that you're incapable of relaxing could lead to harboring a belief that relaxation is dangerous, and prevent you from accessing techniques like Applied Relaxation that are often recommended for people with anxiety, like progressive muscle relaxation or slow breathing through the diaphragm, sometimes with a hand placed over the heart or stomach. The irony is that since relaxation-induced anxiety is more common in people with anxiety, the people who might benefit the most from Applied Relaxation are the ones who would rather spend the day doing just about anything else.

When people with relaxation-induced anxiety don't relax, it means their bodies don’t get much of the down time they need. During relaxation, our parasympathetic nervous systems are dominant, Luberto explained—which is the opposite of the “flight of fight” stress response. “We need to spend time in the relaxation response because this is where the body rests and repairs itself to offset the negative health effects of chronic stress," she said.

All this could interfere with day-to-day functioning or leave people feeling frustrated and like there is something wrong with them. (A therapist once asked me, "Don't you ever have any fun?" The question has haunted me ever since.)

The solution, Newman said, is that anxious people should stop avoiding relaxation, even if it makes them feel bad. Instead they need to confront any fears of sharp increases in anxiety, and manage that before trying any relaxation techniques.

Luberto agreed that exposing people to relaxation in a safe and supportive environment could be helpful. The difference between that and simply trying to relax is recognizing that it will be an anxious experience, that that’s perfectly normal, and doing it anyway.

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