Depression Treatment Medication Why Do SSRIs Cause Anxiety At First? Coping With Anxiety Brought On By Antidepressants By Nancy Schimelpfening Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our editorial process Updated on September 13, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Ponomariova_Maria / Getty Images Table of Contents View All Table of Contents Why Do SSRIs Cause Anxiety At First? Emotional Physical Social Helping Others Although they're often used to treat anxiety, antidepressants can potentially cause anxiety, especially when people begin taking them for depression. Using various strategies, it is possible to get a better handle on these anxiety symptoms. Some strategies you can use yourself; others may require working with your healthcare provider. There are also strategies that are helpful to family and friends wanting to support a loved one who is coping with antidepressant-related anxiety. Why Do SSRIs Cause Anxiety At First? The reason for heightened anxiety symptoms may be related to the levels of the neurotransmitter serotonin. Low serotonin in the brain is thought to play an important role in causing both depression and anxiety. It is also believed that fluctuating serotonin levels during the early days of treatment might be the reason that some people feel anxiety as an antidepressant side effect. A 2014 study revealed that, after taking antidepressants for one month, approximately 7% of the participants developed antidepressant-induced jitteriness/anxiety syndrome. Individuals experiencing this response, which is sometimes referred to as jitteriness syndrome or activation syndrome, may notice not only an increase in anxiety, but also an increase in: Agitation or irritability Elevated mood state or energy levels Hostility or aggression Impulsiveness Insomnia Panic attacks Trouble staying still Do Antidepressants Work? Emotional It is important to recognize that these emotional changes don't mean that you've developed a new mental health condition. It simply means that your body has either not yet adjusted to the new antidepressant or that the medication may need to be tweaked to reduce the anxiety response. Talking with your doctor is the first step to deciding whether any changes need to be made to your antidepressant or if feelings of anxiety will get better over time. If the doctor determines that a change needs to be made, the following approaches are a few potential options: Lowering your dose, then gradually increasing it to the needed amount Switching to another antidepressant Temporarily using an anti-anxiety medication like a benzodiazepine (such as Ativan or Klonopin) You should not, however, stop taking your medication or change your dosage without first consulting with your doctor. Rapidly stopping your antidepressant may result in uncomfortable discontinuation symptoms or the reemergence of depression. Your doctor can best advise you on what to do in order to avoid this problem. Anxiety felt while taking an antidepressant is generally mild. In addition, it will most likely get better in time as your body becomes more adjusted to the medication. Anti-Anxiety Medication and Other Coping Strategies Physical There are several proactive ways to cope with increased anxiety: Physical activity such as jogging, biking, or aerobics can positively impact how you feel. How much physical activity should you get? Modify your diet. Research reveals that eating high-fat and high-sugar foods could increase feelings of anxiety, as can eating at irregular times. Choosing lower-fat, lower-sugar foods and having regularly timed meals may help reduce your symptoms. Other dietary triggers for anxiety include caffeine, alcohol, and some food additives such as monosodium glutamine (MSG). You might find that reducing these substances or eliminating them completely can help relieve your feelings of anxiousness. Mindfulness exercises. Incorporating deep breathing exercises and muscle relaxation can help when your anxiety flares up, too. The nice thing about these is that you can do them anywhere. Recommended Amount of Physical Activity The Centers for Disease Control and Prevention (CDC) recommends that most adults get at least 150 minutes of moderate-intensity physical activity per week. If this seems overwhelming, it may help to break it down into more manageable chunks. Aim to do 10 minutes of exercise three times a day. Social Sometimes antidepressant-induced anxiety can be relieved simply by realizing that you are not alone. Connecting with others who are dealing with the same effect can make it feel less daunting or concerning. You may even learn a few tips or tricks that they find helpful for reducing anxiety caused by antidepressant medications. Search your local area to find any anxiety support groups that are close to you. There are also a variety of online anxiety support groups available. Check a few out to see what you think. The important thing is to find one that is accessible when you need it and makes you feel comfortable and welcome. Resources & Organizations The Anxiety and Depression Association of America offers helpful online resources, allowing you to choose the resources most applicable to you based on your specific situation. If you find that your anxiety is not getting better, or is getting worse—especially if you are experiencing certain other symptoms like mania, worsening depression, or suicidal thoughts—do not hesitate to contact your physician or seek emergency help. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Caregiving & Helping Others Watching someone you love deal with feelings of anxiety can be difficult. Johns Hopkins shares that there are a few things you can do to help. One of the first steps is to recognize the signs of anxiety. Physical symptoms may include: Feeling lightheaded, nauseous, or short of breathPersistent worry and second-guessing Showing irritability or frustration Once you recognize their anxiety, ask them how to best support them with this feeling. Let them tell you what they need to feel less anxious. At the same time, validate their anxiety and express your concern in a positive way. It can also be helpful to acknowledge what you don't understand about anxiety and encourage them to seek treatment. Be there for them while they work through their anxiety. Press Play for Advice On Dealing With Caregiver Stress Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring actor Nathan Kress, shares how to handle the stress that can arise after you've taken on a caregiver role. Click below to listen now. Follow Now: Apple Podcasts / Spotify / Google Podcasts 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Li Z, Pfeiffer P, Hoggatt K, et al. Emergent anxiety after antidepressant initiation: a retrospective cohort study of Veterans Affairs Health System patients with depression. Clin Ther. 2011;33(12):1985-1992.e1. doi:10.1016/j.clinthera.2011.11.010 Santarsieri D, Schwartz TL. Antidepressant efficacy and side-effect burden: a quick guide for clinicians. Drugs Context. 2015;4:212290. doi:10.7573/dic.212290 Harada T, Inada K, Yamada K, Sakamoto K, Ishigooka J. A prospective naturalistic study of antidepressant-induced jitteriness/anxiety syndrome. Neuropsychiatric Disease and Treatment. 2014;10:2115-2121. doi:10.2147/NDT.S70637 Johnson CF, Williams B, Macgillivray SA, Dougall NJ, Maxwell M. 'Doing the right thing': factors influencing GP prescribing of antidepressants and prescribed doses. BMC Fam Pract. 2017;18(1):72. doi:10.1186/s12875-017-0643-z Harvard Health Publishing. Benzodiazepines (and the alternatives). Keks N, Hope J, Keogh S. Switching and stopping antidepressants. Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039 Gollan JK, Fava M, Kurian B, et al. What are the clinical implications of new onset or worsening anxiety during the first two weeks of SSRI treatment for depression? Depress Anxiety. 2012;29(2):94-101. doi:10.1002/da.20917 Stonerock GL, Hoffman BM, Smith PJ, Blumenthal JA. Exercise as treatment for anxiety: Systematic review and analysis. Ann Behav Med. 2015;49(4):542-56. doi:10.1007/s12160-014-9685-9 Murphy M, Mercer J. Diet-regulated anxiety. Int J Endocrinol. 2013;2013:701967. doi:10.1155/2013/701967 Centers for Disease Control and Prevention. How much physical activity do adults need? Johns Hopkins Medicine. How to help someone with anxiety. Anxiety and Depression Association of America. Spouse or partner. Additional Reading Albert PR, Benkelfat C. The neurobiology of depression--revisiting the serotonin hypothesis. II. Genetic, epigenetic and clinical studies. Philos Trans R Soc Lond, B, Biol Sci. 2013;368(1615):20120535. doi:10.1098/rstb.2012.0535 Amitai, M., Chen, A., Weizman, A. et al. SSRI-Induced activation syndrome in children and adolescents—What is next? Curr Treat Options Psych. 2015;2,28-37. doi:10.1007/s40501-015-0034-9 Ho D. Antidepressants and the FDA’s black-box warning: Determining a rational public policy in the absence of sufficient evidence. Virtual Mentor. 2012;14(6):483-488. doi:10.1001/virtualmentor.2012.14.6.pfor2-1206. National Institute on Mental Health. Anxiety disorders. Sinclair LI, Christmas DM, Hood SD, et al. Antidepressant-induced jitteriness/anxiety syndrome: systematic review. Br J Psychiatry. 2009;194(6):483-90. doi:10.1192/bjp.bp.107.048371 By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.