Why Do SSRIs Cause Anxiety At First?

Coping with anxiety brought on by antidepressants

African American woman feels anxiety and emotional stress. Depressed black girl experiences mental health issues

Ponomariova_Maria / Getty Images

Table of Contents
View All
Table of Contents

Although they are often used to treat anxiety, antidepressants can potentially cause anxiety, especially when people begin taking them for depression. By using various strategies, it is possible to get a better handle on these anxiety symptoms.

Some strategies you can try on your own; others may require working with your healthcare provider. There are also strategies that are helpful to family and friends who want to support a loved one who is coping with antidepressant-related anxiety.

Reasons for Anxiety When You Start Your Meds

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 syndrome (or anxiety syndrome). Individuals experiencing this response may notice not only symptoms of anxiety but also an increase in:

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
  • Temporarily using an anti-anxiety medication like a benzodiazepine (such as Ativan or Klonopin)
  • Switching to another antidepressant

Warning!

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 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.

Physical

There are several proactive ways to cope with increased anxiety:

  • 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 altogether 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.
  • Physical activity such as jogging, biking, or aerobics can positively impact how you feel. How much physical activity should you get?

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 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 close to you. There are also a variety of online anxiety support groups available. Check a few out to see what you think. It is important 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. Based on your specific situation, you can choose the resources most applicable to you.

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 Medicine shares that there are a few things you can do to help. One of the first steps is to recognize the signs of anxiety. They may exhibit physical and emotional symptoms, including:

  • Feeling lightheaded, nauseous, or short of breath
  • Persistent worry and second-guessing
  • Showing irritability or frustration

Once you recognize their anxiety, ask them how you can best support them with this feeling. Let them tell you what they need to feel less anxious. Maybe they would like to take a walk or air out their feelings for a minute. At the same time, validate their anxiety, acknowledging that it is a fairly common side effect when you start antidepressants, 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 further assistance from a support group or their healthcare provider. Be there for them while they work through their anxiety.

Press Play for Advice On Dealing With Caregiver Stress

Hosted by 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

13 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.
  1. 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

  2. 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

  3. 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

  4. 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

  5. Harvard Health Publishing. Benzodiazepines (and the alternatives).

  6. Keks N, Hope J, Keogh S. Switching and stopping antidepressants. Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039

  7. 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

  8. Murphy M, Mercer J. Diet-regulated anxiety. Int J Endocrinol. 2013;2013:701967. doi:10.1155/2013/701967

  9. Stonerock GL, Hoffman BM, Smith PJ, Blumenthal JA. Exercise as treatment for anxiety: Systematic review and analysis. Ann Behav Med. 2015;49(4):542-556. doi:10.1007/s12160-014-9685-9

  10. Centers for Disease Control and Prevention. Adult activity: An overview.

  11. Johns Hopkins Medicine. How to help someone with anxiety.

  12. National Institute on Mental Health. Anxiety disorders.

  13. Anxiety and Depression Association of America. Spouse or partner.

Additional Reading

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.