Your question: Why do I get anxiety in the afternoon?
By
OptimistMinds
| Reviewed by
Dr. Mark Mohan Kaggwa
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Author bio
The Optimistminds editorial team is made up of psychologists, psychiatrists and mental health professionals. Each article is written by a team member with exposure to and experience in the subject matter. The article then gets reviewed by a more senior editorial member. This is someone with extensive knowledge of the subject matter and highly cited published material.
Reviewer bio
Dr. Mark Mohan Kaggwa is a psychiatrist with experience in both clinical and research work. Major research contributions have been in forensic psychiatry, suicidology, medical education, and addiction psychiatry. He writes and reviews articles on these topics.
Brief bio
I have a wealth of expertise and experience in research and publication in psychiatry. I am a psychiatrist who has led and participated in several research projects and trainings, covering various topics such as addiction, forensic psychiatry, student mental health, and suicidology. I have a strong track record of mentoring and guiding early career researchers, especially students, to achieve academic excellence and recognition.
I have supervised and supported several students to publish their first peer-reviewed articles in high-impact journals such as the Lancet. Five of my mentees have received prestigious awards for their scientific contributions through publications, conference presentations, and travel grants. I derive great satisfaction and motivation from seeing others succeed and grow in their research careers.
Through mentoring activities, I have also enhanced my research and publication skills, resulting in over 70 publications in the past three years. My notable publications include several Lancet Psychiatry papers, widely cited and whose findings are implemented in various settings. I have also won several awards for my writing skills, such as the best journal article from the Royal College of Psychiatry Journals in August 2023.
Many of my articles have been featured on the cover pages of various journals, reflecting their significance and impact. I have also disseminated my research findings through conferences, seminars, and lectures, where I have been invited as a keynote speaker on three occasions.
I am passionate about solving real-world problems and improving the lives of people with mental health issues, especially those who are marginalized and vulnerable, through a team-based approach. I believe in training others to increase the field’s diversity of knowledge and perspectives.
I have extensive experience in data analysis, research methodology, design, and implementation science, which enables me to execute and train others effectively and efficiently. I am also a motivated team leader, an innovative problem solver, and a collaborative partner. My contribution is instrumental to this project’s success and advancing knowledge in this field.
Ongoing research projects:
- Self-harming behaviours among forensic patients in Ontario.
This project which started in December 2022, focuses on identifying the risks associated with physical self-harming behaviors and their related correlates
Role: Principal Investigator
- Suicide, all-cause mortality, and self-harming behaviours among forensic patients in Ontario.
This project is based on administrative databases to determine trends of suicide and all-cause mortality among forensic patients in Ontario. The project has been running since July 2023 to date
Role: Principal Investigator.
- Horticulture therapy’s role in reducing aggressive incidences among forensic patients in Ontario.
In this stepwise pragmatic cluster-randomized, we employ horticulture therapy in rehabilitating forensic patients in Ontario.
Role: Principal Investigator
- A preliminary study exploring the relationship between electroretinography waveforms and suicidal behaviour severity.
This project seeks to identify the waveforms that are related to suicidal behaviours among patients with depression. Recruitment for the study started in October 2023
Role: Principal Investigator
- Positions, Scientific Appointments, and Honors
| 2023 – present | American Psychiatry Association Colloquium fellow 2023, American Psychiatry Association, USA |
| 2022 – present | McMaster Forensic Psychiatry fellowship, McMasters University Department of Psychiatry and Behavioural Neuroscience, Hamilton, Canada |
| 2018 – 2021 | First Mile Fellowship (Masters support program), Massachusetts General Hospital Institute of Health Professions, USA
|
- Contributions to Science
- Suicidology epidemiology
I have been involved in projects investigating the prevalence of suicidal behaviours in various parts of the world. This work has reported the burden and associated factors among the following populations: university students, individuals affected by food insecurity, and those affected by the COVID-19 pandemic.
1) Kaggwa M.M, Akatussasira R, et. al. The global burden of suicidal behaviour among people experiencing food insecurity: A systematic review and meta-analysis. Journal of Affective Disorders. 2023. https://doi.org/10.1016/j.jad.2023.09.012
2) Nahrin R, Al-Mamun F, Kaggwa M.M, et al. Prevalence and factors associated with suicidal ideation among students taking university entrance tests: revisited and a study based on Geographic Information System data. BJPsych Open. https://doi.org/10.1192/bjo.2023.526
3) Abaatyo, J., … Kaggwa, M.Ml. Suicidal behaviour among inpatients with severe mental conditions in a public mental health hospital in Uganda. BMC Psychiatry 23, 346 (2023). https://doi.org/10.1186/s12888-023-04858-x
4) Kaggwa MM, Nuwamanya S, Ashaba S, Rukundo GZ, Harms S. An Adolescent’s Use of Veterinary Medicines: A Case Report Exploring Addiction. Journal of Psychoactive Drugs. 2021/08/08 2021;53(4):339-344. doi:10.1080/02791072.2021.1873466
5) Kaggwa MM, Muwanguzi M, Nduhuura E, et al. Suicide among Ugandan university students: evidence from media reports for 2010–2020. BJPsych International. 2021;18(3):63-67. doi:10.1192/bji.2021.13
6) Mamun MA, Al Mamun F, Hosen I, … Kaggwa MM, et al. Suicidality in Bangladeshi Young Adults During the COVID-19 Pandemic: The Role of Behavioral Factors, COVID-19 Risk and Fear, and Mental Health Problems. Risk Manag Healthc Policy. 2021;14:4051-4061. doi:10.2147/rmhp.S330282
7) Kaggwa MM, Arinaitwe I, Muwanguzi M, et al. Suicidal behaviours among Ugandan university students: a cross-sectional study. BMC Psychiatry. 2022/04/01 2022;22(1):234. doi:10.1186/s12888-022-03858-7
8) Kaggwa MM, Mamun MA, Najjuka SM, et al. Gambling-related suicide in East African Community countries: evidence from press media reports. BMC Public Health. Jan 24 2022;22(1):158. doi:10.1186/s12889-021-12306-2
9) Kaggwa MM, Rukundo GZ, Wakida EK, et al. Suicide, and Suicide Attempts Among Patients Attending Primary Health Care Facilities in Uganda: A Medical Records Review. Risk Manag Healthc Policy. 2022;15:703-711. doi:10.2147/rmhp.S358187
10) Rukundo GZ, Wakida EK, Maling S, Kaggwa MM, et al. Knowledge, attitudes, and experiences in suicide assessment and management: a qualitative study among primary health care workers in southwestern Uganda. BMC Psychiatry. Sep 12 2022;22(1):605. doi:10.1186/s12888-022-04244-z
11) Manouchehri A, Marznaki ZH, Atim LM, Mohammadian Amiri M, Kaggwa MM. The relationship between causes of suicidal attempts in Iran and individual and social variables: a retrospective study. BMC Psychiatry. Dec 12 2022;22(1):780. doi:10.1186/s12888-022-04449-2
12) Kaggwa MM, Najjuka SM, Favina A, Griffiths MD, Mamun MA. Suicidal behaviors and associated factors among medical students in Africa: A systematic review and meta-analysis. Journal of Affective Disorders Reports. 2022/12/09/ 2022:100456. doi:10.1016/j.jadr.2022.100456
13) Al-Mamun, F., Kaggwa, M.M., Hosen, I. et al. Suicide related to the COVID-19 pandemic in India: A systematic review. Discov Psychol 3, 2 (2023). https://doi.org/10.1007/s44202-022-00063-1
- University student’s mental health
Following my experience as a student and seeing many of my colleagues face vast challenges in their pursuit of knowledge. I investigated various aspects of university students’ mental health to find solutions to an ever-growing problem. I have published a few peer-reviewed articles on subjects ranging from depression, burnout, behavioural addictions, and sexual risk behaviours, among others.
1) Kaggwa MM, Devine J, and Harms S. The opioid crisis fuelled by health systems: how will future physicians fare? BJPsych International, 2023, 1-3, https://doi.org/10.1192/bji.2023.12
2) Sserunkuuma, J., Kaggwa, M. M., et al. Problematic use of the internet, smartphones, and social media among medical students and relationship with depression: An exploratory study. Plos One, 18(5), e0286424. https://doi.org/10.6084/m9.figshare.22794644
3) Kajjimu J, Kaggwa MM, Bongomin F. Burnout and associated factors among medical students in a public university in Uganda: A cross-sectional study. Adv Med Educ Pract. 2021;12:63-75. doi:10.2147/amep.S287928
4) Al Mamun F, Hosen I, Misti JM, Kaggwa MM, Mamun MA. Mental Disorders of Bangladeshi Students During the COVID-19 Pandemic: A Systematic Review. Psychology research and behavior management. 2021;14:645-654. doi:10.2147/PRBM.S315961
5) Najjuka SM, Checkwech G, Olum R, Ashaba S, Kaggwa MM. Depression, anxiety, and stress among Ugandan university students during the COVID-19 lockdown: an online survey. Afr Health Sci. Dec 2021;21(4):1533-1543. doi:10.4314/ahs.v21i4.6
6) Kaggwa MM, Kajjimu J, Sserunkuma J, et al. Prevalence of burnout among university students in low- and middle-income countries: A systematic review and meta-analysis. PLoS One. 2021;16(8):e0256402. doi:10.1371/journal.pone.0256402
7) Kaggwa MM, Arinaitwe I, Nduhuura E, et al. Prevalence and Factors Associated With Depression and Suicidal Ideation During the COVID-19 Pandemic Among University Students in Uganda: A Cross-Sectional Study. Front Psychiatry. 2022;13:842466. doi:10.3389/fpsyt.2022.842466
8) Kihumuro RB, Kaggwa MM, Kintu TM, et al. Knowledge, attitude and perceptions of medical students towards mental health in a university in Uganda. BMC Med Educ. Oct 20 2022;22(1):730. doi:10.1186/s12909-022-03774-0
9) Kihumuro RB, Kaggwa MM, Nakandi RM, et al. Perspectives on mental health services for medical students at a Ugandan medical school. BMC Med Educ. Oct 25 2022;22(1):734. doi:10.1186/s12909-022-03815-8
10) Kaggwa MM, Muwanguzi M, Najjuka SM, et al. Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, substance use history, and family environment. PLoS One. 2022;17(11):e0277129. doi:10.1371/journal.pone.0277129
11) Muwanguzi, M., Kaggwa, MM., et al. Exploring adverse childhood experiences (ACEs) among Ugandan university students: its associations with academic performance, depression, and suicidal ideations. BMC Psychology, 2023/01/13.
- Influence of family caregivers and peer influence on patient’s mental health
From the unique perspective of using caregivers in caring for mental health patients in Mbarara Regional Referral Hospital. I embarked on understanding their roles, burdens, and significance in patients’ recovery. I continued to explore this in different populations, such as those involved in the criminal justice system. In this adventurous journey, I published a few peer-reviewed articles.
1) Kaggwa, M.M, Olagunju, A.T, Prat, S, Harms, S, and Chaimowitz, G. Peer support mental health teams in correctional settings in Uganda. Lancet Psychiatry, January 2023. https://doi.org/10.1016/S2215-0366(22)00431-X.
2) Kaggwa MM, Najjuka MS, Kesande C, et al. Length of stay of hospitalized patients at tertiary psychiatry facilities in Uganda: the role of caregiver’s presence. Discover Mental Health. 022/07/04 2022;2(1):15. doi:10.1007/s44192-022-00018-x
3) Kaggwa, M.M, Najjuka SM, Mamun, MA, Griffiths, MD, Nyemara, N, and Ashaba, S. Involvement and burden of informal caregivers of patients with mental illness: the mediating role of affiliated stigma. BMC Psychiatry. January 2023. http://dx.doi.org/10.1186/s12888-023-04553-x
4) Nuwamanya S, Nkola R, Najjuka SM, et al. Kaggwa MM. Depression in Ugandan caregivers of cancer patients: The role of coping strategies and social support. Psychooncology. Oct 26 2022;doi:10.1002/pon.6057
5) Najjuka SM, Iradukunda A, Kaggwa MM, et. Al., The caring experiences of family caregivers for patients with advanced cancer in Uganda: A qualitative study. Plos One, October 2023.
- Mental healthcare and psychiatry epidemiology in Uganda
I have also contributed to understanding Uganda’s mental healthcare system through written commentaries, perspectives, reviews, and primary research.
1) Kaggwa MM, Harms S, Mamum M, A. Mental health in Uganda. Lancet Psychiatry; 2022. Oct;9(10):766-767. doi: 10.1016/S2215-0366(22)00305-4.
2) Kaggwa MM, Najjuka SM, Bongomin F, Mamun MA, Griffiths MD. Prevalence of depression in Uganda: A systematic review and meta-analysis. PLoS One. 2022;17(10):e0276552. doi:10.1371/journal.pone.0276552
3) Abaatyo J, Kaggwa MM, Favina A, and Olagunju AT. Readmission and associated clinical factors among individuals admitted with bipolar affective disorder at a psychiatry facility in Uganda. BMC Psychiatry, 23, 474 (2023). https://doi.org/10.1186/s12888-023-04960-0
4) Abaatyo, J., Favina, A. & Kaggwa, M.M. Absconding among admitted patients with bipolar affective disorder diagnosis in Uganda. BMC Psychiatry 23, 318 (2023).
5) Anyayo L, Ashaba S, Kaggwa MM, Maling S, Nakimuli-Mpungu E. Health-related quality of life among patients with bipolar disorder in rural southwestern Uganda: a hospital-based cross-sectional study. Health and Quality of Life Outcomes. 2021/03/10 2021;19(1):84. doi:10.1186/s12955-021-01729-5
6) Kaggwa MM, Namatanzi B, Kule M, et al. Depression in Ugandan Rural Women Involved in a Money Saving Group: The Role of Spouse’s Unemployment, Extramarital Relationship, and Substance Use. Int J Womens Health. 2021;13:869-878. doi:10.2147/ijwh.S323636
7) Kaggwa MM, Acai A, Rukundo GZ, Harms S, Ashaba S. Patients’ perspectives on the experience of absconding from a psychiatric hospital: a qualitative study. BMC Psychiatry. 2021/07/26 2021;21(1):371. doi:10.1186/s12888-021-03382-0
8) Kaggwa MM, Najjuka SM, Harms S, Ashaba S. Mortality Among Patients Admitted in a Psychiatric Facility: A Single-Centre Review. Clinical Audit. 2021 2021-06-17 2021;13:21-28. doi:10.2147/CA.S308757
9) Kaggwa MM, Nkola R, Najjuka SM, Bongomin F, Ashaba S, Mamun MA. Extrapyramidal Side Effects in a Patient with Alcohol Withdrawal Symptoms: A Reflection of Quality of the Mental Health Care System. Risk Manag Healthc Policy. 2021;14:2789-2795. doi:10.2147/rmhp.S314451
You can view some of my scholastic work from the following
eRA COMMONS: ORCID ID: https://orcid.org/0000-0002-4733-154X
Scopus Author ID: https://www.scopus.com/authid/detail.uri?authorId=57221518864
Researchgate ID: https://www.researchgate.net/profile/Mark-Kaggwa
Loop profile: https://loop.frontiersin.org/people/926359/overview
Semantic Scholar Link: https://www.semanticscholar.org/author/Mark-Mohan-Kaggwa/2046806840
Google scholar: https://scholar.google.com/citations?user=pPNqr_AAAAAJ&hl=en
My reply:
Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy. Through this article I will respond to why some people feel anxiety during the evening, or at some specific time of the day, proposing strategies to help you cope with the feeling of anxiety.
Experiencing anxiety is annoying and exhausting. An unpleasant experience that generates physical and psychological symptoms, but is nonetheless common and necessary to live with. Anxiety puts your body in a state of alert, it basically warns you that there is a threat, real or not, and prepares you to face it.
The problem is when your anxiety becomes recurrent and intense and diminishes your happiness and overall quality of life. When anxiety occurs at a specific time of the day it can be for several reasons, either because you associate this time of the day with something negative or because your body and mind are more stimulated at that time.
The evening is a time of day that means different things to many people. For some it is a period of work, for others a period of rest. Whatever your case may be, if you experience anxiety specifically in the afternoon there is something going on in your body that generates these symptoms.
Anxiety is common, even if it is intense and recurrent, it is something that happens constantly and does not have to define you as a person, and it has a solution. It is necessary that you first get to know your body and how anxiety works before you start applying strategies to improve.
It is a difficult process, but you are already taking the first step by seeking help to get better on your own.
What does it feel like to have anxiety?
Anxiety is your body’s response to a real or imagined threat, which triggers both physical and emotional symptoms that are bothersome and distressing. Some of these are:
- Tachycardia and duration
- Intense fear or sadness
- Shortness of breath
- Persistent worry
- Fear of losing control
- Desire to run away or escape from a situation
- Muscle tension
- Headache or stomach ache
Why do you feel anxious in the afternoon?
The truth is that anxiety does not ask for permission to appear in your life, it simply appears when it considers that there is something too stressful or threatening that you must face, and it overflows you with intense emotions and unpleasant physical symptoms.
Time perception and anxiety are closely related. One study showed that the feeling of anxiety makes people feel that time is passing faster(1), which in turn triggers more anxiety, as people feel that the activities or responsibilities they had to accomplish during the day fade away because of the state of anxiety.
The evening in particular is a period of the day that makes people feel stressed. In many jobs such as those related to customer service, the afternoon is the busiest time for work and customers. For stay-at-home parents, the afternoon is the most hectic time because children are most active.
Even if the afternoon is a time of rest for some people, the afternoon can generate anxiety because anxious thoughts accumulated during the day are presented at this time, generating excessive worry.
What can you do?
In any case, regardless of the time of day when anxiety occurs during the day, coping with anxiety is aimed at reducing both physical and psychological symptoms, and accepting anxiety as part of life, learning to differentiate when it is normal and necessary, and when it needs our attention to prevent it from damaging our mental health.
Write to understand your feelings
In a journal you can write down and specify exactly what you mean by “crazy”. It is important to learn to name our emotions to eventually work on them. In this document I attach a link to an image that shows a circle with different emotions. You can look at them and find one that gives a name to what you are feeling in an anxiety attack, and then we would be clearer where to work to improve.
Guided Imagery
In this exercise(2), in addition to inhaling and exhaling slowly, you will close your eyes, and visualize a scenario that generates calm and happiness, and distracts you from the negative thoughts that come with anxiety. It can be a beach, a mountainous landscape or even a pleasant memory. You will apply this when you start to feel the anxiety episode. This technique takes time and training, so don’t worry if you initially feel that it doesn’t work for you.
5, 4, 3, 2, 1
This technique(3) consists of using your senses to dissuade emotional discomfort at a specific moment. It is useful when you are experiencing a lot of physical agitation or you feel that you have a lot of unpleasant thoughts, and find it difficult to control your emotions. Wherever you are, you will focus on identifying 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. Whether you are in your room, in a car or a public place, you can sit and practice this exercise in silence, breathing slowly as you do it as many times as you feel necessary to decrease the anxious symptoms.
In my experience…
Whether in the morning, afternoon or evening, anxiety, when it appears, sends you a kind of “message” regarding that period of the day in which it occurs recurrently. Very often, it is related to the fact that you spend a lot of activity and effort at this time of the day that is already taking its toll and wearing out your energies, generating anxiety as a response of alertness and fatigue.
Therefore, you must learn to identify what are the triggers of your anxiety in the course of the day, because learning to know yourself, you are taking the first step to build a stronger and more confident personality, dealing with anxiety in a more effective and functional way.
I hope that with these suggestions you can improve. I recognize and applaud you for seeking professional counseling, because it shows that you want to feel better and you are on the right path to change the things that make you feel bad. I believe that you have the capacity to improve, although sometimes your mind makes you believe that you have no solution. It was a pleasure to write to you.
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References
Take Control of Your Anxiety Today: Personalized Counseling with BetterHelp
