Restlessness is a state of being unable to relax, often characterized by an ongoing feeling of agitation, unease, or the constant need to move. While it can occasionally be caused by temporary stress or excitement, chronic restlessness may signal an underlying mental health condition that requires attention and care.
What is Restlessness?
Restlessness can manifest in both physical and mental forms. Physically, it may include fidgeting, pacing, or an inability to stay still. Mentally, it often appears as racing thoughts, irritability, or difficulty concentrating. These symptoms can disrupt daily functioning, impair sleep, and create a persistent sense of discomfort.
Common Causes of Restlessness
Restlessness can stem from a variety of psychological, neurological, and physical sources. Anxiety disorders are one of the most common contributors. Individuals with generalized anxiety disorder (GAD), panic disorder, or obsessive-compulsive disorder (OCD) frequently report intense internal unease and physical agitation.
Depression may also involve restlessness, particularly when combined with anxiety. In these cases, a person might feel simultaneously fatigued and unable to relax, leading to both mental and physical turmoil.
Certain medications, especially stimulants or antidepressants, may cause or worsen restlessness as a side effect. Caffeine, alcohol, and illicit drugs can have similar effects. Withdrawal from substances, including nicotine and alcohol, is another potential cause.
Medical conditions such as hyperthyroidism, restless legs syndrome (RLS), or neurological disorders like Parkinson’s disease may present with symptoms of restlessness. Hormonal changes, particularly during menopause or pregnancy, can also play a role.
Symptoms of Restlessness
Symptoms may differ depending on the underlying cause but typically include:
- Constant fidgeting or pacing
- An inability to sit still or relax
- Irritability and frustration
- Racing thoughts or excessive worry
- Sleep disturbances due to mental or physical unease
- A feeling of being “on edge” most of the time
For many, restlessness intensifies in the evening, making it especially disruptive to sleep and overall well-being.
Treatment Options for Restlessness
Effective treatment of restlessness requires identifying its root cause. For cases linked to anxiety or mood disorders, therapy and medication are commonly used.
Cognitive Behavioral Therapy (CBT) helps individuals manage thoughts and behaviors that contribute to restlessness. Mindfulness-based stress reduction (MBSR), meditation, and breathing exercises can promote a sense of calm and improve emotional regulation.
When medication is appropriate, doctors may prescribe anti-anxiety medications, antidepressants, or sleep aids depending on the diagnosis and symptoms. These can help restore chemical balance in the brain and reduce restlessness over time.
Lifestyle changes such as regular physical activity, reduced caffeine intake, and structured routines often provide additional support. Practicing good sleep hygiene, avoiding screens before bed, and creating a calming nighttime routine can also reduce nighttime restlessness.
How TMS Therapy May Help
Transcranial Magnetic Stimulation (TMS) is a non-invasive, FDA-approved therapy primarily used to treat individuals with treatment-resistant depression. However, because restlessness is frequently tied to mood and anxiety disorders, TMS may offer indirect benefits by targeting the neurological imbalances that contribute to these symptoms.
TMS works by using magnetic pulses to stimulate specific areas of the brain—especially the prefrontal cortex—that are associated with mood regulation. This stimulation can help normalize brain activity, potentially alleviating symptoms of both depression and associated restlessness.
TMS does not require anesthesia, has no systemic side effects like medications, and allows patients to resume their normal activities immediately after each session. A typical course of TMS consists of multiple sessions over four to six weeks, with improvements often observed by the second or third week.
For individuals who have not found relief through traditional treatments and continue to experience restlessness tied to depression or anxiety, TMS represents a safe and effective alternative.
Sources:
Mayo Clinic. “Restlessness.” https://www.mayoclinic.org/symptoms/restlessness/basics/definition/sym-20050894
National Institute of Mental Health (NIMH). “Anxiety Disorders.” https://www.nimh.nih.gov/health/topics/anxiety-disorders
Cleveland Clinic. Akathisia. https://my.clevelandclinic.org/health/diseases/23954-akathisia
Harvard Health Publishing. “Understanding Generalized Anxiety Disorder.” https://www.health.harvard.edu/a_to_z/generalized-anxiety-disorder-a-to-z
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