Psychotherapy works best in the morning, new research finds.
It is partly down to higher cortisol levels in the morning, the study suggests.
People in the study had agoraphobia and panic disorder.
Treatments for anxiety disorders often involve exposure to the phobic situation or object.
With exposure people can learn that their worst fears do not materialise.
Dr Meuret, a clinical psychologist and the study’s first author, said:
“For example, a patient may think that standing in an elevator could cause him or her to lose control or faint, suffocate, or may create physical symptoms that would be intolerable.
By having them stand in an elevator for a prolonged time, the patient learns that their feared outcome does not occur, despite high levels of anxiety.
We call this corrective learning.”
The results showed that people had more success overcoming their fears when tackled in the morning.
Dr Meuret said:
“The hormone cortisol is thought to facilitate fear extinction in certain therapeutic situations.
Drugs to enhance fear extinction are being investigated, but they can be difficult to administer and have yielded mixed results.
The findings of our study promote taking advantage of two simple and naturally occurring agents – our own cortisol and time of day.”
Cortisol levels are likely not the only factor.
Other ways to explain the effect include:
- sleep quality and quantity,
- natural circadian rhythms,
- memory and learning changes,
- and attentional control.
Dr Meuret said:
“Notably, higher cortisol was related to greater reductions in threat appraisal, perceived control and panic symptom severity at the next session, and that was the case over-and-above the effects of time-of-day, with large effect sizes.”
The study was published in the journal Psychoneuroendocrinology (Meuret et al., 2016).
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