Two Critical External Triggers of Anxiety: Overstimulation and Understimulation (Triggers Part IV)

by Jennifer L. Fee, Psy.D. Health Professional

If you've been following my posts, you'll recall that external triggers are things that occur outside of ourselves that are usually (but not always) intimately linked with an internal trigger, such as a thought, feeling, memory, image, or body sensation.
This post is part four in a series that I've affectionately titled, "Out of the Blue to Blue's Clues, finding Clues for your Anxiety Triggers."

Over-stimulation (Too many external stimuli)

Under-stimulation (Too little external stimuli)

Fluorescent Lights

Things experienced by senses (Sights, Sounds, Smells)


When I was in high school I worked for an amazing woman who could multi-task and not miss a beat. All at one time she would eat her lunch, talk on the telephone, have the radio on an all-news station, and a TV tuned to a soap opera. What perplexed me was the fact that she seemed to know what was going on with the soap opera, the news, and her phone conversation. Just having the radio on along with the TV was bothersome to me, and there is no way I could talk on the phone and enjoy a lunch at the same time

Over-stimulation occurs when too much is going on for us to handle. Although I can count on one hand the number of times I've been to a Nightclub, what I recall is that they are perfect examples of over-stimulating environments. They can be crowded (so one can feel "closed in"), smoky (when smoking is still allowed), and noisy. There is significant crowd noise as well as music such that it's hard to hear a conversation or hear the words to the music. The nightclub might be dark with strobe lights or other brightly covered lights. All of these factors can be somewhat disorienting, or lead to the physical sensation of unreality. Add some alcohol to the mix and those sensations can intensify. Some people like those sensation (hence the popularity of night clubs). For other people, they trigger anxiety.

Another good example of a potentially over-stimulating environment is some shopping malls. When I first started working as a therapist I lived near a very large and popular shopping mall with many major department stores. There was one large department store in particular that I thought was amazingly designed. The floor plan was essentially a circle, with various entrances and exits to both the parking lot and the mall. The interesting things to me were, however, that the exits were not clearly visible from many parts of the store, and it was extremely easy to lose track of where you had entered the store. In other words, it was easy to get lost in the store!

Other factors about the store (and common to many department stores) included the fact that it was brightly lit with fluorescent lighting and that it was often crowded. The combination of the layout, the lighting, and the crowdedness was over-stimulating for a number of my clients.

What situations do you find over-stimulating? Ask yourself while in different enviroments (restaurants, concerts, malls, etc) if you are being overstimulated.


In contrast to over-stimulation, under-stimulation occurs when there's not enough going on in our environments to keep our attention or keep us interested. In other words, situations that are boring can be anxiety provoking! One common example of under-stimulation is standing in line. Have you ever been in line in a grocery store where the line was moving really, really slowly? Have you notice what other people do? Countless times I have seen people turn around and complain about the store or its employees, either to me or another person in line.

I once carpooled with a colleague to a meeting that involved a freeway trip into the city of Los Angeles. Without traffic this would be about a half hour trip, but with traffic the trip can take close to an hour. We were fine on the way to the meeting, but on the return trip we hit terrible traffic and came to almost a complete standstill. To this point we were having a seemingly enjoyable trip, discussing the meeting, etc. When traffic stopped, however, my friend's demeanor changed dramatically. I suddenly noticed him fidgeting, complaining about traffic around L.A., and he appeared irritable. He seemed anxious to me! This was a surprising thought because I thought of my friend as being one of the calmest people that I know. Not to say that he is not a calm person, but the circumstance of being stuck in traffic seemed to be enough to trigger a high level of anxiety.

Standing in line, driving in slow moving traffic, waiting at the doctor's office or DMV (or anywhere) are all situations where we are limited as to what we can do. They are all under-stimulating or boring situations. Boredom is a potential anxiety trigger.

Why are boring situations a potential anxiety trigger? When there's not a lot going on, such as sitting in a doctor's office, there is room to focus on thoughts, feelings, or bodily sensations that get the vicious cycle moving. You are not going about your day, you are sitting and thinking about what you're feeling in your body.

So, how can you "untrap" yourself from under-stimulation? Although being bored does not trigger anxiety for me personally, I don't like being bored. Therefore, I generally take my laptop with me when going somewhere were I'm going to have to sit and wait. In fact, I wrote this SharePost while sitting at a doctor's office! Other people I know carry knitting bags, books or magazines, or make calls on their cell phone. In the car you can listen to music, talk radio, or books on tape.

Have you ever noticed what children do when standing in line at the grocery store? They play, explore, experiment, or pull on the pants of their caregiver. In other words, they keep themselves busy. While you might not want to duck your head down and see what it looks like under the magazine rack at the grocery store, you can read the covers of the magazines, or pick one up and thumb through it. You could talk to the person next to you in line.

If your focus is on something absorbing, there's less room to pay attention to bodily symptoms or anxious thoughts. However, sometimes anxious thoughts are extremely powerful and it is difficult to get absorbed into some other activity.
In a future SharePost I will talk more specifically about how to address anxious thoughts that you might be having.
In my finally post of this series, I will discuss flourescent lights and things experienced by the senses. Meanwhile, keep searching for your anxiety triggers!

Jennifer L. Fee, Psy.D.
Meet Our Writer
Jennifer L. Fee, Psy.D.

Jennifer Fee is Director of Vision Quest Psychological Services. She is a psychologist licensed to practice in the State of California. She wrote for HealthCentral as a health professional for Anxiety Disorders.