Why Anxiety Gets Worse Before It Gets Better

The extinction burst

In behavioural psychology, an "extinction burst" is a well-documented phenomenon: when you stop reinforcing a behaviour, the behaviour initially increases before it decreases. The classic example is a vending machine — if it stops dispensing drinks, you don't calmly walk away. You press the button harder, press it multiple times, maybe hit the machine. The behaviour escalates before it stops.

Anxiety works the same way. Your anxiety has been maintained by avoidance, reassurance-seeking, and other safety behaviours for months or years. When you start challenging these patterns through CBT or ACT, your anxiety initially escalates. It's pressing the button harder. It's your brain's way of saying: "THIS STRATEGY HAS ALWAYS WORKED. WHY ARE YOU CHANGING IT?"

Why awareness increases discomfort

Before therapy or self-help, many anxious thoughts are automatic and unexamined. They just happen. Starting CBT means you begin noticing these thoughts — catching cognitive distortions, recognising catastrophising, observing the spiral as it forms. This awareness is essential for change — but it initially makes you feel more anxious, because you're now conscious of thought patterns that previously operated below awareness.

Think of it like turning on a light in a cluttered room. The room was always cluttered — you just couldn't see it. The light didn't create the mess; it revealed it. And you need to see the mess before you can clean it up.

How long does this phase last?

For most people, the "worse before better" phase lasts 2-4 weeks. After that, you start to see the benefits: distorted thoughts are caught earlier, spirals are shorter, the techniques feel more natural. By 6-8 weeks of consistent practice, most people report significant overall improvement even if individual bad days still occur.

The key during this phase is consistency over intensity. Don't abandon the techniques because they "aren't working." The extinction burst is evidence that they are. Your anxiety is fighting back because its maintenance strategies are being dismantled. Keep going.