Definition
Restlessness is a subjective sense of being unable to settle, often paired with a physical urge to move. It's one of the diagnostic features of generalized anxiety disorder and a common feature of depression with anxiety, withdrawal states, and certain medication effects.
What it can feel like
Pacing without a destination. Bouncing a leg under the table. Needing to change position every few minutes. Difficulty sitting through a movie or a long meeting. Many people describe a humming or buzzing sensation under the skin that's hard to localize.
Why it happens
Sympathetic activation prepares the body for movement. When the activation has nowhere to go, the urge to move persists as restlessness. It can also be a side effect of certain medications, particularly in the early weeks of treatment with SSRIs, SNRIs, and stimulants. A specific form called akathisia is associated with antipsychotics and some antidepressants and feels intensely uncomfortable; it should be reported to the prescribing clinician promptly because dose adjustment or a different medication usually resolves it.
When to see a clinician
Restlessness that runs most days, that's paired with sleep disruption or muscle tension, and that has lasted more than a few weeks is part of a generalized anxiety pattern that responds to treatment. New restlessness after starting a medication should be reported to the prescriber promptly.