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Pupils Anxiety Symptoms – Dilated Or Contracted

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated May 19, 2021

pupils anxiety symptoms

Dilated or contracted pupils are common symptoms of anxiety disorder, including generalized anxiety disorder, social anxiety disorder, panic disorder, and others.

This article explains the relationship between anxiety and how it can affect the pupils in your eyes.

Pupils anxiety symptoms - dilated or contracted - common descriptions:

It's wise to discuss this symptom with your doctor to ensure correct diagnosis. If you prefer, you can also discuss this symptom with an optometrist.

  • The pupils in your eyes look dilated and unusually big. For some people, the dilation can be substantial, and to the point of where it looks like it takes up the entire iris.
  • The pupils in your eyes look contracted and unusually small. For some people, the constriction can be so significant that the pupil is barely noticeable.

Dilated or contracted pupils can come and go rarely, occur frequently, or persist indefinitely. For example, you may notice a change in the size of your pupils once and a while and not that often, notice it off and on, or experience it persistently.

Dilated or contracted pupils may precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.

Dilated or contracted pupils can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur ‘out of the blue’ and for no apparent reason.

The change in pupil size can range in degrees from slight, to moderate, to extreme. Your pupil size can also change in episodes, where it’s extreme one moment and barely noticeable the next.

Dilated or contracted pupils can change from day to day, and/or from moment to moment.

All of the above combinations and variations are common.

To see if anxiety might be playing a role in your anxiety symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely it could be contributing to your anxiety symptoms, including Pupils anxiety symptoms.

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Why can anxiety cause pupil symptoms, such as dilated or contracted pupils?

The eyes are a sensory organ that function in conjunction with the nervous system. Because elevated stress can adversely affect the nervous system and how the sensory organs function, stress, including anxiety-caused stress, and a lack of sleep can affect the size of the pupils in the eyes.

Moreover, as part of our survival mechanism, the stress response is supposed to dilate the pupils in the eyes so that they can take in more visual information when danger is perceived. This is why the pupils become larger and why our eyes become overly sensitive to light when the body is experiencing a stress response and/or when overly stressed. But since each person is somewhat chemically unique, elevated stress can also cause pupils to contract for some people.

It’s also common for medications to affect the size of the pupils. For example, benzodiazepine medications can reduce pupil size in some people whereas Effexor (SNRIs) can cause pupils to dilate. There are many medications that can affect pupil size.

Recreational drugs can also affect pupil size. Some recreational drugs can cause pupils to dilate whereas others to contract.

And there are medical conditions that can dilate or contract pupils.

For that reason, it’s recommended you talk with your doctor about this symptom in order to rule out any other cause. If your doctor attributes this symptom to anxiety/stress, you can treat it like you would any other symptom of stress.

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How to get rid of dilated or contracted pupil anxiety symptoms?

When dilated or contracted pupils are caused by apprehensive behavior and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the active stress response, this anxiety symptom should subside. Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.

When dilated or contracted pupils are caused by persistent stress, such as from stress-response hyperstimulation, it may take a lot more time for the body to calm down and recover, and to the point where this anxiety symptom subsides.

Nevertheless, when the body has fully recovered from the stress of being anxious, dilated or contracted pupils will completely disappear. Therefore, this anxiety symptom needn’t be a cause for concern.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your rest and relaxation, and not worrying about pupil symptoms. Sure, dilated or contracted pupils can be annoying, but again, when your body has recovered from the stress response and/or sustained stress, your pupils will return to normal.

If you are having difficulty containing your worry about pupil symptoms, you may want to connect with one of our anxiety disorder therapists, coaches, or counselors. Working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to overcome what seems like unmanageable worry.

For a more detailed explanation about anxiety symptoms, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page. Information, support, and therapy for anxiety disorder and its symptoms, including Pupils Anxiety Symptoms.