Have you ever noticed your heart starting to race for seemingly no reason, started sweating before an important meeting, or maybe had an ongoing digestive issue during a time of change?
Because anxiety is a mental health condition, we tend to focus more on psychological symptoms and less on physical ones. It’s easy to forget about or chalk up physical symptoms to be something else. But physical symptoms of anxiety are not something to be forgotten about.
What is anxiety?
Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes. People who experience anxiety tend to have reoccurring and intrusive thoughts. While it’s normal to experience anxiety from time to time, especially if it’s situational, anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, anxiety doesn’t dissipate once the triggering has passed, rather it lingers and tends to worsen over time. Symptoms can be debilitating, and interfere with day-to-day activities like work, school, relationships, and maintaining physical health.
Persistent feelings of anxiety that interfere with daily life may be a sign of a diagnosable anxiety disorder. There are five main types of anxiety.
Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder (GAD) is the most common anxiety disorder, affecting 6.8 million adults in the United States. GAD produces chronic, exaggerated worry about everyday life. The worry someone experiences can consume hours of every day, making it difficult to concentrate on the tasks at hand.
Obsessive-Compulsive Disorder (OCD)
The second most prevalent type of anxiety disorder is obsessive-compulsive disorder (OCD). OCD affects 2.2 million United States adults and is marked by recurrent, intrusive thoughts (obsessions) and/or unwanted behaviors (compulsions). People with OCD become obsessed with or compelled to perform certain behaviors because they believe it helps them avoid psychological distress or prevents something bad from happening.
Social Anxiety Disorder
Sometimes called social phobia, social anxiety disorders produce overwhelming anxiety and excessive self-consciousness in social situations. It can be limited to specific situations like public speaking, being in a crowd of people, or eating in public. Severe cases of social anxiety disorder can be so broad that someone experiences symptoms anytime they are around other people. Sometimes people with social phobia can develop agoraphobia, a fear of situations that can cause panic.
Post-Traumatic Stress Disorder (PTSD)
PTSD develops after exposure to a traumatic event, like death, threatened death, serious injury, or physical violence occurred. PTSD can manifest in different ways depending on the event, frequency of exposure to the event, and previous exposure to traumatic events.
Panic disorder, commonly referred to as panic attacks, is marked by unexpected and repeated episodes of intense fear. Panic attacks are sudden and often occur in instances where there is no real life-threatening danger. Panic disorder is commonly comorbid with other anxiety disorders and mental illnesses, like depression.
What are common symptoms of anxiety?
While symptoms of anxiety can vary from person to person, and differ depending on the specific type of anxiety disorder, some common psychological symptoms include:
- Feeling nervousness or restlessness
- Being tense
- Having a sense of impending danger or panic
- Having difficulty concentrating
- Difficulty control feelings of worry
- Disturbances in sleep
- Unable to stay calm
When most people think about anxiety, they picture panic attacks or being house-bound – forgetting how anxiety manifests physically. But, there’s more happening inside our bodies when we’re feeling anxious than we may realize.
How does it affect the body?
Whether you experience occasional anxiety or have an anxiety disorder, it manifests in the body in various ways. Physical symptoms occur when the body’s fight-or-flight response is triggered.
The fight-or-flight response also called an acute stress response, is the body’s natural response to a stressful situation driven by the sympathetic nervous system. It’s designed to help you survive situations that are perceived as stressful or life-threatening.
This response begins in the brain. When you are faced with a triggering event, the eyes and ears send information of what they see and hear to the amygdala, the part of the brain responsible for emotional processing. When it receives information that is perceived as a danger, like the sound of a car crashing or someone screaming, it sends a distress signal to the hypothalamus. The hypothalamus acts as a command center, sending information to the rest of the body through the autonomic nervous system.
The autonomic nervous system has two primary components, the sympathetic nervous system, and parasympathetic nervous system. The sympathetic nervous system is responsible for controlling the fight-or-flight response by giving it the energy it needs to respond to danger. In contrast, the parasympathetic nervous system does the opposite. It promotes the rest and digest response that calms the body and brings it back to homeostasis after the danger has passed.
Once the hypothalamus sends the signals that activate the sympathetic nervous system, hormones like adrenaline and noradrenaline are released, telling the body to stay and fight or turn away and flee. This chain of reactions is responsible for the physical symptoms of anxiety.
Here are some common ways anxiety manifests itself physically:
Rapid Heart Rate
A racing heart is one of the most common and most distressing symptoms associated with anxiety. Research shows that an “adrenaline rush”, or a sudden and overwhelming amount of adrenaline, can cause the receptors in the heart to speed up. Sometimes, a rapid heartbeat can come alongside heart palpitations, which can feel like your having a heart attack. Heart palpitations feel like your heart is pounding, fluttering, or skipping beats. While an increased heart rate allows the heart to pump more blood throughout the body, combating the potential stress, these physical effects can make anxiety worse if you aren’t expecting it.
Shortness of Breath
When the heart starts pumping more blood throughout the body, it’s normal for breathing rates to increase to help accommodate the increased amount of oxygen circulating. When breathing increases too quickly, you may start hyperventilating. Hyperventilation occurs when you exhale more than you inhale, resulting in a rapid reduction in carbon dioxide in the body. Low carbon dioxide levels cause blood vessels to narrow, hindering blood supply to the brain and the rest of the body. Because of this, it’s common to experience lightheadedness and some tingling in the fingers. Hyperventilating isn’t harmful in the long term but can add to anxiety if you can’t get enough oxygen.
Dizziness, lightheadedness, and feeling faint are all associated with hyperventilation and may be caused by vestibular, neurological, or psychiatric issues. When heart rate increases, it’s normal to experience a change in blood pressure which can lead to feelings of lightheadedness. In severe cases, people can experience cardiac syncope and faint.
More often, dizziness is attributed to the impact that adrenaline and cortisol have on the vestibular system of the inner ear. Research found that elevated levels of stress and anxiety, triggering the release of adrenaline and cortisol, leading to vestibular dysfunction. The vestibular system is part of the inner ear and is responsible for hearing, maintaining balance, stability, and spatial orientation. When this system is negatively affected, you can lose balance and become dizzy.
Fatigue is one of the most common symptoms associated with anxiety and many other mental health disorders. Chronic anxiety leaves the body in a constant fight-or-flight state. When the body is consistently scanning the internal and external environment for perceived threats or danger, it puts you at risk for high levels of emotional and physical distress. Being on high alert all the time is exhausting.
When stress hormones are consistently elevated, it can be difficult to fall or stay asleep, resulting in poor sleep quality. Sleep issues and the inability to relax can make anxiety worse.
A study showed that people with anxiety or depression are more likely than the general population to have hyperhidrosis. Hyperhidrosis is abnormal or excessive sweating that’s not linked to heat or exercise. The study revealed that of the 500 patients with hyperhidrosis, 13.8 percent had anxiety, 12.4 percent had depression and 6.4 percent had another mental illness. While the connection between the two is unknown, it has been shown that excess sweating and anxiety are bi-directional. As one worsens, so does the other.
It’s well known that anxiety can affect the gastrointestinal system. People with anxiety are more likely to experience general stomach pain, constipation, diarrhea, nausea, and irritable bowel syndrome (IBS). Researchers have found a powerful connection between the gut and brain, known as the mind-gut connection. Both the brain and gut are full of nerves that send signals to each other through neurotransmitters. When your brain signals to the rest of your body that you are anxious, hormones and chemicals released enter the digestive tract causing digestive issues. This interference harms the gut microbiome, resulting in poor communication from the gut to the brain, a decrease in antibody production, and chemical imbalances.
Muscle Aches and Pain
Frequency feelings of fear and worry can contribute to muscle aches and pain. Prolonged stress and consistent release of adrenaline cause blood vessels to constrict. In return, muscles aren’t able to receive the blood flow they need to function properly, causing unwanted tension and aches. In addition, when you’re constantly in a fight-or-flight mode, the body naturally tenses up.
But muscle aches don’t always come from the body’s reaction to stress, they come from the way you handle and process stress. People with anxiety tend to have poor posture, exercise less, and have changes in sleep. Each of these behaviors puts tension on your muscles, leading to muscle aches and pain.
Shaking or Trembling
Shaking is another common symptom of anxiety and is one of the easier symptoms to identify. While it’s completely normal to experience some situational shaking, like when giving a speech or taking an important test, people with anxiety will experience shaking at random times of day without any triggers.
Shaking is a result of the adrenaline released when your body goes into fight or flight mode. When the body has too much adrenaline in the system and without a release, like movement, it manifests itself as shaking and trembling.
Anxiety can also trigger other preexisting conditions, like tremors, that can make trembling and anxiety worse. Tremors induced by anxiety are called psychogenic tremors. They can be difficult to diagnose, but once a diagnosis is made by a psychological and neurological examination, most people can successfully reduce their tremors through various therapies, like cognitive behavioral therapy (CBT).
You Are Not Alone
If you have anxiety and have experienced any of the psychological or physical symptoms listed above, know you are not alone. There are over 50,000 members at PatientsLikeMe who have anxiety disorders and experience these symptoms, too. Join the conversation with our members to learn about symptoms they experience with anxiety and how to manage it.