The Relationship Between Anxiety and Illness

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Anxiety and illness often go hand-in-hand. Physical health concerns are worrying on their own, but even more so when you also have mental health problems. Anxiety disorders such as social anxiety disorder (SAD) tend to be associated with illnesses such as heart disease, gastrointestinal issues, and respiratory illness.

Although the relationship between anxiety and illness has been established, it is a bit of a chicken-and-egg scenario as far as the causal relationship between the two.

Does anxiety trigger biological processes that lead to physical health problems? Does poor physical health (e.g., migraines or arthritis) lead to anxiety? Or does something else, such as genetic or environmental factors, cause both anxiety and physical health issues?

What research has clearly shown is that those who have physical health problems complicated by anxiety tend to have worse symptoms, respond less well to treatment, and are more likely to have fatal illnesses.

What the Research Shows

  • Studies of the relationship between anxiety and physical health have generally grouped anxiety disorders together as a whole. Therefore, we don't know, for example, whether someone with social anxiety disorder (SAD) is more likely to suffer from a different type of physical health complaint than someone with panic disorder.
  • Research has shown, however, that those with SAD are more likely to have problems with health in general. A study of 202 Iranian students examined the impact of social phobia on physical health and found that students with social phobia scored lower on measures of general health and vitality.
  • As might be expected, those with chronic respiratory disease such as asthma or COPD have been shown to have higher rates of anxiety. Again, the causal nature of this relationship hasn't been established and is likely complex, but it is reasonable to assume that at least some of the connection involves fear of respiratory failure.
  • Higher rates of anxiety have been linked to the development of irritable bowel syndrome (IBS) in those diagnosed with gastroenteritis.
  • A connection has been shown between phobic anxiety and sudden cardiac death.
  • People with hypertension, thyroid disease, and cancer have been shown to have higher rates of anxiety.
  • A study of 4,181 individuals found that most people with both anxiety and physical health problems reported developing anxiety first.

What This Means for You

What do these study results mean for you? If you have been diagnosed with social anxiety disorder (SAD) and also have a physical health problem, talking to your doctor about both issues is important.

Those who suffer from both anxiety and physical illness have been shown to have a poorer quality of life, so it is important that you receive treatment to address both your anxiety and physical health concerns.

If you suffer from a physical health issue such as IBS, asthma, COPD or heart disease, and have symptoms of anxiety but haven't received a formal assessment, you may want to ask your doctor whether this step might be appropriate.

If it turns out that you do suffer from an anxiety disorder, your doctor will be able to tailor your treatment program to best suit your needs.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • Ghaedi GH, Tavoli A, Bakhtiari M, Melyani M, Sahragard M. Quality of Life in College Students With and Without Social Phobia. Social Indicators Research. 2009.

  • Harvard Health Publications. Anxiety and Physical Illness.

  • Johns Hopkins Medicine Health Alerts. Anxiety and Your Physical Health. 
  • ScienceDaily. Anxiety Disorders Linked To Physical Conditions.

By Arlin Cuncic, MA
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology.