The Physical Symptoms of Anxiety

This high-alert state can cause pain, changes in heartbeat, and more

As anyone who has experienced it can tell you, anxiety is brings about both a psychological and physical symptoms—both of which can be overwhelming. Anticipating future threats, the body gears up for a fight-or-flight moment: The brain activates the heart, lungs, and muscles so you'll be ready to engage or flee. With that, the heart beats faster, you begin to sweat, and muscle tense, among other things. Anxiety disorders are characterized by persistent and intense physical symptoms, and considering these reactions is especially important when diagnosing generalized anxiety disorder (GAD).

In fact, to meet the formal criteria for generalized anxiety disorder (GAD), anxiety must be associated with multiple physical symptoms. In children, the presence of even one of these symptoms is sufficient for a diagnosis to be made.

While there are several types of anxiety disorders, a look at the physical symptoms that may be experienced with GAD can give you a sense of what is possible.

Muscle Tension

Woman rubbing her neck

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The muscle tension associated with normal anxiety might involve a brief tensing of the back and neck that relaxes when a threat passes. The muscle tension described by people with GAD include unrelenting aches and pains in overly active shoulder, back, neck, and jaw muscles. The tension might also include a restless fidgeting of tense legs or a grinding of the teeth.

These manifestations of muscle tension don't subside in the absence of a threat; rather, they persist until specific relaxation or mindfulness skills are employed, or medications that promote relaxation are taken. 

Headache and Dizziness

The psychological distress associated with GAD involves chronic worry for most of a person's waking hours. Thoughts may race down a spiral of anticipation and fear about one topic or may bounce incessantly from one issue or scenario to the next. This psychological experience can result, literally, in an aching head.

When accompanied by an increased heart rate and changes in body temperature, dizziness can also occur.

Stomachaches and Other Digestive Problems

The gut also holds and expresses anxiety. This can take the form of non-specific unsettling of the stomach, outright nausea, constipation, or diarrhea. Digestive problems can have a particularly negative impact on day-to-day functioning.

Beyond being uncomfortable and disruptive in their own right, these symptoms may perpetuate worries about the presence of a medical illness.

Edginess

The edginess associated with GAD can manifest behaviorally as irritability or physically as trembling and shaking. The fidgeting or restlessness may be more obvious to observers than to the anxious individual in some cases. 

Tiredness and Insomnia

Chronic worry, simply put, is exhausting, so it's typical for people with GAD to be fatigued. But sometimes the worry or other physical symptoms of anxiety make it difficult either to fall or stay asleep. In the short-term, this can take a toll on other aspects of physical and psychological well-being. For people experiencing even mild sleep disruptions, anxiety treatment is likely to involve changes to the bedtime routine.

Shortness of Breath

With increased heart rate, elevated blood pressure, sweating, and/or dizziness, shortness of breath can occur. However, the constellation of symptoms that fit the description of a panic attack is more likely to occur in those with GAD and panic disorder, another type of anxiety disorder, than other anxiety disorders. They're less common in people with "uncomplicated" GAD, meaning the condition doesn't overlap with other emotional and behavioral problems, including depression, other anxiety disorders, and substance use disorders. 

A Word From Verywell

Physical symptoms are only considered a manifestation of anxiety if they're not better explained by the presence of a medical condition. Thus, careful evaluation by both a medical professional and a mental health provider is the most assured way to distinguish their cause. 

The physical complaints that are symptomatic of an anxiety problem are no less uncomfortable than those ascribed to a medical condition. Fortunately, as you undergo treatment for the anxiety, the symptoms and your tools to cope with them will improve.

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  • Cleveland Clinic. Anxiety disorders. https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders.

  • Mayo Clinic. Anxiety disorders. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961.