This is what happens to your body when you're anxious
Anxiety isn't just a feeling; it causes a physical response.
I experienced my first panic attack when I was a freshman in college. I was away from home for the first time in my life, and I was stressed out about assignments that needed to be completed, papers that needed to be written, and tuition bills that needed to be paid. I knew I was anxious, but I didn’t anticipate waking up in the middle of the night, gasping, sweating, and shaking with a pounding heart. I ended up calling my parents at 3 a.m. “Something is wrong,” I said. “I think I need to go to the hospital.”
In hindsight, it’s pretty clear that I was experiencing a panic attack. But here’s the thing: When you’re experiencing a panic attack, or any kind of heightened anxiety, it’s hard to believe that it’s not something else, something more pressing and dangerous. That’s because anxiety can manifest as physical symptoms (I, for one, didn’t realize this until after I was diagnosed with an anxiety disorder). Take it from Dr. Richard Firshein, leading expert in integrative and precision-based medicine and founder of the Firshein Center: “Anxiety is part of a complex series of internal responses and reactions that begin with what’s known as a fight-or-flight response.”
Below, we chatted with Dr. Firshein to find out exactly what happens to your body when you experience anxiety. Here’s what he had to say.
How does anxiety manifest in physical symptoms?
This fight-or-flight response, which refers to a physiological reaction that occurs when you’re faced with a perceived threat, is initiated by the release of the hormones adrenaline and cortisol. According to Dr. Firshein, these hormones cause symptoms that include (but aren’t limited to) increased heart rate and changes in blood sugar and blood pressure. “There are numerous symptoms that are associated with the release of these hormones,” he says. “When this response doesn’t turn off, it’s like a light switch that never goes off. The effects start to increase over time, and then it becomes chronic. Symptoms that should ebb and flow with an immediate crisis become persistent.”
According to Dr. Firshein, these pathways will shorten over time, and the reaction to anxiety will become faster and more persistent. “In some cases, this can occur slowly; in others, it might be part of a condition called PTSD,” he says.
What are some of the physical symptoms of anxiety?
According to Dr. Sanam Hafeez, N.Y.C.-based neuropsychologist and Columbia University faculty member, the physical symptoms of anxiety can differ from patient to patient. “It really comes down to what messages our body sends us to alert us of what we already know is anxiety,” she says. “This can include stomachaches, shaking, extreme fatigue or emotional distress, perspiration, and headaches. Our brain sends out the necessary code to physically manifest our concern.”
Other common physical symptoms of anxiety (some of which I myself have experienced) include nausea, restlessness, neck and backache, chest pain, lightheadedness, numbness and tingling, shortness of breath, and even fibromyalgia. “If we begin to understand that anxiety is a large part of our reaction to hormones, then it’s easier to understand that anxiety is more than just a feeling,” Dr. Firshein says. “It’s part of a complex warning system that has little value in a typical day where threats may be present but don’t represent a red-alert crisis (think of a sabertooth tiger or a prowling bear).”
What can you do to alleviate the physical symptoms of anxiety?
For me, I’ve found that alleviating my anxiety is the most effective way to alleviate the physical symptoms that stem from it (since the anxiety is the root of the issue). That means spending time outside, journaling, sharing my feelings and fears with friends and family, and trying my best to maintain a consistent sleep schedule, since Dr. Hafeez says that “sleep deprivation is one of the gateways for many other things to distress your system. Without sleep, your hormones can shift, your brainpower is reduced, your immune system and digestive systems become hindered by the lack of restorative rest.”
Dr. Hafeez says staying active is also important. “As more and more cities put forth plans to open up, follow your local guidelines and get some sunlight and physical activity,” she says. “What we are starting to see is more and more experts explaining that outdoor activities—complying with other social distancing procedures—can minimize your risk of contracting coronavirus (COVID-19), making it okay for you to get fresh air and decompress from the social isolation and boredom of quarantine.”
Aside from staying active, Dr. Hafeez says it’s important to invest time in yourself. “This is a great time to learn, practice, and share skills that you have always wanted to try,” she says. “This can mean painting, writing, the arts, or learning and reading. If you have shows that have been on your watch list for months, you can catch up on those as long as you don’t do it all at once [and] balance it out with proper sleep, physical activity, work, and fresh air.”
Finally, Dr. Hafeez recommends finding ways to be of use to others. “During experiences like a pandemic, we first think of our survival and those immediately close to us, but figuring out what you can do to help others throughout this crisis can be as rewarding to you as it is helpful to those you are helping.” I know that for me, it’s beneficial to think of others when I’m anxious. Not only does it get me out of my own anxious thoughts, but it also feels good to help someone else.
Dr. Firshein says that, first and foremost, you should consider disconnecting from social media and negativity with friends and family. Then, try “practicing mediation, yoga, visual imagery, getting extra sleep, getting extra sunlight, and taking supplements such as vitamin D. Some of my patients respond to CBD, GABA, magnesium, or even gentle chamomile tea. Of course, talking to a health professional should be the first step, since there may be underlying triggers that are worth discovering.” Of course, if these natural aids don’t work, it might be worth talking to your doctor about exploring medication. Please talk to a medical professional before self-medicating.
How can you tell if you have chronic anxiety?
Everyone experiences anxiety, but not everyone experiences chronic anxiety. The difference is how often you experience it and to what extent. “Chronic anxiety usually feels like a constant and prolonged feeling of concern and unease,” Dr. Hafeez explains. “Everyone experiences anxiety regularly, but if you are going through what is called generalized anxiety disorder, you may be weighed down excessively by your anxiety, which could be affecting your everyday life.” This kind of worry interferes with sleep, concentration, energy levels, appetite, and decision-making. “This is emotionally and mentally exhausting for any person to go through, especially if, on top of the anxiety, there are situations that exacerbate your worries, such as financial instability, health issues, relationship issues, and life changes,” she says.
If you’ve noticed that you’ve been more anxious than normal lately, you’re not alone. “It has been well-reported that concerns about an increase in depression, anxiety, and other mental health conditions are on the rise,” Dr. Hafeez says. “While different communities are affected differently, the truth is we are all touched to some degree by this pandemic and the economic, health, and social ramifications of our current situation.” This is especially true when we consider that separating ourselves from our community of loved ones can feel isolating, and “everything—from getting the physical activity [we] need to the mundane task of gathering the supplies [we] need from the grocery stores and pharmacies—comes with an anxious list of things we must do to keep safe.”
So, what can you do about it? According to Dr. Hafeez, we should be gentle on ourselves. “When we are responsible for others or we hold ourselves to a high standard—or for those of us who are entrepreneurs and are always thinking of innovations and career moves—it can be difficult to accept that we are experiencing anxiety, and that this is okay,” she says. “There is no sense in blaming yourself or thinking that anxiety is something you will power through. We must acknowledge it and learn to navigate and manage it.”
If you think you’re chronically anxious and you’re experiencing such symptoms as insomnia, reduced energy levels, and constant worry, it’s important to reach out to a doctor and/or mental health professional for help. For me, a combination of talk therapy and medication has been incredibly helpful for managing my anxiety disorder. Remember, there’s absolutely no shame in asking for help when you need it.