Learn to Identify the Physical Symptoms of Anxiety

It’s normal to feel anxious occasionally, but if you become very fearful, nervous, or anxious when you think about or are in certain situations, then you may have an anxiety disorder.

Anxiety disorders are a group of mental health conditions in which anxiety and worry arise in response to a perceived danger. Although anxiety is classified as a mental heath disorder, it has physical, as well as emotional and cognitive, components.

Signs of Anxiety

“Physical symptoms of anxiety include muscle tension, headaches, indigestion, stomachaches, sweaty palms, dizziness, back pain, and a racing heartbeat,” explains Susan Evans, PhD, Professor of Psychology in Clinical Psychiatry and Director of Education in Psychology at Weill Cornell Medicine. Other common symptoms include restlessness, feeling keyed up or on edge, irritability, fatigue, and sleep disturbances.

Sometimes, anxiety presents in the form of a panic attack. According to Dr. Evans, a panic attack is an abrupt, sudden surge of intense fear that can come out of the blue for no apparent reason. A panic attack is accompanied by a number of physical symptoms, including heart palpitations (pounding or racing heart), sweating, trembling, a choking sensation, nausea, and/or dizziness, along with the fear that one is dying or losing control. These symptoms usually peak within a few minutes, and then the attack subsides.



A panic attack and a heart attack can feel similar; both may involve chest pain, shortness of breath, dizziness, sweating, and other physical symptoms. Therefore, it can be challenging to differentiate between the two. If you experience these symptoms, seek emergency medical care immediately in case you are having a heart attack. Once the symptoms have passed, see your primary care physician to rule out any physical cause of the symptoms and to ensure that your heart is healthy. You can then learn to identify these physical symptoms as a panic attack and learn how to cope with them if they recur.

Panic attacks are extremely distressing, and they can result in maladaptive behavioral changes due to the person’s fear of having another panic attack. These changes may include avoiding or restricting usual activities, such as using public transportation, driving, or grocery shopping. If these behavioral changes are not addressed, they can interfere with one’s ability to work, take care of family and self, and interact with others.

Other Symptoms

The cognitive aspect of anxiety refers to thoughts that occur in response to fear. For example, the person may think, “I am going to die if I have another panic attack,” or “I am going to be in a horrible accident if I drive on the freeway.” These thoughts may run in a constant loop in the person’s head, making it difficult to attend to or concentrate on their current surroundings or situation. The emotional experience of anxiety includes feeling worried, frightened, or a sense of dread.

Treatment Options

Some primary care physicians (PCPs) screen for anxiety and may choose to treat the patient themselves. Often, the PCP will refer the patient to a mental health specialist who is trained to teach the patient skills that are effective in ameliorating anxiety.

“Cognitive behavioral therapy (CBT) can be very helpful for the physical and emotional symptoms of anxiety, as well as maladaptive behavioral patterns that have emerged as a result of anxiety. Cognitive techniques address negative, dysfunctional thoughts and cognitive processes that may include worry and rumination. Behavioral strategies include progressive muscle relaxation, diaphragmatic breathing, exercise, sleep hygiene, yoga, and meditation. Massage and acupuncture may also help ease physical symptoms and promote a sense of well-being,” says Dr. Evans.

Some patients get more relief by combining therapy with medications. Medications used to treat anxiety include selective serotonin reuptake inhibitors, such as Prozac®, Zoloft®, and Lexapro®, and serotonin norepinephrine reuptake inhibitors, such as Cymbalta® and Effexor®. Other medications that are sometimes used for anxiety include Buspar® and Neurontin®.

Benzodiazepines, including Xanax® and Valium®, are also used to treat anxiety. These drugs work quickly and can be used “as needed” rather than taken daily. However, side effects may include sedation, confusion, and falls, as well as the possibility of addiction and abuse. These risks should be reviewed as part of the decision-making process.

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