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Anxiety disorders affect many people, and the symptoms can be more complex than you might think. The link between physical and mental health can be profound, and physical symptoms of anxiety can run along a spectrum of distressing to debilitating. If you live with anxiety, then you might find that you experience both physical and mental symptoms of the disorder.

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“Mental health and physical health are inextricably linked in both primary and secondary ways,” clinical psychologist Dr. Deborah Offner tells SheKnows. “The mind-body connection is much deeper, pervasive and reciprocal than many people realize. While many of us recognize that physical health — ranging from a cancer to the flu to a poor night’s sleep — can affect our mood and emotional wellness, many of us underestimate the contributions that mental health can make to physical health or illness.”

Stress and anxiety can contribute to compromised immune system functioning, Offner says, leaving you more susceptible to infections. Additionally, anxiety and depression can mess with sleep or your appetite, which may also make your body more vulnerable to illness as a result.

“When we experience anxiety, we are essentially experiencing a fight/flight response in the body,” Erica Curtis, a licensed marriage and family therapist and author of the upcoming The Innovative Parent: Raising Connected, Happy, Successful Kids Through Art, tells SheKnows.

That means the body is preparing itself to either fight off a threat or run away from it, she explains. “For example, muscles tense to act quickly or protect against injury, the heart pumps harder to oxygenate the muscles to mobilize. Even if there is no ‘real’ threat, when the brain thinks there is one, it mobilizes the body for self-protection,” Curtis notes. “And because the survival part of the brain doesn’t differentiate between emotional or relational threat and physical threat, when we experience — or perceive — any threat, the part of the brain tasked with protecting you jumps into gear.”

If your anxiety disorder is manifesting in physical ways due to the effects of chronic stress on your nervous system, receiving an accurate diagnosis from a qualified mental health professional is key, Curtis says. “A single chronic physical condition alone doesn’t confirm a challenge with anxiety. Look at the symptom(s) in context. Pay attention to other symptoms and accompanying thoughts and feelings.” Experiencing ongoing uneasiness about the future, worrying about what could happen in the future and social avoidance can mean that you have an anxiety disorder, Curtis says.

“Some people can have long-standing physical health issues with no biological cause that may simply result from anxiety,” says Offner.

While a trained therapist can help you identify whether you’re dealing with a mental health condition, the following physical symptoms can mean your anxiety disorder is also having an impact on your physical health. Here are six physical symptoms of anxiety that may be affecting your daily life.

Feeling jittery or having heart palpitations

Anxiety and panic commonly result in feelings of jitteriness along with heart palpitations, according to Harvard Health. Anxiety-induced palpitations may improve with meditation, exercise, yoga, tai chi or another stress-busting activity. Additionally, deep-breathing and progressive muscle relaxation exercises can also help.

Shortness of breath

Generalized anxiety disorder can lead to a condition called dyspnea, which can make breathing deeply much harder when you feel stressed out, according to a 2012 study published in American Family Physician. Not being able to breathe well can make your anxious feelings worse, while dyspnea can mean that you can’t breathe deeply enough to calm down when you feel upset — resulting in a pretty distressing feedback loop. For this reason, shortness of breath is a common symptom of anxiety, and with time and practice, deep-breathing exercises may help.

Headaches & dizziness

“Stress, trauma and anxiety can have significant effects on the central nervous system,” Offner explains. “Medical research has clearly established that trauma or long-term stress or anxiety can cause your brain to release stress hormones, like adrenaline and cortisol, on a regular basis — even at times when you are not actually under strain.” This kind of hormonal reaction in the body can lead to chronic headaches and dizziness, says Offner.

Stomach aches & digestive issues

If you’ve ever had “butterflies” in your stomach when you’re feeling anxious, then you know that anxiety can cause major gut distress. Ken Goodman, a licensed clinical social worker, wrote for the Anxiety and Depression Association of America that the gut-brain connection is the main reason for anxiety-induced stomach problems. When you feel anxious, Goodman wrote, stress hormones enter your digestive tract and may interfere with digestion.

 Muscle tension & chronic pain

Muscle tension and chronic pain are common symptoms of anxiety disorders, the Anxiety and Depression Association says. Additionally, pain disorders like arthritis, fibromyalgia and chronic back pain are often seen in people with anxiety. Treating anxiety that occurs with a pain condition can be challenging and usually requires a multipronged approach that may combine medical treatments along with lifestyle adjustments.

Chest pain & tightness

Feeling as though you might be having a heart attack when anxiety strikes is common, explains Curtis. “Whether [it’s] anxiety or a heart attack, however, seek a doctor’s advice. Your doctor will hopefully be able to clarify if the symptoms are related to a medical problem or caused by anxiety. If the culprit is anxiety, if not treated, it will likely worsen.” No matter the cause, if you’re experiencing pain or tightness in the chest, especially if it’s accompanied by other symptoms, see your doctor as soon as you can.

When seeking treatment, it’s important to be wary of doctors who dismiss the physical symptoms of anxiety as unreal, or “all in your head,” says Curtis. “Anxiety is not only ‘in the head’ — it is also in the body. Anxiety is a real physiological response to the brain’s belief that there is more threat than there actually is. Anxiety is a normal, self-protective system that simply gets carried away, such as when, for example, we learn from adverse childhood experiences that there are dangers in the world and we need to stay on alert more than we actually need to. You are not alone. There is help.”

Offner suggests that if you’re living with an anxiety disorder, there are many treatment approaches that can help improve both your mental and physical health. If it’s clear that anxiety is the cause of your symptoms, and other medical conditions have been ruled out by your doctor, you have a number of interventions to choose from. Traditional talk therapy might help you address the root causes of your anxiety while providing emotional support in the process. Cognitive-behavioral therapy can help change anxious thought patterns, and exercise may also help treat anxiety. Running, yoga, weight lifting or other forms of exercise that release endorphins and reduce stress on the body and mind might be helpful.

No matter what form of treatment you choose, it’s important to check in with a therapist you trust if your symptoms aren’t resolving — especially if you have anxiety that becomes chronic after trauma or a major upheaval in your life. While the mental and physical symptoms of anxiety can be scary and intense, they can be successfully managed over time.

A version of this story was published February 2019.

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