Dealing with the Physical Symptoms of Anxiety

We discuss the physical symptoms of anxiety. As you may have seen from other content, we often like to review questions from subscribers and provide replies that will be helpful for everyone.

Question: “Does anxiety as well GAD make you feel sick all day like you’re going to pass out or going to vomit or have a heart attack and does it cause chest pain all day and headaches?”

Answer: If you believe the above symptoms to be physical symptoms of anxiety then your first step should be getting checked out by a medical doctor.  Once a physical check-up rules out a physical cause then the rest of my discussion becomes relevant.

An abundance of research on anxiety and panic attacks demonstrates that anxiety can bring on or contribute to many physical symptoms.  For instance, according to such physical symptoms of anxiety can include:

“racing or pounding heartbeat (palpitations); chest pains; stomach upset; dizziness, lightheadedness, nausea; difficulty breathing, a sense of feeling smothered; tingling or numbness in the hands; hot flashes or chills; trembling and shaking; dreamlike sensations or perceptual distortions; terror, a sense that something unimaginably horrible is about to occur and one is powerless to prevent it; a need to escape; nervousness about the possibility of losing control and doing something embarrassing; fear of dying.”1

As you can see the above physical symptoms of anxiety constitute a wide range of symptoms.
I find comments made by a physician quite telling “In fact, doctors can’t find physical causes for pain suffered by one of every six people who comes to the emergency department, including three out of four patients who have chest pain and nine out of every 10 patients who have abdominal pain, he said. It’s becoming more and more clear that a lot of these problems are based in emotional distress.”2

Famous actors have discussed the physical symptoms of anxiety they experience before going on stage, some even have diarrhea for example.  Believe it or not even someone as extroverted as Robin Williams has had this experience.3

Not everyone who suffers from anxiety or panic attacks has all these symptoms.  However, it can be reassuring to know the relationship between anxiety and such symptoms.

It is quite possible to allow the physical symptoms of anxiety to pass. Cognitive behavioral therapy (CBT) can help you accomplish this end.

In the event that you are not fully aware of CBT, here is a quick explanation.  CBT is a process in which the anxiety sufferer analyzes his/her thoughts to locate the cognitive distortions present.  These distortions cause your emotions and consequently can do the same with physical symptoms of anxiety.  Cognitive distortions are errors in your thinking.  Once these distortions are located, a healthier thought can be substituted in their place and you can start to feel better.

A list of Cognitive Distortions can be accessed in a separate window by clicking here.

I would encourage you to go through the below example with me and then look try to apply this process to your own thoughts by, again, using the list at the end of this installment.

Looking at the above physical symptoms of anxiety utilizing CBT, imagine having the thought that you might be having a heart attack and might get nauseas.

You need to consult the list of cognitive distortions above and locate the distortion.  You should have a pen and paper handy to write down everything – this is extremely helpful.

Well, having consulted the list you might have recognized that “fortune telling” and “disqualifying the positive” were present.

Okay, now that the distortions have been located, you need to locate a healthier more realistic thought.  If you think about it, there have probably been other times when you’ve had these feeling and you didn’t get sick or have a heart attack.

I’m sure that you can think of other times in your life when you didn’t have heart attack or vomit despite thinking this would occur.  This is an alternate thought that you could write down. I’m sure that you can think of other thoughts to write down, but you probably get the idea now.

As you can see from this example CBT can be helpful with a wide range of issues related to the physical symptoms of anxiety- and much more!

Please note, though, that the process of change through CBT won’t always be instant. It does take work.  A key lesson here is that you can start to feel better once you work through your thoughts every time they come up.  This way you continually challenge those thought processes that bring about your anxiety.

1. Roxanne Dryden-Edwards & M. Conrad Stöppler. Panic Attacks (Panic Disorder).
Retrieved October 30, 2010 from website:

2. (2010 January 29). Chronicle Herald Newspaper.

3. Robin Williams. James Lipton (host). Inside the Actors Studio. Bravo. 2001-06-10. No. 710, Season 7.