anxiety: the mental disorder with physical consequences
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anxiety can cause insomnia, muscle tension, headaches and stomach issues.
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anxiety is a normal reaction to stress, and in some cases, it’s just a part of human evolution geared toward helping people survive and thrive in the world around them.
“there’s a certain level of optimal stress that’s good for us to have,” said dr. alexandra gold, licensed clinical psychologist at mass general brigham. “it’s not really stress, i would say, but alertness. it’s this balance midway because it allows us to care about things.”
she notes that without stress or alertness, people would have no motivation to go out into the world and care for themselves or others in their lives, such as their families and pets.
“it’s good to have concerns. it’s good to be alert. it’s good to have things that make you concerned, and you might worry about them because they matter,” she said. “it can actually be helpful, but when it goes too far, that’s when it becomes an issue.”
when the feelings associated with the condition, such as fear, intense worry or impending danger or doom, remain consistent or worsen over time, it is referred to as an anxiety disorder.
there are many different types, ranging from generalized anxiety disorder, which affects people daily, to panic disorder, which results in panic attacks with symptoms coming on suddenly. as many as 25 per cent of canadians will live with an anxiety disorder at some point in their lifetime.
while anxiety is a mental disorder, it can also negatively affect physical health in many ways.
what does anxiety feel like physically?
people with anxiety can experience a range of different physical sensations, according to dr. gold. because there are several types as well, the way it presents physically may vary for people diagnosed.
she notes that people could experience:
- shortness of breath
- heart pounding
- sweating
- face flushing
- tingling in their hands
- nausea
- hives
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“there can be a lot of different physical sensations that go on in those panic moments,” she said. “that’s more with panic attacks, like a rush of anxiety that comes up and you see physical symptoms.”
but when people with anxiety have more generalized symptoms that occur over a longer period than a panic attack would, those symptoms present differently. people with generalized anxiety may:
- have trouble sleeping (insomnia)
- chronic fatigue
- headaches
- nausea
- diarrhea
- dizziness
- upset stomach
- feel muscle tension
- feeling jumpy or on edge
- skin rashes
how can anxiety affect your physical health long-term?
dr. gold also notes that because anxiety keeps people in a heightened state of stress, it leads to too much cortisol in the body and long-term health complications.
“your body is not supposed to be staying in that heightened cortisol state indefinitely,” she said. “we’re supposed to come down from that. so, if you’re constantly in this high cortisol stress state, you’re going to have more stress in your body, which leads to inflammation, which leads to these different types of conditions.”
for example, the physical effects of anxiety can be long-lasting and increase the risk of developing certain cardiovascular diseases, such as:
- heart disease
- high blood pressure
- coronary artery disease
- stroke
- heart attack
it can also affect gut health and lead to irritable bowel syndrome, as well as a higher risk of developing other mental health conditions that can also affect physical health, such as depression and substance use disorder.
according to dr. gold, it all comes back to inflammation.
“if you are chronically ongoing feeling stressed out, there’s research that there might be more inflammation in your body that can lead to different health conditions, too,” she said. “and also, thinking about things like substance use, substance misuse, sometimes people will have alcohol, and that’s a function of coping with their mood symptoms or maybe anxiety, and that can become its own health issue.”
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when should you see a doctor for physical symptoms of anxiety?
it can be challenging for people living with anxiety to differentiate between physical symptoms of their existing ailment and physical symptoms that have nothing to do with their anxiety. for example, if someone experiences the symptoms of ibs, which can mimic other stomach conditions, but also has anxiety, it can be hard to know where it’s really coming from.
that’s why dr. gold always recommends seeing a doctor for any physical sensations because the symptoms are so “non-specific.”
“you can have nausea when you’re having panic attacks, it’s one of the crisis symptoms that come up, or vomiting, but you can also have that when you have a serious health condition or a really benign health condition, so they’re just non-specific,” she said.
she notes that “as a general rule,” seeing a doctor is vital to ensure that there’s nothing more sinister happening in two cases: new symptoms or the symptoms are interfering with your daily life.
“if you have new symptoms, physical symptoms that are distressing to you, that are bothering you, that are getting in the way of your daily life, that is a red flag to go seek professional help,” she said. “interference is number two. if you notice that these symptoms are getting in the way of your relationships, your work, your productivity, your social time, your recreation, your downtime, your sleep … go get professional help and don’t be afraid to do so.”
however, there is a catch. if you’ve already been to the doctor, are diagnosed with anxiety and have been told that there’s nothing physically wrong, it’s important to keep that in mind as well.
“we don’t want to encourage people to just repeat going to a doctor when they’ve already talked to their doctor, and it’s not a new issue, and it’s clear because that can also be an anxiety behaviour, health checking,” she said.
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coping with physical symptoms of anxiety
there are different treatments based on the type of anxiety a person has and the symptoms they’re presenting with.
for example, people who experience panic attacks will likely be given a different treatment route when compared to people with generalized anxiety. treatment will also differ based on the individual as well.
however, one treatment method that can be effective for both is cognitive behavioural therapy (cbt).
“cognitive behavioural therapy is very good for panic attacks,” said dr. gold. the goal of cbt for this type of symptom is to help people expose themselves to those symptoms intentionally, so it’s actually called exposure therapy, where you intentionally bring on these symptoms so that the person can acclimate to those symptoms and realize they’re not dangerous.”
one example she notes is breathing through a straw if you experience shortness of breath during bouts of anxiety as a way to get used to the feeling in a safe setting. it’s important to do this under a doctor’s supervision, though.
“the person can keep repeating that because, again, the idea is to expose them to those sensations of anxiety and for the person to realize, ‘oh. i can deal with this. it’s not dangerous.’”
cbt also works for generalized anxiety because it helps to restructure thought patterns that contribute to those feelings of anxiety.
“it’s less specifically focused on physical symptoms, because general anxiety is not really so much about the physical symptoms. it can be, but it’s about the thoughts and everything going on for someone and all the things they’re worried about on a daily basis.”
she also notes that medication can be an additional course of action alongside cbt, as well as other forms of coping outside of medical interventions.
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“sleep is so important,” she said. “our clock (circadian rhythm) is structured, and when the clock is off, it affects your mood, and it can affect your vulnerability to anxiety. so, i would say absolutely try to just be really consistent with when you go to bed, when you wake up, get as much consistent sleep as you can, and really prioritize that.”
adding exercise, even for 15, 20, or 30 minutes a day, is also helpful, she said, as is spending time with the people you love most.
“start small. once a week, twice a week, walking around your house if it feels like that’s what’s manageable right now,” she said. “time with loved ones and friends because these are the balancing acts in life, and having good balance and kind of regulating the constant stress and not feeling like ‘i don’t have agency here to manage it’ because there are some tools that can help, but professional help is very useful.”
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