6 Physical Symptoms of Anxiety and When to Get Checked

Common physical symptoms of anxiety include a racing or pounding heart, shortness of breath, stomach upset, muscle tension and headaches, dizziness or lightheadedness, and fatigue or poor sleep. These symptoms are real, not imagined. They come from the body's stress response. Because they can overlap with medical problems, new or severe symptoms should be checked by a health care provider.

This article is for adults and parents of teens who have unexplained physical symptoms and wonder whether anxiety could be part of the picture. It explains six common symptoms, why they happen, how to tell when to seek urgent care, and what to say to a provider.

Why does anxiety cause physical symptoms?

Anxiety causes physical symptoms because it switches on the body's stress response, which prepares you to react to danger. MedlinePlus explains that stress hormones make the brain more alert, tense the muscles and increase the pulse.

That response is helpful in a real emergency. When it is triggered often, or without a clear threat, the same changes can leave you with a tight chest, an upset stomach, sore muscles and exhaustion. The National Institute of Mental Health (NIMH) lists physical signs of generalized anxiety disorder that include headaches, muscle aches, stomachaches, trembling, sweating, lightheadedness, feeling out of breath, trouble sleeping and fatigue.

Physical symptoms of anxiety can appear even when you do not feel especially worried. Some people notice their body first, such as a tight stomach every Sunday night, and only later connect it to stress. Others have been to several appointments for a symptom before anxiety is considered. Both experiences are common, and neither means the symptom is "all in your head."

1. Can anxiety make your heart race or cause chest pain?

Yes, anxiety can make your heart race or pound, and some people feel chest tightness or pain. The NIMH lists a racing heart and chest pain among the symptoms of a panic attack, along with sweating, trembling and a sense of doom.

Chest pain always deserves caution. The Centers for Disease Control and Prevention (CDC) says major heart attack symptoms include chest pain or discomfort; feeling weak, light-headed or faint; pain in the jaw, neck, back, arm or shoulder; and shortness of breath, and it advises calling 911 right away. Do not assume chest pain is anxiety, especially the first time.

Once a provider has ruled out heart problems, a few steps can help when a racing heart is driven by anxiety:

• Sit down and let your out-breath be longer than your in-breath.
• Remind yourself what your provider found, in a calm sentence.
• Notice how the sensation peaks and then eases over several minutes.
• Limit caffeine and energy drinks, which can add to a pounding heart.

2. Can anxiety cause shortness of breath?

Anxiety can cause shortness of breath, often by triggering fast, shallow breathing called hyperventilation. MedlinePlus lists panic attacks among the emotional causes of hyperventilation and describes symptoms such as feeling lightheaded, being unable to catch your breath, and a pounding heart.

MedlinePlus notes that a first episode of hyperventilation may be an emergency because it can have medical causes. It also describes pursed-lip and belly breathing as techniques that can help when anxiety is the cause. Our guide on telling if shortness of breath is from anxiety covers this in more detail.

3. Why does anxiety upset your stomach?

Anxiety upsets the stomach because the brain and gut are closely connected, so stress can show up as nausea, cramps, bloating, diarrhea or frequent trips to the bathroom. The NIMH lists stomachaches and frequent bathroom trips among GAD symptoms.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) describes irritable bowel syndrome as a problem with how the brain and gut work together, and notes that depression and anxiety are more common in people with IBS. Ongoing digestive symptoms should be checked by a provider. See our article on anxiety and digestive issues.

4. Can anxiety cause muscle tension, aches and headaches?

Yes, ongoing anxiety often causes muscle tension, body aches and headaches, because stress hormones keep muscles tensed and ready. Many people notice a clenched jaw, tight shoulders, neck pain or back pain without realizing they have been bracing all day.

The NIMH includes headaches, muscle aches and tension among the physical symptoms of GAD. Gentle stretching, regular movement, warm showers and progressive muscle relaxation can help. To try progressive muscle relaxation, tense one muscle group, such as your shoulders, for about five seconds, then release and notice the difference, moving slowly from your feet to your face. If headaches are sudden and severe, or come with weakness, confusion or vision changes, seek emergency care.

5. Can anxiety make you dizzy or lightheaded?

Anxiety can cause dizziness or lightheadedness, often from fast breathing or a surge of adrenaline. The NIMH lists dizziness among panic attack symptoms and lightheadedness among GAD symptoms.

Dizziness also has many other causes, including dehydration, blood pressure changes, inner ear problems, low blood sugar and heat illness. Sit or lie down if you feel faint. Fainting, a new severe headache, slurred speech, or weakness on one side are reasons to call 911.

6. Can anxiety cause fatigue or trouble sleeping?

Yes, anxiety commonly causes fatigue and sleep problems, and poor sleep can make anxiety worse the next day. The NIMH lists trouble falling or staying asleep and feeling fatigued among the signs of GAD.

Staying on alert uses energy, even when you are sitting still. Worry at bedtime can delay sleep, and a tense body may wake easily. Keeping a regular wake time, limiting late caffeine and having a short wind-down routine are good first steps. Our guide on calming anxiety at night has more ideas.

How do you check whether a symptom is anxiety, step by step?

The safest approach is to rule out urgent problems first, then look for patterns over time. Anxiety is often a diagnosis made after other causes have been considered.

1. Check for emergency signs such as chest pain, fainting, sudden severe headache or trouble breathing. Call 911 if present.
2. See a primary care provider for new or ongoing symptoms. MedlinePlus notes that diagnosing panic disorder can include a medical history, a physical exam and blood tests to rule out problems such as thyroid conditions.
3. Keep a two-week log of symptoms, time of day, what you were doing and what you were thinking about.
4. Look for links between symptoms and stressful situations, worry or avoidance.
5. Share the log with your provider and ask whether anxiety could be contributing.

What should you say to a provider about physical anxiety symptoms?

Describe the symptom, when it happens and what is going on around it. Clear details help a provider consider both medical and emotional causes.

• "I have had ___ for about ___ weeks."
• "It happens mostly when ___, and lasts about ___."
• "I also feel worried or on edge about ___."
• "I have been avoiding ___ because of these symptoms."
• "My medical tests so far have shown ___."
• "Could anxiety be part of this, and what are my options?"

When should you get help sooner?

Get urgent help for symptoms that could be a medical emergency, and get prompt professional care if anxiety symptoms are frequent or disrupting your life. When in doubt, it is always reasonable to get checked.

• Chest pain, pressure or pain spreading to the arm, jaw or back: call 911
• Trouble breathing that is sudden or severe: call 911
• Fainting, confusion, or weakness on one side of the body: call 911
• Repeated panic attacks, or avoiding places because of symptoms
• Symptoms most days for weeks
• Thoughts of suicide or self-harm

Do Texas summers make anxiety symptoms harder to read?

Texas heat can make physical anxiety symptoms harder to read, because heat illness can also cause a fast pulse, sweating and feeling unwell. The National Institute for Occupational Safety and Health (NIOSH) lists the symptoms of heat exhaustion and heat stroke, including irritability, and explains first aid. If you feel sick in the heat, move somewhere cool, drink water and seek care if you do not improve.

Being aware of both possibilities helps. On hot days, plan outdoor time for cooler hours, drink water regularly and take breaks in air conditioning. If you work outdoors, as many Texans do in construction, landscaping or events, follow your workplace heat plan and tell a coworker if you start to feel unwell. Heat symptoms that do not improve with rest and cooling need medical attention, whether or not you also live with anxiety.

Getting support in Texas

If medical causes have been checked and physical symptoms of anxiety are still affecting your life, treatment can help. Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area. Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit.

Most new patients are seen within 1–2 business days. Weekend appointments are limited. All Lyte Psychiatry services are available in Spanish. Lyte Psychiatry is an outpatient practice. It does not provide inpatient care, crisis or after-hours coverage, medically supervised detox, or intensive outpatient or partial hospitalization programs. Availability, insurance and clinician fit require confirmation. Learn more about anxiety care, or read about physical symptoms of stress.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.