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Anxiety - Let's get physical

I hear a lot of people saying that they have anxiety, and is it normal for them to have this or that symptom? Or people saying that they have this or that symptom and not realizing it’s because they have anxiety. So I thought I’d write this blog about the physical effects anxiety (which includes chronic stress) can have on your body.

While anxiety is principally an emotional disorder it’s not just emotional. The body, mind and emotions are so intrinsically linked that it’s pretty much impossible for anything to happen to one aspect of it without it having an effect on the others. We know this; we know that being angry makes us feel hot, shaky and breathless, that excitement makes it hard to sit still, that pain causes emotional distress. We just don’t think about it in terms of when something is wrong somewhere.

What is anxiety?

Anxiety is an emotional response to circumstances. It could be a particular situation, such as social anxiety, or more generalized in conditions such as agoraphobia or general anxiety disorder. As the name suggests, the circumstances prompt a fear response which is disproportionate to the actual risk – that’s why it’s called a disorder and not common sense.

A fear response triggers – or is triggered by, depending on which theory you subscribe to – a release of hormones. Principally adrenaline, norepinephrine and cortisol. The first two of these are released immediately your brain decides there’s a threat. Their main functions are to heighten awareness; which means you see things in your direct field of vision more clearly, your breathing and heart rate speed up and your muscles tense. They’re preparing your body for the urgent task of saving you from whatever danger you’re in. Some people also sweat, although it’s not totally clear why; there is a theory that says your body is making itself slippery so you’re harder to grab hold of.

Cortisol takes a bit longer to be released, and is considered by some to be something of a backup to the adrenal glands which are responsible for the other two stress hormones. In small quantities it's very good for you. It does much what adrenaline does, but also helps maintain fluid balance and blood pressure in the body which is important for staying alive. There are other hormones involved too, some of which we may not know about yet (50 years ago scientists were confidently telling us there were no more than 40 or 50 hormones in the human body, now they’re saying there may be more than 700) but these three are the main players.

Cortisol takes time to dissipate, anywhere from a few minutes to a couple of days for its effects to stop being felt in the body. That’s fine if you have an alarming experience – say someone pulls out in front of you when you’re driving – that’s soon over. But when you have stress or anxiety, your brain is continually seeing threats so cortisol, adrenaline and norepinephrine are continually being released. Like a pan of water on the heat, it just builds up. They never get the chance to dissipate, so you continually feel the heightened awareness, physical tension and increased heartrate that comes with the fear response. Your blood pressure is also permanently raised, which can cause headaches, dizziness and heart palpitations. Breathing too fast causes an imbalance of oxygen and carbon dioxide in the body, otherwise known as hyperventilation; that can cause tingling, muscle cramps and spasms, dizziness, belching, weakness and confusion, and fainting.

As if that wasn't bad enough

The stress hormones don’t just do that, though. In order to release more resources for the systems that are urgently needed to rescue you from danger, they also repress the systems that aren’t. These include digestion, libido, immunity, healing and growth, and skin. (Yes, your skin isn’t just a bag to keep your insides in, it’s a system. More on that another day).

If your digestion is in a permanent state of repression that means you can lose your appetite, feel sick, stop producing saliva (hence the dry mouth) and stop digesting the food you’ve already eaten, leading to bowel problems and stomach ulcers. This is made worse by the continual muscle tension, because your digestive system relies on muscle spasms (peristalsis) to function. In some people this can effectively mean clearing out the digestive system so it’s not a nuisance (otherwise known as vomiting and diarrhoea.) It also messes up your nutritional balance so your blood sugar goes up (increasing the risk of diabetes) and gives you spots. Some people lose weight because they’re not effectively digesting their food, but some people’s bodies respond to this by desperately holding on to any scrap of nutrition they do get and that means they gain weight.

Repressing your immune system means you’re more prone to minor – and major – illnesses. Health anxiety is an effective form of self-destruction; the very act of worrying so much about getting sick ironically not only means you’re more likely to get sick but also to be sicker than a tranquil person. Your body’s ability to heal any illnesses or injuries you already have is reduced. If you’re young enough to be still growing, you won’t be as tall or as strong as you otherwise would be.

Cortisol turns off the body’s inflammatory response, which is part of the healing process. If you have a cold, the symptoms are not the cold itself but the results of the inflammatory response fighting it off. There are lots of other things that are affected by the inflammatory response, including but not limited to asthma, eczema, autoimmune disease, fibromyalgia and cardiovascular disease - so anxiety can exacerbate the symptoms of any of those.

If you want to get pregnant, the loss of libido will obviously be a problem but your body also won’t be well equipped to fertilise and nourish a foetus, so the chances of you conceiving are much lower. Estrogen and testosterone are minor stress hormones as well as being important to conception and libido.

As your brain is hyper-focused, it prioritizes vison immediately in front of you (usually if we’re in danger, we look at what’s causing it). That means peripheral vision and hearing can be impaired. The brain also prioritizes information about the danger at the cost of other factors, so you’re easily distracted and struggle to remember things. But if you’re afraid of everything, the brain doesn’t know what to focus on so it becomes overwhelmed and you can get panicky, disorientated and confused.

As your body is in a continued state of heightened awareness, it’s not surprising you’ll also struggle to sleep – which brings a set of physical issues of its own.

All these symptoms impact each other as well. Reduced nutrition affects growth, immunity and the ability to conceive. Lack of sleep contributes to confusion, poor memory, headaches and potentially to digestive disorders. And all of this makes you unhappy.

So to all the people saying ‘does anyone else get symptom X because of their anxiety?’ the answer is probably Yes. You may have symptoms I haven’t listed here, and the ones I have listed may not be major factors for you. But in short, anxiety screws up your body as well as your mind.

Of course you may have some of these symptoms for other reasons too, and if you’re worried then I would always advise you to go to see your GP just to be on the safe side. After all, worrying about your palpitations or your acne isn’t going to make things any easier for you.

All of this really can be helped by simple breathing exercises and by physical or even mental activity. Breathing exercises bring oxygen and carbon dioxide back into balance and lower the blood pressure. Exercise helps dissipate the stress hormones and boosts endorphins which make you feel better. So it’s not just a cliché – it actually counteracts the physical effects of your anxiety. Rhythmic, repeated activity like running or walking is the best form of exercise so it doesn't even have to be very hard work.

If you have found this article helpful, please share it with a friend.


Caeredwen is a counsellor, coach and physical therapist based in Coleford in the Forest of Dean. If this blog has touched you and you would like to contact her in confidence, you can reach her at or via her website at

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