The Physical Symptoms of Anxiety

As anyone who has experienced it can tell you, anxiety brings about both psychological and physical symptoms—both of which can be overwhelming. Anticipating future threats, the body gears up for a fight-or-flight moment: The brain activates the heart, lungs, and muscles so you’ll be ready to engage or flee. With that, the heart beats faster, you begin to sweat, and muscle tense, among other things.

Anxiety disorders are characterized by persistent and intense physical symptoms. Considering these reactions is especially important when diagnosing generalized anxiety disorder (GAD).

In fact, to meet the formal criteria for generalized anxiety disorder (GAD), anxiety must be associated with multiple physical symptoms. In children, the presence of even one of these symptoms is sufficient for a diagnosis to be made.

While there are several types of anxiety disorders, a look at the physical symptoms that may be experienced with GAD can give you a sense of what is possible.

Muscle Tension

The muscle tension associated with normal anxiety might involve a brief tensing of the back and neck that relaxes when a threat passes. The muscle tension described by people with GAD includes unrelenting aches and pains in overly active shoulders, back, neck, and jaw muscles. The tension might also include restless fidgeting of tense legs or grinding of the teeth.

These manifestations of muscle tension don’t subside in the absence of a threat; rather, they persist until specific relaxation or mindfulness skills are employed, or medications that promote relaxation are taken.

Stomachaches and Other Digestive Problems

The gut also holds and expresses anxiety. This can take the form of non-specific unsettling of the stomach, outright nausea, constipation, or diarrhea. Digestive problems can have a particularly negative impact on day-to-day functioning.

Beyond being uncomfortable and disruptive in their own right, these symptoms may perpetuate worries about the presence of a medical illness.

Headache and Dizziness

The psychological distress associated with GAD involves chronic worry for most of a person’s waking hours.2 Thoughts may race down a spiral of anticipation and fear about one topic or may bounce incessantly from one issue or scenario to the next. This psychological experience can result, literally, in an aching head and dizziness.


The edginess associated with GAD can manifest behaviorally as irritability or physically as trembling and shaking. The fidgeting or restlessness may be more obvious to observers than to the anxious individual in some cases.

Tiredness and Insomnia

Chronic worry, simply put, is exhausting, so it’s typical for people with GAD to be fatigued. But sometimes the worry or other physical symptoms of anxiety make it difficult either to fall or stay asleep. In the short-term, this can take a toll on other aspects of physical and psychological well-being.

For people experiencing even mild sleep disruptions, anxiety treatment is likely to involve changes to the bedtime routine.

Shortness of Breath

Along with increased heart rate, elevated blood pressure, sweating, and/or dizziness, shortness of breath can occur. However, shortness of breath as an anxiety symptom is more likely to occur as part of a panic attack, not in uncomplicated GAD.

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