Anxiety Symptoms: Physical, Emotional and When to Get Help

Quick answer

Body, thoughts and behaviour: know the pattern

Physical symptoms of anxiety include a racing heart, chest tightness, shortness of breath, sweating, trembling, dizziness, stomach upset, muscle tension and sleep problems. Emotional and cognitive symptoms include feeling on edge, dread, irritability, difficulty concentrating and constant worry. Behaviourally, people avoid situations or seek constant reassurance. Anxiety disorders affect about one in five adults over a year and respond well to cognitive behavioural therapy, medication or both. See a professional if symptoms last for weeks, are out of proportion to events or limit work, study or relationships.

Important. Chest pain, severe breathlessness, fainting or symptoms that feel like a heart attack should be assessed urgently, because physical causes need to be excluded. If you are in crisis or thinking about harming yourself, seek help right away: in the US call or text 988, in the UK call Samaritans on 116 123, in Spain call 024, or call your local emergency number.

Normal anxiety versus an anxiety disorder

Everyone feels anxious before an exam, a job interview or a medical test. This kind of anxiety is short-lived and helps you prepare. An anxiety disorder is different: the fear or worry is out of proportion to the situation, lasts for weeks or months, is hard to control and causes distress or disrupts daily life. It is one of the most common mental health conditions and one of the most treatable.

Physical symptoms

Rapid or pounding heartbeat; chest tightness.
Shortness of breath or a feeling of not getting enough air.
Sweating, trembling or shaking, hot flushes or chills.
Dizziness, light-headedness, tingling or numbness.
Nausea, stomach cramps, diarrhoea or “butterflies”.
Muscle tension, headaches, jaw clenching and fatigue.
Dry mouth, a lump in the throat.
Sleep problems: difficulty falling or staying asleep.

Emotional and cognitive symptoms

Feeling nervous, restless, tense or on edge.
Sense of dread or that something bad will happen.
Constant worry that is hard to control.
Irritability and a short temper.
Difficulty concentrating, mind going blank.
Overthinking, catastrophising and “what if” thoughts.
Feeling detached from yourself or surroundings (depersonalisation) during intense anxiety.

Behavioural symptoms

Avoiding situations that trigger anxiety (crowds, driving, social events, medical appointments).
Seeking constant reassurance or checking.
Procrastination and difficulty making decisions.
Using alcohol, drugs or food to cope.
Withdrawing from friends and activities.
Avoidance brings short-term relief but strengthens anxiety in the long run.

Types of anxiety disorders

Generalised anxiety disorder (GAD): persistent worry about many things. See generalised anxiety disorder.
Panic disorder: recurrent panic attacks and fear of more attacks. See panic attacks.
Social anxiety disorder: intense fear of social situations and judgement.
Specific phobias: intense fear of particular objects or situations.
Agoraphobia, separation anxiety and health anxiety.
Obsessive-compulsive disorder and post-traumatic stress disorder are classified separately but share anxiety features.

What causes anxiety?

Anxiety disorders result from a combination of genetic vulnerability, temperament, brain chemistry, life experiences (particularly early adversity and trauma), chronic stress and learned patterns of thinking and avoidance. Medical conditions (thyroid problems, heart rhythm disorders, diabetes), substances (caffeine, alcohol, stimulants, cannabis) and medicines can cause or worsen anxiety symptoms, so a medical check is part of a proper assessment.

Checking your symptoms

The GAD-7 is a brief, validated seven-item questionnaire used to screen for anxiety and measure severity: scores of 5, 10 and 15 are the cut-offs for mild, moderate and severe symptoms. It does not give a diagnosis, but it helps you decide whether to seek help. See test de ansiedad (Spanish).

Treatment options

Cognitive behavioural therapy (CBT): the best-supported psychological treatment, using exposure, cognitive restructuring and relaxation skills.
Medication: SSRIs and SNRIs are first-line; other options include buspirone and pregabalin; benzodiazepines are for short-term use only because of dependence risk.
Lifestyle: regular exercise, good sleep, reduced caffeine and alcohol, relaxation and mindfulness.
Self-help: guided books and apps based on CBT.
Support: talking with trusted people and peer groups.
Combining therapy and medication helps people with more severe symptoms.

What you can do today

Practise slow breathing (in for 4, out for 6) for a few minutes. See deep breathing for anxiety.
Move your body: a brisk walk reduces tension.
Cut back on caffeine and alcohol.
Write down worries and sort them into “can act on” and “cannot control”.
Face fears in small steps instead of avoiding.
Keep a regular sleep schedule.
Talk to someone you trust.

When to seek professional help

Symptoms most days for several weeks.
Anxiety that interferes with work, study, relationships or sleep.
Panic attacks, or avoidance of places and activities.
Use of alcohol or drugs to cope.
Depression or thoughts of self-harm.
Physical symptoms that have not been checked by a doctor.

Three common situations

Constant worry and tension about work, health and money for months: may be GAD; seek assessment and CBT.

Sudden episodes of intense fear with palpitations and fear of dying: may be panic attacks; get a medical check and treatment.

Avoiding meetings and social events out of fear of judgement: may be social anxiety disorder; CBT is highly effective.

Caffeine, alcohol and medicines that can mimic or worsen anxiety

Caffeine, energy drinks, nicotine, cannabis, stimulants, decongestants and some asthma and thyroid medicines can all provoke anxiety symptoms, as can alcohol withdrawal and the “hangover anxiety” after drinking. If your symptoms began after a new substance or medicine, mention it to your doctor. Cutting back on caffeine gradually often reduces palpitations and jitteriness within a week or two.

Key points to remember

Anxiety symptoms involve the body, thoughts and behaviour. They are common, real and treatable. If they persist or limit your life, speak to a doctor or psychologist; early treatment gives the best results.

This guide is for general information and does not replace an assessment by a qualified health professional.

Questions about anxiety symptoms

These answers are general information and do not replace an examination or individual medical advice.

What are the first signs of anxiety?

Restlessness, constant worry, trouble sleeping, muscle tension, irritability, a racing heart and difficulty concentrating.

Can anxiety cause physical symptoms?

Yes. Chest tightness, palpitations, dizziness, stomach upset and headaches are common.

How do I know if it is anxiety or a medical problem?

Only a clinician can tell; physical causes such as thyroid or heart problems should be excluded.

How long does anxiety last?

Normal anxiety passes when the stressor ends; an anxiety disorder persists for months without treatment.

Is anxiety curable?

Anxiety disorders are very treatable, and many people recover or manage symptoms well.

Can children have anxiety?

Yes, anxiety disorders are common in children and teenagers and are treatable.

Sources

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.