What Anxiety Actually Feels Like in the Body (and Why It's Not Just "in Your Head")

If you've ever had a racing heart before a big conversation, a stomach that won't settle, or a chest so tight it feels hard to breathe, you already know that anxiety isn't only a thought. It's something your whole body does.

Many people I work with have been told to "just relax" or "stop overthinking." Others have had scans and tests come back normal and quietly wondered whether they're imagining it. You're not. Anxiety symptoms in the body are real, measurable and well documented. This post explains what's happening and what can help.

Common physical symptoms of anxiety

Anxiety looks different for everyone, but these are some of the most common ways it shows up:

• Heart and breathing: a pounding or racing heart, chest tightness, shortness of breath, or feeling like you can't get a full breath

• Stomach and gut: butterflies, nausea, cramping, changes in appetite, or an unsettled digestive system

• Muscles: tension in the jaw, neck and shoulders, restlessness, trembling, or a constant feeling of being "on edge"

• Head and senses: dizziness, headaches, feeling hot or flushed, sweating, or tingling in the hands and feet

• Energy and sleep: exhaustion, trouble falling or staying asleep, and difficulty concentrating

Restlessness, fatigue, muscle tension, poor concentration, irritability and disturbed sleep are all recognised features of generalised anxiety in the diagnostic manual clinicians use (American Psychiatric Association, 2013). Racing heart, sweating, shaking and breathlessness are typical of panic attacks.

Why does anxiety show up in the body?

Anxiety is the body's alarm system doing its job, just at the wrong time. In the early 1900s, physiologist Walter Cannon described the "fight-or-flight" response: when the brain detects a threat, it triggers a surge of stress hormones that speeds up your heart, sharpens your breathing and sends blood to your muscles (Cannon, 1915).

That's helpful if you're facing a real danger. But the same system can switch on when the "threat" is an overflowing inbox, a difficult relationship, or a memory your body hasn't finished processing. Your body reacts as if the danger is real, even when your logical mind knows you're safe.

Why it's not "just in your head"

Here's the part I find most reassuring for clients: the science of interoception, the brain's ability to sense and interpret signals from inside the body, helps explain why anxiety feels so physical.

Interoception is the process by which the nervous system senses, interprets and integrates signals coming from within the body. Researchers Martin Paulus and Murray Stein proposed that in anxiety, the brain's predictions and beliefs about these internal signals become noisily amplified, so ordinary bodily sensations can feel more intense or threatening than they are. Anxiety has often been linked with heightened sensitivity to internal body signals.

In plain language, your body and brain are in constant conversation. Anxiety turns up the volume on that conversation, and it does so in the body, not just in your thoughts. That's why reassurance alone ("there's nothing to worry about") so rarely works. The body needs to feel safe, not just be told it is.

Anxiety, trauma and the body

For people who have lived through trauma, the body can stay on high alert long after the danger has passed. You might startle easily, feel unsafe in situations that "should" be fine, or notice your body tensing before you even know why. This isn't weakness or overreacting. It's a nervous system that learned to protect you and hasn't yet been shown it can stand down.

Trauma-informed counselling works with both the story and the body, helping your system learn, gradually and safely, that the threat is over.

You're not alone

Anxiety is the most common group of mental health conditions in Australia. The Australian Bureau of Statistics found that 17.2 per cent of Australians aged 16–85 had an anxiety disorder in the previous 12 months, according to the 2020–2022 National Study of Mental Health and Wellbeing. That's more than one in six people.

When to see your GP first

Because anxiety and physical health conditions can look alike, it's always sensible to rule out medical causes. See your GP promptly if you have chest pain, fainting, sudden severe shortness of breath, or symptoms that are new, unexplained or getting worse. If you think you're having a medical emergency, call 000.

What can help

1. Slow your breathing, with a longer exhale. In a randomised controlled trial, five minutes a day of breathwork, especially "cyclic sighing" with prolonged exhalations, improved mood and lowered breathing rate more than mindfulness meditation. Both practices reduced anxiety. To try it, take a full breath in through your nose, add a second short sip of air on top, then let out a long, slow breath through your mouth. Repeat for a few minutes. This is a helpful daily tool for managing stress. It isn't a substitute for treatment if anxiety is affecting your life.

2. Ground yourself in the present. Press your feet into the floor, name five things you can see, or hold something cold or textured. These simple cues help signal safety to the body.

3. Move your body. Walking, stretching or a swim can help burn off the stress hormones your body has produced.

4. Get support that works with the body and the mind. Counselling can help you understand your triggers, change unhelpful patterns, and build a nervous system that feels safer over time.

When to reach out for anxiety counselling

Consider reaching out if anxiety is disrupting your sleep, work, relationships or daily life, if you're avoiding things you care about, or if you've simply been coping alone for too long. You don't need to be in crisis to deserve support.

At Fearless Footsteps, I offer counselling for anxiety, trauma and related concerns, in person on the Tweed Coast and via online therapy across Australia. If you'd like to talk, you're welcome to get in touch to ask any questions first. A GP referral may also help you access Medicare-subsidised support.

If you're in distress right now, Lifeline is available 24/7 on 13 11 14.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.

• Australian Bureau of Statistics. (2023). National Study of Mental Health and Wellbeing, 2020–2022. abs.gov.au

• Cannon, W. B. (1915). Bodily Changes in Pain, Hunger, Fear and Rage. D. Appleton and Company.

• Khalsa, S. S., et al. (2018). Interoception and mental health: A roadmap. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(6), 501–513.

• Paulus, M. P., & Stein, M. B. (2010). Interoception in anxiety and depression. Brain Structure and Function, 214(5–6), 451–463. https://doi.org/10.1007/s00429-010-0258-9

• Yilmaz Balban, M., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895