When Anxiety Feels Physical: Heart Racing, Stomach Turning, Mind Racing

Your heart pounds. Your stomach twists. Your breathing gets shallow. Sweat breaks out. Your mind races with worst-case scenarios. Is it a heart attack? A serious illness? Or could these intense physical sensations actually be anxiety wearing a physical disguise?

At Televero Health, we work with many people who experience anxiety primarily as physical symptoms. They often come to us after multiple medical visits that found no clear physical cause for their symptoms, leaving them frustrated, scared, and questioning their own experience. What they discover is that anxiety isn’t just a mental state – it’s a whole-body experience that can generate intense and often frightening physical sensations.

Maybe you’ve experienced this yourself. Maybe you’ve had episodes of heart palpitations, dizziness, chest tightness, digestive distress, or other physical symptoms that seem to come out of nowhere. Maybe you’ve gone to the emergency room convinced something was seriously wrong, only to be told it was “just anxiety.” Maybe you’ve found yourself in a cycle where worry about these physical sensations creates more anxiety, which then intensifies the very symptoms you’re concerned about.

This physical experience of anxiety isn’t imaginary or “all in your head.” It reflects how thoroughly interconnected your mind and body are, particularly in states of perceived threat or danger. When your brain registers something as potentially threatening – whether an external situation or even a worried thought – it activates the body’s stress response system. This triggers a cascade of physiological changes designed to prepare you for fight, flight, or freeze responses.

Your heart rate increases to pump more blood to large muscles. Your breathing quickens to take in more oxygen. Blood flow shifts away from your digestive system (causing stomach symptoms) and toward muscles needed for quick movement. Your body releases stress hormones like adrenaline and cortisol. Your muscles tense in preparation for action. These changes are automatic, happening before conscious thought can intervene, and they generate very real and sometimes intense physical sensations.

What makes this experience particularly challenging is that these bodily sensations then often become threats themselves. You notice your racing heart and worry it might be a heart attack. This worry triggers more anxiety, which further increases your heart rate, creating a cycle of escalating physical symptoms and fear. Or you feel lightheaded and dizzy, which generates fears about fainting or having a neurological problem, which increases anxiety and intensifies the very symptoms causing concern. These cycles can culminate in panic attacks – episodes of intense fear accompanied by severe physical symptoms that can genuinely feel life-threatening.

We see these physical manifestations of anxiety take many forms. The person whose anxiety presents primarily as gastrointestinal symptoms – stomach pain, nausea, or digestive distress that seem unrelated to worry but intensify during stressful periods. The individual who experiences chest tightness and shortness of breath that mimics cardiac problems but consistently checks out as normal in medical tests. The client whose anxiety manifests as persistent tension headaches or muscle pain that pain relievers never fully resolve.

If you experience anxiety in primarily physical ways, know that this doesn’t mean your symptoms are imaginary or unimportant. The physical sensations of anxiety are real and can be extremely uncomfortable or even frightening. And while medical evaluation remains important to rule out physical causes, discovering that your symptoms relate to anxiety doesn’t make them any less real or deserving of care.

In therapy, we help people address the physical aspects of anxiety through several approaches. First, by providing education about how anxiety operates in the body, helping make sense of symptoms that have often felt mysterious or frightening. Then, by developing skills to work directly with physical manifestations of anxiety, rather than just trying to change worried thoughts. Finally, by addressing any underlying issues that might be contributing to the anxiety response, whether obvious stressors or more subtle patterns of thinking and responding.

These skills might include breathing techniques that help regulate the nervous system when anxiety activates. Or grounding practices that interrupt the escalating cycle between physical sensations and worried thoughts. Or body-based approaches that directly address the physical manifestations of anxiety rather than just their cognitive aspects. Or gradual exposure to anxiety-triggering sensations in safe contexts, helping the system learn that these sensations, while uncomfortable, aren’t dangerous.

What many discover through this work is that while they can’t always prevent anxiety from generating physical sensations, they can change their relationship to those sensations. They can learn to recognize them as anxiety rather than illness, to ride the wave of uncomfortable feelings without being overwhelmed by them, to interrupt the cycle where fear about sensations intensifies the very symptoms causing concern.

This doesn’t mean simply dismissing physical symptoms as “just anxiety” without appropriate medical evaluation. Some symptoms that resemble anxiety can indeed reflect underlying physical conditions that require treatment. But for many people, addressing the anxiety component directly – rather than continuing to search for an elusive physical explanation – creates pathways to relief that repeated medical tests and interventions haven’t been able to provide.

Over time, this approach often leads not just to better management of acute episodes, but to a gradual shift in how the nervous system responds to triggers. The cycle of physical sensation → fear → increased anxiety → intensified sensation begins to interrupt at various points. The body learns that while anxiety sensations are uncomfortable, they aren’t dangerous and don’t need to trigger emergency responses. What once escalated into overwhelming experiences may become more manageable waves that can be navigated rather than feared.

Because the truth is, the physical manifestations of anxiety aren’t character flaws, signs of weakness, or figments of imagination. They’re the result of a mind-body system designed to protect you, but sometimes activating in situations where the “threat” isn’t something you can fight or flee. And lasting relief often comes not from continuing to search for an elusive physical explanation, but from learning to work with rather than against this mind-body connection – addressing anxiety as the whole-person experience it actually is.

Ready to explore approaches to anxiety that address both its physical and mental aspects? Start here.