Those who don’t understand anxiety often have the misconception that anxiety is “all in your head,” and therefore somehow less real, and less critical, than other illnesses. But as anxiety sufferers know all too well, anxiety disorders cause real and often distressing or even debilitating physical symptoms. Describing anxiety and the accompanying physical symptoms as “all in the head” is a drastic oversimplification of what’s really going on.

The Mental and Physical Health Connection

When a person has physical symptoms caused by mental stress, this is called psychosomatic illness. Psychosomatic symptoms can be troubling for anyone with anxiety. We may not fully understand what it is, or we may think the symptoms are a sign of a serious physical illness, such as cancer – which as you probably know, is a common tendency among anxiety sufferers. When psychosomatic symptoms cause excessive concern and fear, or when a person is incredibly anxious about possible (but unlikely) illnesses, the DSM-5 calls this somatic symptom disorder and illness anxiety disorder, respectively.

Let’s take a look at the six most commonly experienced physical anxiety symptoms, and what to keep in mind while they’re happening. (Keep in mind that today we’re looking at symptoms that occur with regular anxiety and not during a panic attack.)

• Dizziness. While dizziness is sometimes a sign of inner ear infections or other illnesses, it is also one of the most common physical symptoms of anxiety. Anxiety-related dizziness t may not sound like a big deal to a lot of people, but many sufferers report that it is so distressing that they sometimes think they may be dying, especially when they’re new to anxiety or this particular symptom. And even for those who know the feeling well, dizzy spells can be very disruptive and make it difficult to go about your day.
  What to remember: Anxiety-related dizziness is not actually dangerous (as long as you’re not driving or operating heavy machinery). Sitting or lying down helps for some, but not for everyone. The reality is that most of the time, you just need to let it pass. (And it will pass.) Some helpful strategies for coping in the meantime include deep breathing, and really focusing in on one particular thing, such as drinking a glass of water or tea.

• Pain. Everyone experiences aches and pains, especially as they get older, but anxiety is a huge contributor to chronic pain issues. Anxious people tend to tense up and clench their muscles, which over time leads to pain. In addition, health-related anxiety can bring about seemingly inexplicable pain – a perfect example of a psychosomatic symptom. Besides making it hard to function day-to-day, pain issues can also exacerbate anxiety and health fears, as the sufferer may worry that it is a sign of a horrible disease.
  What to remember: Aches and pains are — unfortunately! — a universal human experience, and definitely NOT a sure sign of devastating illness. The good news is that there are a lot of good ways to alleviate pain in the body: stretching, yoga, physical therapy, relaxation techniques, massage therapy, acupuncture, regular exercise, and more. Practicing good posture can also work wonders, as slouching may cause pain from the neck to the lower back. (You should of course address serious pain issues with your doctor to rule out other causes and to help you find an appropriate pain management strategy.)

• Headaches/migraines. Headaches and migraines can become a vicious cycle for those with anxiety — anxiety can cause headaches, and frequent headaches can cause anxiety. Whether you have tension headaches or full-blown migraines, it can be very difficult to function normally. In many cases, the pain is completely debilitating for the duration of the headache/migraine.
  What to remember: The most effective way to decrease the frequency and intensity of headaches is to take the best possible care of yourself. This means looking into potential food-related causes (coffee and chocolate are common culprits), practicing relaxation techniques to ward off excess tension, prioritizing nutrition, exercising regularly, and exploring treatment options with a doctor if necessary.

• Stomach problems. Gastrointestinal problems commonly occur alongside anxiety disorders. In fact, it is estimated that at least 60% of people with irritable bowel syndrome (IBS) also fit the criteria for anxiety, depression, or other mental disorders. Even if you don’t suffer from IBS, you may experience “nervous stomach,” gas and bloating, or indigestion, which are all uncomfortable and disruptive.
  What to remember: Diet is the most important part of managing IBS and other stomach issues. Even if you believe that your stomach problems are rooted in anxiety, the fact is that certain foods will stress your digestive system much more than others – in particular, processed and fast food, coffee, alcohol, and foods high in fat. Cutting down on or eliminating these things can help a lot. If you improve your diet and still struggle with stomach problems, don’t jump to the conclusion that it’s something terrible – stay off Google and address your issues with a doctor!

• Trouble breathing. Hyperventilation often occurs during panic attacks, but breathing troubles related to anxiety can occur at other times as well. Many anxiety sufferers describe feeling like they can’t get a deep breath, which leads them to yawn excessively or desperately try to expand their chest to take in more oxygen. Sometimes, the distress from this eventually evolves into a panic attack, which only makes it worse.
  What to remember: Breathing problems in anxious individuals are very rarely caused by something other than anxiety itself. If your doctor confirms that there is nothing physically wrong with you, he or she will likely recommend treatment options for anxiety, as there is little else that can be done medically. Therefore, if you have trouble breathing due to anxiety, practicing breath work is SO important! Some of these exercises may seem silly or too simple to possibly work, but current medical research shows that breath work greatly benefits those with mental and physical ailments. Yoga and cardio exercise can also help you feel more in control of your breath.

• Fatigue and sleep problems. If you feel tired all the time, join the club! Mental illnesses like anxiety and depression tend to be completely draining and lead to persistent fatigue. In addition, daily stressors often make it hard to fall or stay asleep, compounding the problem.
  What to remember: Sleep is extremely important in overcoming anxiety, so insomnia or constant fatigue is not something you should simply accept. Aside from the usual strategies – exercise, eat healthy, practice meditation and breath work – fortunately, there are a number herbal and natural supplements that can greatly improve quality of sleep and decrease daytime fatigue. Supplements containing melatonin and Valerian root are gentler than prescription sleep aids, and have the added benefit of not being habit-forming or addictive.

The fact is that there’s no sure-fire way to cure psychosomatic symptoms unless you really commit to managing the underlying mental health causes. But by utilizing the reminders and strategies outlined above, you can hopefully find some comfort and relief while you work toward a healthier, happier you.