Physical symptoms of anxiety: what they feel like and what helps

Anxiety triggers the body's stress response, which is designed to prepare you for danger. The NHS describes anxiety as affecting how you feel physically, mentally and in your behaviour, and notes that it is not always easy to recognise anxiety as the reason you feel unwell. When anxiety is frequent, the body can feel as though it is under threat much of the time.

Because the sensations are so physical, it is understandable that people worry first about their heart or stomach rather than about anxiety itself.

Physical symptoms of anxiety named by the NHS include:

• A faster, irregular or more noticeable heartbeat (palpitations).

• Feeling light-headed or dizzy.

• Headaches and chest pains.

• Loss of appetite, indigestion, stomach cramps, bloating and nausea.

• Constipation or diarrhoea.

• Sweating, feeling hot and shaking.

• Breathlessness.

• In generalised anxiety disorder, restlessness, getting tired easily, feeling tense, difficulty sleeping and stomach problems are also listed.

A panic attack is a surge of intense anxiety and fear. The NHS lists a racing heartbeat, feeling faint, dizzy or light-headed, a feeling of losing control, sweating, trembling, shortness of breath or very fast breathing, tingling in the fingers or lips, and nausea. An attack usually lasts 5 to 20 minutes. It can be frightening, but the NHS says it is not dangerous and should not harm you.

If attacks come out of the blue or you start avoiding places for fear of one, this may be panic disorder, which the NHS describes as one of several anxiety disorders that often occur together.

The same symptoms can come from heart or lung problems, so do not assume anxiety if the picture is new or severe. The NHS says to call 999 for chest pain that feels tight or squeezing, chest pain spreading to the arms, neck or jaw, severe difficulty breathing (gasping or unable to speak), pale, blue or grey skin or lips, or someone who has passed out and is not responding normally. Do not drive yourself to A&E.

The NHS also says to call NHS 111 if you are suddenly more breathless than usual, have chest pain with nausea or vomiting, or have chest pain with a racing, slow, skipping or fluttering heart. Regular palpitations that last more than a few minutes should be checked with a GP.

A GP asks about worries and physical symptoms and may rule out other causes. The NHS says a GP may diagnose generalised anxiety disorder if you have typical symptoms and you often worry about a wide range of things, anxiety affects your daily life, you find it hard to control, and you have felt anxious much of the time for at least 6 months. Honest answers help even when talking about emotions is difficult.

The NHS says treatment may take time. A GP may offer talking therapies, usually cognitive behavioural therapy, either one-to-one or in a group; medicines, usually an SSRI antidepressant; or referral to a community mental health team. The GP will usually advise trying talking therapies before medicine. Adults aged 18 and over can refer themselves directly to an NHS talking therapies service.

Self-help the NHS suggests includes talking about feelings with someone you trust, self-help books and online courses, calming breathing exercises, yoga or pilates, getting enough sleep, regular exercise such as walking, running, swimming or yoga, and a healthy diet with regular meals. It suggests avoiding alcohol, cigarettes, gambling and drugs as ways to cope, and not avoiding anxious situations altogether but building up gradually.

If anxiety is overwhelming or you feel unable to keep yourself safe, the NHS directs people to urgent mental health help through NHS 111, and to emergency services if life is at risk. Samaritans offer someone to talk to at any time. Everyone has a right to support, and you do not need to wait until things feel unbearable.

NHS talking therapies accept self-referral in England and are the usual first step. Private therapists and psychiatrists can offer quicker access; check the clinician is registered with a professional body and ask about the approach, number of sessions and cost.