contact Justine

Takeaway: In this post. we dive into the physical pains or discomforts that the body expresses as a result of anxiety, and most importantly, what to do about it.

What Are the Somatic Symptoms of Anxiety? The Truth Behind Your Physical Symptoms

If you experience anxiety on a regular basis, you’re most likely familiar with its many physiological symptoms. These include shakiness, sweating, a pounding heart, and fast, shallow breathing. Symptoms like these can feel scary and uncomfortable.


But did you know there are also other somatic symptoms of anxiety that are usually assumed to be medical in nature?


Physical symptoms like migraines, stomach pain, irritable bowel syndrome, and many types of chronic pain are often perpetuated by anxiety. They aren’t always associated with structural problems within your body.


Healthcare practitioners and therapists are becoming aware of the many ways anxiety impacts the body. This has created a significant difference in the way healthcare professionals treat anxiety and somatic symptoms.


Many of my clients experience both anxiety and somatic symptoms of anxiety. But they don’t always know they’re connected. So what causes somatic anxiety symptoms? Let’s take a look.


What Are the Somatic Symptoms of Anxiety?


Somatic symptoms of anxiety are any physical pains or discomforts that the body expresses as a result of anxiety.


Such symptoms can include:

  • Headaches and migraines
  • Fatigue
  • Vertigo and fainting
  • Back, hip, or leg pain
  • Neck or shoulder pain
  • Irritable Bowel Syndrome (IBS)
  • Vomiting
  • Other types of chronic pain


The biggest problem with somatic symptoms of anxiety is that these symptoms often perpetuate the anxiety itself. As the anxiety increases, so do the somatic symptoms. It’s a vicious cycle.


Think of it like this: when you experience uncomfortable or even debilitating physical symptoms, like migraines, you start to become very afraid of a migraine coming on. You might do everything in your power to avoid getting a headache. You might start associating certain foods with migraines, so you stop eating these things. You don’t want to risk getting a splitting headache in public, so you stop socializing and going out with friends. Your anxiety skyrockets because you’re constantly worried about getting a migraine.


In other words, your life shrinks down to your physical symptoms and your anxiety. You become hyper-vigilant because of the risk of an impending migraine. The migraines themselves fuel your fear and anxiety.


Unfortunately, doctors often don’t understand that anxiety can cause physical problems. They don't always work with the patient to treat their anxiety. They might wrongly attribute these somatic symptoms to underlying medical conditions. When doctors misdiagnose, the patient often goes through years of these mysterious and painful symptoms. Sometimes people become addicted to dangerous medications. Others might undergo expensive surgeries and procedures that don't work.


But luckily, there is hope. Most of the time, treating somatic symptoms of anxiety doesn’t require surgery or specialist doctor appointments. Instead, it’s important to understand the real relationship between pain and anxiety. You have the power to change that relationship.


Somatic Anxiety Causes


Heightened fight-or-flight responses can cause somatic anxiety symptoms. The brain generates pain as a way to warn us of danger. Somatic anxiety symptoms are the result of an overactive alarm signal in the brain.


Here’s how it works: if you have regular somatic anxiety symptoms, your brain perceives everything as dangerous. It goes into fight-or-flight mode. Hypervigilance and fear of pain are a result.  This is the perfect breeding ground for increased anxiety. The more somatic symptoms you have, the higher your anxiety gets. And the higher your anxiety gets, the worse your somatic symptoms get.


Anxiety and somatic symptoms of anxiety feed off of one another because they both lead to increased hypervigilance. This leads your brain to create both more pain and more anxiety. And all this is happening because your brain is trying to alert you to potential danger – it’s trying to protect you.


Somatic anxiety symptoms often crop up during times of increased stress or emotional turmoil. Exposure to stress and adversity can increase the likelihood of developing somatic anxiety symptoms.


Trauma in early life is one example of adversity that can cause somatic symptoms. Trauma wires your brain to become more vigilant in an attempt to protect you from further harm. This hypervigilance is partly responsible for causing somatic problems and pain throughout life.


So what “counts” as trauma? Trauma is anything your body and nervous system was unable to handle or process. This includes things like moving a lot as a child, losing a loved one, growing up in an unstable home, bullying, abuse, neglect, or growing up with toxic family members.


Other learned behaviors and traits, which can stem from trauma, also predict pain and somatic anxiety symptoms. These include:

  • General anxiety
  • Perfectionism
  • Hypersensitivity
  • People-pleasing


These traits can lead to somatic anxiety symptoms. Because, like trauma, they increase hypervigilance and danger signals in the brain.


Treating Somatic Symptoms of Anxiety Disorders


To change your somatic anxiety symptoms, you have to change your brain’s perception of danger. Your brain has learned to become hypervigilant toward small triggers in your environment or body. Soothing these signals will help soothe your symptoms.


One way to do this is to decrease your fear response to your symptoms. Without anxiety fueling your symptoms, the pain loses its power. It eventually decreases on its own. You can practice decreasing your fear of pain by paying gentle attention to your symptoms as they’re happening.


The point isn’t to get rid of your pain by doing this. It's to observe the physical sensations of your symptoms without attaching meaning to them, almost as though you were a scientist observing an experiment in a lab. This is also known as somatic tracking, and it helps you lower the threat associated with your pain.


Another key to treating somatic anxiety symptoms is to change your beliefs about these symptoms. If you believe they’re indicative of underlying medical concerns, it will be harder to stop the fear-pain cycle. When you work to heal your underlying anxiety or trauma, you can fundamentally change your nervous system. Ultimately you can deactivate faulty fight-or-flight signals.


Treating somatic anxiety symptoms doesn’t happen overnight. It requires a ton of patience and skill-building. You have to learn tools and skills for anxiety management. It's important to be willing to work to be less perfectionistic. It's helpful to practice boundary-setting and reduce people-pleasing. You can learn healthy coping skills for uncomfortable emotions. Most of all, you should practice continuous self-compassion. Over time, all these practices will help your nervous system feel safe and calm.


Therapy Can Help Decrease Somatic Symptoms of Anxiety Disorder


If you’re experiencing somatic symptoms of anxiety, you don’t have to navigate them alone. I can help. Together, we can figure out what underlying issues are the root of your symptoms, how to ease your nervous system out of hypervigilance mode, and how to reframe your thoughts and beliefs to soothe both anxiety and somatic symptoms.


Get in touch to learn more about counseling or anxiety coaching with me and see if we are a good fit to work together. 


Not interested in therapy but want new skills to manage your anxiety? Check out my new online program for anxiety management, The Path to Peace. This is my step-by-step mini-course to help you create your unique anxiety management routine in just seven days.

Meet the author

Justine Carino

Justine is a licensed mental health counselor with a private practice in White Plains, NY. She helps teenagers, young adults and families struggling with anxiety, depression, family conflict and relationship issues. Justine is also the host of the podcast Thoughts From the Couch.