Generalized Anxiety Disorder Can Have Physical Symptoms
In my NYC anxiety therapy practice, many patients come in with physical symptoms, whether panic attacks, IBS issues, constipation or heart palpitations, which can indicate internalized anxiety. These symptoms may have been there for weeks, months, or even, years.
These physical experiences can vary widely. Some folks come into anxiety therapy with tightness in their chest, while others have a headache that just seems to occur whenever they are stressed or overwhelmed. Some have debilitating panic attacks. Some complain of general fatigue, sleeplessness or restless sleep. And many patients complain of stomach issues like IBS, constipation, or nausea. There can also be muscle tension and twitching that is unrelated to sports or physical injury. Despite this range of symptoms, they all can indicate generalized anxiety disorder expressing itself physically.
Your Body Can Take Unacknowledged Anxiety Out On You
Why do you hurt physically? Because when you do not acknowledge that you are stressed, anxious, worried, scared, sad, or in emotional pain, your body takes it on for you. Anxiety is not just a neurological measurement. There are physical experiences of anxiety as well. For example, you feel shaky before a board meeting or a performance, or you feel restless in your sleep the night before a big interview, having a new baby or starting a new semester. These experiences are both a physical and emotional process. Our body is trying to process that something feels scary, unknown, overwhelming, sad, and possibly, stressful.
When unacknowledged, anxiety can become even more physically felt. Anxiety often turns into physical pain because the emotional hurt or pain has no acknowledgement or emotional process. In a sense, the emotional pain has nowhere to go but internally. The anxiety continues to grow, and you are left with a build-up of physical symptoms, expressing itself as IBS, panic attacks, nausea, headaches, constipation, insomnia or muscle tension.
For example, say you read something in the news (that could be most anything these days) and you have a sneaking feeling you don’t like it. But, when you keep reading, your head starts hurting, you feel dizzy and sick to your stomach. Well, you are probably also feeling anxious. The anxiety you feel is internalized and can become physical because you aren’t recognizing, “Hey, that made me feel anxious.” When we are not having an active conversation (with ourselves and others) about what makes us anxious, stressed out, fearful or in pain emotionally, then our body takes it on.
Checking-In With Physical Symptoms Emotionally
Sometimes patients come to me after they went to the ER or a primary care doctor let them know they may need to see someone. Some patients list these physical symptoms as a side concern, but it’s not the challenge that brought them into therapy.
Many people do not first think to ask themselves, “What has been going on in my life?” when experiencing physical pain or symptoms. You feel it physically, but an emotional cause does not typically come to mind.
In my anxiety therapy practice, I often ask people about how they feel physically. Whenever someone has anxiety, I ask about sleep or if there is a physical sensation. I ask these questions because I want to get close to their physical symptoms and see if it has any emotional root.
Your Body Can Indicate Anxiety Before Your Brain Catches Up
The physical symptoms that bother you are essential to name in therapy because it might be where you experience anxiety in your body. Your anxiety can be located in places other than just your head. Anxiety can be located in your chest, heart, legs, stomach and digestive systems. Naming where it hurts is important because our body can be the key system to alert us that something doesn’t feel right and needs attention.
Sometimes your body can tell you that you are anxious even before your brain catches up. Your body is fast to react (Just think about adrenaline in an emergency situation). Even in everyday life, your body often reacts first, and then, your mind processes what you are seeing, smelling, tasting, hearing, touching or feeling. If you are conscious that your body might be taking in the anxiety first before your brain, then you can work on processing these scenarios.
For instance, if your stomach hurts when your kid was rushed to the hospital, you can read it as anxiety, worry and fear. Or if you wake up every morning with a headache that goes away on the train, but returns at the office, you can understand this as a physical indication of anxiety and stress.
Lessening Physical Symptoms In Therapy
In therapy, I talk to people about their physical pain to find out what it feels like, as well as why, where and when it started and how often it occurs. I want to be curious and know what was going on in their life at the time–both emotionally but also logistically–with family and relationships.
Then, we can examine together how and if these life situations, past events/experiences and physical symptoms are connected. What do you want or need to do even though you are anxious and your stomach hurts? What can you do to take care of yourself? How can we talk together to let the anxiety be released and less painful? It is therapy’s role to answer these questions and find ways for you and your therapist get closer to the anxiety together. Getting close to the anxiety, in my therapy practice, means talking about what makes you anxious, acknowledging it and seeing how to move slower and with more power with the anxiety present.
Therapy Bridges The Gap Between Physical and Emotional Experiences
I’ve often observed that once anxiety is acknowledged, there is usually physical relief or at least, an awareness of where the physical symptoms came from. That is how anxiety therapy can help to bridge the gap between physical and emotional experiences.
We can talk about what you want to do about the physical symptoms whether it’s breathing, writing, drawing, walking, talking, or sharing and connecting about what your experience is and what makes you anxious. Sometimes, this is enough for the physical symptoms to lessen. However, other times, medication is needed and you need to seek both medical and therapeutic intervention concurrently. What is most important is that you and your therapist connect about what you are physically and emotionally feeling and decide together how to help you grow in understanding this process.
