Anxiety — Symptoms, Physical Signs, and What Helps (2026)
- Anxiety affects 1 in 5 UK adults and 40 million Americans at any given time
- Physical symptoms (heart palpitations, dizziness, chest tightness) are as common as psychological ones
- CBT is the most evidence-backed treatment — as effective as medication at 1 year
- Exercise reduces anxiety by 48% in people with anxiety disorders (meta-analysis)
- Deep breathing (4-7-8) activates the parasympathetic nervous system within minutes
Normal Anxiety vs Anxiety Disorder
Anxiety is a natural, adaptive response to perceived threat — it evolved to protect us. The autonomic nervous system activates the fight-or-flight response: heart rate increases, breathing quickens, muscles tense, attention narrows. In healthy proportions, this is essential. An anxiety disorder occurs when this response is triggered excessively, chronically, or without genuine threat.
Physical Symptoms of Anxiety
This is one of the most important and overlooked aspects of anxiety: its extensive physical manifestations. These are caused by chronic activation of the sympathetic nervous system:
- Cardiovascular: Palpitations, racing heart, chest tightness — frequently triggering health anxiety and cardiac investigations
- Respiratory: Shortness of breath, hyperventilation, feeling unable to take a satisfying breath
- Gastrointestinal: Nausea, stomach churning, diarrhoea, IBS symptoms — anxiety is the most common cause of IBS
- Neurological: Dizziness, tingling in hands/feet, headaches, light sensitivity
- Musculoskeletal: Muscle tension, jaw clenching (bruxism), neck and shoulder tension
- Skin: Sweating, flushing, skin picking behaviours
- Sleep: Difficulty falling asleep (cognitive arousal), early morning wakening (cortisol)
Evidence-Based Treatments
CBT — Most Effective
CBT teaches recognition of anxious thought patterns (cognitive distortions), challenges their accuracy and helpfulness, and develops behavioural strategies to reduce avoidance. For panic disorder, CBT including interoceptive exposure (deliberately inducing feared physical sensations) is particularly effective.
Exercise — Underused and Highly Effective
A meta-analysis of 36 trials found exercise reduces anxiety by 48% in people with anxiety disorders. Both aerobic exercise and resistance training are effective. Mechanism: reduces baseline cortisol, increases GABA and serotonin, improves sleep, and reduces inflammation — all of which maintain anxiety.
Medication
SSRIs (sertraline, escitalopram) and SNRIs are first-line pharmacological treatment. They take 4–6 weeks to produce full effect. Benzodiazepines (diazepam) should be used only for acute, short-term situations — they cause dependence and worsen long-term anxiety outcomes.