In today’s fast-paced world, it’s not uncommon to experience moments of anxiety even when there seems to be no apparent reason. This post aims to delve into the various aspects of this phenomenon and shed light on why you might be feeling anxious seemingly out of the blue
Somatic Anxiety Symptoms
Understanding the Physical Manifestations of Anxiety
Anxiety often manifests itself in various somatic (aka physical symptoms). These symptoms can be confusing and distressing as they are the same sensations as those occurring from physical health issues unrelated to anxiety.
Physical anxiety symptoms can include:
Feeling that your heart is pounding, racing, or skipping
Chest pain, heaviness, tightness, or discomfort
Muscle tension, jaw tightness or pain, headaches
Difficulty relaxing, concentrating, or feeling agitated
Feeling short of breath, hyperventilating, and difficulty taking in a full deep breath
Sweating, sweaty or clammy hands
Feeling hot, flushed, blushing, or getting chills
Stomach upset or aches, nausea, sensation of butterflies, and bathroom attacks
Feeling dizzy, faint, unsteady, or lightheaded
Shakiness or trembling
Numbness and tingling in your hands, arms, or legs
Difficulty with sleep including falling asleep, staying asleep, or waking too early
Given that these symptoms span across many body systems, it can be difficult to identify what are anxiety symptoms and what are not. If you have concerns about your physical symptoms, have new symptoms, or changes in the symptoms, it is important to discuss these with your primary care provider.
If you are experiencing symptoms chest pain, shortness of breath, or other acute symptoms it is important to go get your symptoms assessed immediately. It is better to rule out an emergent health concern and discover it is an anxiety symptom than to assume it is anxiety and have it turn out to be urgent.
Anxiety Above or Below the Neck
When people think of anxiety, they often think of worry thoughts. We hear the phrase “I feel anxious but I have nothing to worry about”. However, it is now becoming more commonly understood that anxiety does not always include worry thoughts and may manifest in some people primarily through physical sensations or symptoms. Psychiatrist, Dr. Craig Heacock, shared thinking of anxiety as above or below the neck as a way of viewing the different types of anxiety symptoms. Above the neck, refers to the thoughts, images, and ideas that go through our mind. Conversely, below the neck refers to the physical sensations or somatic symptoms of anxiety.
This idea of above or below the neck is intended as a metaphor (ie. physical sensations such as jaw tightness or headaches are included in the somatic ‘below the neck’ anxiety) that can be helpful to categorize and make sense of your individual pattern of anxiety responses. Many people with anxiety would experience both worry thoughts and physical sensations, though one aspect may be more dominant than the other. Likewise, the therapy approach or focus may differ depending on if physical anxiety symptoms or worry thoughts are more predominate. While cognitive therapy approaches can be quite helpful in addressing the cognitive “worry thought” aspect of anxiety, sometimes other treatment approaches such as Eye Movement Desensitization and Reprocessing (EMDR) can fit better when no cause is identifiable.
Physical Anxiety Sensation Factors
Identifying Triggers and Coping Strategies
When you are experiencing somatic anxiety symptoms, it is useful to identify if there are certain factors that could unknowingly be contributing to or worsening your symptoms. To tackle anxiety effectively, it’s crucial to understand what might be contributing to or exacerbating your physical symptoms. Working alongside a mental health clincian and primary care provider are provide insights into common triggers and offer strategies to manage and alleviate these sensations.
Caffeine
A common culprit is that many people are regularly exposed to is caffeine. Caffeine is in coffee, as well as a number of other foods and beverages (including certain teas, colas, ect.) and some medications. Consider reducing caffeine intake and reading labels to bring awareness to the caffeine content in the items you consume.
Irregular Meals
Skipping meals or having irregular meals can contribute to feeling anxious. Our bodies operate within tightly regulated limits, one of which is blood sugars. If blood sugars begin to drop into a lower range, this can cause physical anxiety sensations. Consider if irregular meal patterns may be impacting your symptoms and try working with a registered dietician if that may be of benefit to you.
Hormone changes
Hormonal changes, particularly for women, can cause fluctuations in anxiety, especially if you have a pre-existing anxiety diagnosis. This includes not only anxiety at various stages of the monthly menstrual cycle, but also increases in anxiety following major hormonal changes including during and following a pregnancy, and commonly with the onset of menopause.
Prescription medication, OTC medication, and supplement side effects
Medications can have anxiety as a side effect including those that are over-the-counter (OTC). As mentioned above, some medications can contain caffeine, and others may cause anxiety due to other pathways. Speak to your doctor or pharmacist if you are concerned that your symptoms may be a medication side effect.
Medical conditions
Some medical conditions can create symptoms similar to those experienced with anxiety, such as thyroid problems, anemia (low iron), respiratory disorders such as COPD or asthma, irritable bowel disease (IBS), heart disease, diabetes, and persistent pain. Sharing relevant medical history with your clinician can help to direct your care. Speak with your primary care provider if you are concerned about anxiety symptoms or medical concerns.
Changes to physical health
Various changes to physical health, even changes that have positive health outcomes, can onset or worsen sensations of anxiety. A good example of this is when a person decreases or stops smoking. Decreasing smoking can cause physical anxiety sensations due to withdrawal from the chemicals that a body grows accustomed to, and the idea of quitting smoking (ie. not having a familiar coping strategy available) can also create physical anxiety or worry thoughts. The same is true for reducing alcohol or other substances, including tapering certain medications.
Consider stressors in your daily life
Lastly, it is important to consider if you may be experiencing anxiety symptoms from your environment. High pressure jobs and roles, looming deadlines, excessive demands, and hostile work or home environments, are common causes of anxiety even if you don’t necessarily feel worried about the stressor. Consider discussing stressors with a licensed mental health provider such as a psychologist, or with your primary care provider.
In conclusion, feeling anxious for no reason is a common experience, but it’s essential to recognize that there are often underlying factors at play. By understanding somatic anxiety symptoms, panic attacks, the physical manifestations of anxiety, and the role of your subconscious, you can better navigate these feelings and seek appropriate support when needed.
