What Does Anxiety Actually Feel Like in Your Body?

Written by Natasha Kiemel-Incorvaia, Registered Psychologist (PSY0001977411)

It is 3am. You are lying in the dark, staring at the ceiling... again. Your chest feels tight, your stomach is in knots, and there is a restlessness inside you, you cannot quite name. Anxiety often shows up in the body before it shows up as a thought, and learning to recognise those signals is often the first step in understanding what is actually happening.

You would not necessarily call yourself an anxious person, but your body seems to be saying something different.

For many women, the first signs they notice are not thoughts like “I am anxious”, but physical sensations such as a tight chest, nausea, shoulder tension, or a sense that their body is on high alert for no obvious reason [1].

Why Does Anxiety Show Up in the Body at All?

Regardless of what anyone tells you, you cannot think your way out of anxiety. It is a whole-body response designed to protect you. When your brain perceives something as a potential threat, whether real or imagined, such as a looming deadline, a difficult conversation, or a memory your mind has hooked onto, it activates your stress response systems. This is your sympathetic nervous system doing its job [2].

There are two common presentations I see in practice. The first is women who are immobilised by their body’s physical sensations of anxiety. These signals are so strong they at times impact the woman’s capacity to focus on their thoughts. The second is women whose focus is primarily on reducing their anxious thoughts and who have often disconnected from their body and the signals it is sending as a way of coping. In this second presentation, women often report that when they do notice their physical symptoms, they come on very fast and feel very strong. Neither presentation is better than the other, and at times women will switch between the two. Both highlight the importance of working with both the body and thoughts, often using a combination of bottom-up and top-down approaches.

What Are the Most Common Physical Sensations of Anxiety?

Everybody who experiences anxiety experiences it differently. Most people will experience anxiety at some point. For many women in particular, the physical symptoms of anxiety in women are often the first signs something is off, before any thought of “I am anxious” even forms. How each person experiences it, how long it lasts, and what helps reduce it will vary significantly. This is because the physiological symptoms of anxiety and what triggers them are different for each person, and for one person they can even vary over the course of a day.

Below are some of the more commonly reported physical symptoms of anxiety:

• Muscle tension, often experienced as shoulder tension, jaw clenching or tightness
• Tension headaches, which may be experienced in the neck and back of the head, behind the eyes, or as a band of tension around the head that often gets worse by the end of the day
• Increased heart rate
• Breathing that feels shallow or fast, feels like it is sitting high in the chest, or feels like you cannot get a full breath in
• A tight, heavy, or squeezed feeling across the chest, even when nothing obvious is happening in the moment
• A churning, knotted, or butterfly feeling in the stomach
• Waves of nausea
• Shaking hands
• Sweaty palms
• Weak or heavy-feeling legs
• A sensation of internal buzzing
• An urge to keep moving even when you are exhausted, for example stress cleaning
• Difficulty falling asleep, often after lying in bed feeling tired but wired, which impacts your capacity to go to sleep even when you feel exhausted

Do you recognise any of these physical symptoms?

If you start to experience any new, intense or concerning physical symptoms, the first step may be to see a GP rather than a psychologist. This is particularly important if you are experiencing significant changes in sleep, appetite, weight, or physical symptoms such as chest pain or breathlessness and are unsure what is causing them. A GP can help rule out physical health conditions that may be contributing, such as thyroid problems, anaemia, perimenopause or sleep disorders, and can support referrals to appropriate clinicians from there [3].

Why Do Some Women Feel Anxious in Their Body Before They Recognise It in Their Mind?

One of the patterns I see most often in my clinical work is that the body often knows something is off before the mind has words for it. Now whether this is completely accurate depends on the person. Sometimes anxious thoughts happen so fast they bypass the thinking brain and go straight to the emotional brain. So technically there are thoughts, but you still cannot figure out the why or how to describe it. The amygdala, which acts as your brain’s threat detector, can activate your stress response before the thinking parts of your brain have had a chance to catch up [7]. For women who have spent years in high-demand environments, parenting, working, caring for others, the gap between those two things can be very wide.

This is connected to what psychologists call interoception, your awareness of your own internal bodily signals such as heart rate, breathing, temperature and emotional felt sense. Research suggests that difficulties noticing or interpreting these signals are linked with higher anxiety and challenges in using what your body is telling you to guide your behaviour [4].

To put it simply, to survive and keep going you have become skilled at disconnecting from what your body is saying until the signals get so loud you can no longer ignore them.

This can look like ignoring early signs of tension or fatigue until a headache or stomach upset forces you to stop. Feeling inexplicably irritable or on edge, then later realising your heart had been racing for hours. Describing yourself as “fine” mentally while noticing a constant knot in your stomach or a sense of buzzing under the skin that has been there all day. It is understandable to push through, but over time this can become harmful. Sometimes burnout is upon you before you fully accept it, and the cost to your work, your relationships, your family, and your recovery time, can be significant [2].

It is also important to note that differences in interoceptive capacity are linked with neurodevelopmental conditions such as Autism and ADHD, which can co-occur with anxiety conditions.

Not sure whether you are the woman who feels overwhelmed by physical sensations or the woman who has learned to disconnect from them? The free Regulation Profile Quiz can help you understand how your nervous system is currently responding and how your body may already be trying to support you. It takes about five minutes. Take the quiz here.

What Is the Difference Between Anxiety and Panic, and Does It Matter?

Anxiety and panic exist on the same continuum, but they can feel different in the body. If you are experiencing panic attacks I would generally recommend you work one on one with a practitioner as a first step before something like a psychoeducation course. Knowing the difference between symptoms of anxiety and panic attacks can help you explain your symptoms more clearly to your GP or psychologist so they can choose tools and therapies to best support you.

Everyday or generalised anxiety often feels like a background hum, a constant low-level “what if?” with your body slightly revved up most of the time, sometimes for weeks or months without an obvious peak. I often describe this sensation to clients as little waves on the surface of the ocean, constantly there in the background, which sometimes spike but often do not settle fully. The physical impact of this may be muscle tightness, restlessness, shallow breathing or breath holding, fatigue, and ongoing sleep difficulties that slowly drain you over time [2].

Panic attacks differ in character. They are sudden, intense spikes that reach a peak within minutes and then subside. Think of them as the tidal waves that come crashing in, and the impact can take longer to recover from compared to smaller spikes of anxiety.

People often describe panic-type symptoms as a racing heart that you feel you have no control over, chest tightness, feeling like you cannot catch your breath no matter what you try, dizziness, nausea, sweating, shaking, and a fear of losing control or dying. These symptoms occurring suddenly and so intensely can create an experience that can feel like a medical emergency even when it is not [8].

For some women, being able to name the difference can help them understand and identify their symptoms and any patterns they experience. For others, the most useful thing is simply being able to name it such as “I am experiencing panic, however, my life is not in danger, I am going to be panicked based on facts, not feelings, these feelings are going to pass, I can cope with this.” Either way, any new or severe physical symptoms (chest pain, breathlessness, sudden dizziness) need medical assessment first. Anxiety can mimic physical illness, and physical illness can mimic anxiety.

This article focuses primarily on the body, but the way anxiety and panic impact the mind and your capacity to support yourself can also differ. Please read to the end about an offer I have that is focused on supporting your mind.

What Can Help When Anxiety Is Mostly Physical?

When anxiety lives mainly in the body, tools that focus only on thoughts can feel frustrating, because you are trying to use the part of your brain that is already least available. This is one reason the Integration System begins with body safety. The Integration System draws on established psychological approaches including CBT, ACT and body-based therapies but organises them around four practical pillars that work together rather than in isolation. You can use the most logical, rational statements in the world, but if your mind is not in a state where it can listen to them, you are unlikely to see the progress you want. It is often helpful to start by working with the body to help reduce sympathetic, fight-or-flight activation that may have been present for much longer than it was designed to be.

Earlier in this blog, we looked at two presentations: women who feel overwhelmed by physical sensations, and women who have learned to disconnect from them. That distinction matters here, because the starting point is different for each.

If you tend to be overwhelmed by physical sensations:

The body needs information that it is not in danger before it will consider easing off. Tools that work with this directly include:

• Slow, lengthened exhales, for example breathing in for a count of four and out for a count of six. It is the extended exhale specifically that engages the parasympathetic nervous system, signalling that there is no immediate threat. This is one reason breathwork can help when anxiety is physical: it is not about distraction, it is about giving your nervous system a bottom-up signal it can actually use [2].
• Anchoring to your senses, such as feeling your feet on the floor, holding something warm, or noticing five specific things around you. This works for the same reason: concrete sensory information about your current environment gives your nervous system data that you are not in immediate danger, which is what it needs before it can begin to settle [2].

If you tend to disconnect from your body and miss the early signals:

The challenge here is different. The goal is not to calm the system down but to rebuild a working relationship with what your body is telling you before the signals become overwhelming. Tools that may support this include:

• Gentle movement, such as stretching, walking, or shaking out your limbs, done with deliberate attention to physical sensation rather than as something to get through [5,6]. The aim is not exercise for its own sake but using movement as a way to practise noticing your body in a low-stakes context, so the signals become more readable over time.
• A brief body scan at one consistent point in the day, not as a relaxation exercise but as a check-in. Simply noticing whether there is tension anywhere, whether your breathing feels shallow, whether your jaw is clenched. Research on interoception suggests that practising this kind of noticing, even briefly, can support better awareness of early anxiety signals rather than discovering them only when they have built to a point you can no longer ignore [4].

Some women also find somatic anxiety responds better when body-oriented approaches are used alongside talking therapies, especially when trauma or chronic stress has been part of their experience. Early research suggests body-oriented psychotherapy can be helpful for some people with trauma-related, anxiety and psychosomatic symptoms, but the evidence base is smaller and more mixed than for more established therapies, and more rigorous studies are needed [5,6].

When Is It Time to Seek Support?

Not every period of increased anxiety needs professional help. Anxiety is a natural part of being human. It gives you information about your environment, relationships and situations. But there are some signs worth taking seriously.

It may be helpful to seek support if you notice a pattern of tension or shutdown that does not ease even when external pressures reduce [2]. If anxiety is affecting your sleep, work, relationships, parenting, or ability to get through the day [1]. If you find yourself avoiding situations because of fear of the physical sensations themselves [3].

If you are in crisis, feeling unsafe, or worried about harming yourself, please contact emergency services (000 in Australia) or Lifeline on 13 11 14 rather than waiting for an appointment.

Your Next Step

If you are reading this saying “this is what happens to me” and recognising yourself in the physical symptoms described, the first step is to consult with your GP if you are experiencing severe symptoms you are unsure about the cause of.

If you know you have been experiencing higher levels of stress and anxiety, a useful starting point may be to understand how your nervous system has been trying to support you.

If you would like to understand the broader framework this post sits within, the Integration System post explains how the four pillars interact and where to start.

Written by Natasha Kiemel-Incorvaia, Registered Psychologist (AHPRA: PSY0001977411). Natasha is the founder of Gracefully Redefine You (natashacourses.com) and Graciously You Psychological Services. She works with women navigating stress, anxiety, burnout and nervous system dysregulation through self-paced psychoeducation courses and individual telehealth appointments.

References

[1] Australian Bureau of Statistics. National Study of Mental Health and Wellbeing, 2020-2022. Canberra: ABS; 2024.

[2] Zheng Y, Jin L, Jiang Y, et al. Analysis of somatic symptoms in patients with anxiety and depression. Frontiers in Psychiatry. 2019.

[3] Life in Mind. National Study of Mental Health and Wellbeing, 2020-22: summary of key findings; 2023.

[4] Duran PS, et al. Interoceptive awareness in a clinical setting: the need to bring interoceptive perspectives into clinical evaluation. Frontiers in Psychology. 2024;15:1244701.

[5] Bloch-Atefi A, Smith J. The effectiveness of body-oriented psychotherapy: a review of the literature. Psychotherapy and Counselling Journal of Australia. 2015.

[6] Rohricht F, Papadopoulos N, Priebe S. An exploratory randomised controlled trial of body psychotherapy for patients with chronic depression. Journal of Affective Disorders. 2013;151(1):85-91.

[7] Kenwood MM, Kalin NH, Barbas H. The prefrontal cortex, pathological anxiety, and anxiety disorders. Neuropsychopharmacology. 2022;47(1):260-275. PMC8617307.

[8] Beyond Blue. Panic disorder and panic attacks. Available from: https://www.beyondblue.org.au/mental-health/anxiety/types-of-anxiety/panic-disorder. Accessed 2026.