Anxiety and Physical Pain: What’s the Connection?

Your heart begins to race, your body temperature begins to rise, and you start to feel lightheaded.

You can’t catch your breath.

Within seconds, you experience jolts of intense chest pain while simultaneously feeling like you can’t breathe.

You don’t completely understand what’s happening to you, but you know one thing for sure: you’re going to die.

And then, as rapidly and as unexpectedly as they started, the symptoms subside.

You weren’t drowning. You weren’t having a heart attack. And you weren’t about to die.

You had a panic attack.

Panic and Physical Symptoms, Anxiety and Pain

Panic disorder and other anxiety disorders are characterized by overwhelming fear and excessive worry. As described above, they can also cause considerable physical distress.

Panic disorder may be the most dramatic example of a mental health disorder with distressing physical symptoms. But it’s not the only one:

• Depression and bipolar disorder can affect a person’s appetite, sleep patterns, and energy levels.
• Posttraumatic stress disorder (PTSD) can promote persistent muscle tension and an exaggerated startle reflex.
• Other anxiety disorders – such as generalized anxiety disorder (GAD) and social anxiety disorder – can cause headaches, stomach aches, and other physical symptoms.

In other words, anyone who has ever described mental health disorders as “all in your mind” has demonstrated a fundamental misunderstanding of what these illnesses actually are.

Of course, acknowledging the existence of this type of a mind-body connection isn’t the same as understanding how unpleasant thoughts and feelings can cause physical distress. Thankfully, recent research by several experts has shed additional light on how this occurs.

The Physiology of Fear

Arash Javanbakht is a psychiatrist and neuroscientist who specializes in fear and anxiety. In a September 2023 article on The Conversation website, Javanbakht explained that processing fear involves multiple parts of the human brain:

• The amygdala receives input from the senses and tries to place the information in appropriate context (such as deciding if what the person is seeing is something to fear or attack).
• The hippocampus, which is near the amygdala, stores memories. This helps your brain determine if the individual has seen a certain animal or person before – and if so, if they posed a threat.
• The prefrontal cortex assesses social cues for signs that a threat may be present.

Once the brain has determined that a person is facing an actual threat, it quickly triggers several physical actions, such as:

• Tightening the muscles in the chest and abdomen to protect vital organs.
• Tensing other muscles to prepare for rapid, vigorous activity.
• Releasing adrenaline to speed up various physical processes.
• Expanding airways to get more oxygen into the body.
• Increasing heart rate to push additional oxygen to muscles.
• Diverting blood flow from the digestive system to get extra blood to the brain and heart.

It can feel as though these responses occur almost instantaneously. Part of the reason for this is that the amygdala has the ability to bypass the brain’s logical processes and move directly to a physical response. In life-or-death situations, this capability can be crucial for survival.

The responses that Javanbakht described are what should happen when someone encounters a person, animal, or situation that could pose a threat.

Unfortunately, certain developments – such as anxiety disorders, which can cause people to feel as though they are perpetually in danger – can throw a proverbial monkey wrench into the body’s threat assessment and response system.

Anxiety, Fear, Physical Distress, and Pain

When fully functional, the human body’s fight or flight response system saves lives. But when adaptations compromise the brain’s ability to accurately detect and act upon legitimate threats, the negative impact can extend to all parts of a person’s life – including their physical well-being.

A January 2016 paper in the journal Current Opinion in Psychiatry discussed how this can occur.

Anxiety: Mechanisms That Affect Physical Health

• Anxiety disorders are linked with altered circuitry in the brain. These alterations can cause the amygdala to trigger exaggerated responses to perceived threats.
• The altered circuitry can also disrupt the ability of the hippocampus and prefrontal cortex to regulate processes that triggered by the amygdala.
• Chronic exposure to stress can also cause these structural and physical disruptions within the brain.

Whether due to chronic stress or an anxiety disorder, this type of harm to the brain can cause considerable physical distress.

Think (or scroll) back to the previous section, where we posted a list of actions that are triggered when a person is in imminent danger. These are designed to occur on the hopefully rare occasions when a person’s life may be at risk.

Now, consider the effect of these actions if the brain caused them to repeat over and over when there is no credible threat.

Physical Consequences of Anxiety

• The tightening of chest muscles – due to anxiety – to protect organs can turn into chest pain.
• Keeping the body perpetually prepared for a rapid response can lead to persistent muscle tension and headaches.
• Continued calls for additional adrenaline can lead to the depletion of this important hormone. This, in turn, can affect a person’s energy levels, blood pressure, and other functions.
• Respiratory changes that are meant to briefly increase oxygen intake can cause a person to feel like they can’t catch their breath.
• Increased heart rate can weaken the heart muscle and cause hypertension.
• Diverting blood from the digestive system can lead to an upset stomach and other types of gastrointestinal distress.

In each of these cases, the body is doing what it is designed to do when the brain identifies a threat. Unfortunately, when the brain’s ability to perform its role is compromised, the body can be forced into a perpetual state of emergency that is not sustainable. The result of this mind-body disconnect can include persistent physical pain.

Complicating matters even more, this pain can reinforce the mind’s belief that it is facing a threat, which can exacerbate the individual’s psychological distress. The result, as described by Dr. Arthur Barsky of Harvard Medical School, is a spiral of increasing despair.

“Anxiety and stress themselves produce these physical symptoms, and on top of that your reaction to those symptoms can make them worse. The more you focus on them, the more alarmed you become, and the more intense your symptoms become,” Barsky said in an August 2020 article on the Harvard website.

“It can get really out of control and become so uncomfortable that you might not be able to do much more than sit and worry,” he added.

Treating Anxiety-Related Pain

Anxiety-related physical pain can have a harmful impact in the behavioral, social, and financial aspects of a person’s life.

When a person’s psychological distress is accompanied by physical discomfort, they may be less capable of performing to expectation at work, maintaining healthy relationships, establishing financial independence, and otherwise engaging in a full, satisfying life.

The likelihood that a person will endure these types of negative outcomes underscores the importance of seeking proper professional care.

At Crownview Psychiatric Institute, treatment for anxiety disorders is a comprehensive, personalized experience that incorporates therapy, medication, education, and wraparound support services.

Guided by the principles established in the Unified Protocol for Treatment of Emotional Disorders, we help patients learn to manage their symptoms, exert greater control over their thoughts and feelings, and eliminate maladaptive behavior patterns.

When a person is able to experience relief from the psychological distress of anxiety disorders, the physical effects of this condition should also begin to subside. With the brain no longer sending continual fight or flight messages, the body can return to a more relaxed state.

To learn more about treatment for anxiety disorders and other complex mental health conditions at Crownview Psychiatric Institute, please visit our Contact Us page or call our center today. We look forward to providing you with the details you need, so that you can make the most informed decisions for yourself or on behalf of a loved one.