Anxiety and Physical Symptoms: An Educational Guide

Why physical symptoms need a careful, whole person assessment

Anxiety can be accompanied by physical sensations such as a pounding heart, chest tightness, breathlessness, dizziness, nausea, shaking, muscle tension, sleep disruption or fatigue. These experiences can be frightening, especially when they arrive suddenly or interfere with work, relationships or daily routines. They can also have medical, medication related, hormonal, sleep related or other causes. This guide cannot determine the cause of a physical symptom. New, severe, unusual or concerning symptoms should be assessed through the appropriate medical route. Do not assume that a sensation is anxiety simply because you have felt anxious before, and do not use a webpage to decide whether medical care is needed. An appropriate assessment can consider physical symptoms, medical advice, current pressures and emotional experience together. It should not reduce all bodily sensations to anxiety. It can be useful to notice when a symptom occurs, what has happened around it, what meaning it takes on and what response follows, while keeping medical questions within the appropriate medical setting. Anxiety can sometimes affect breathing patterns, attention, sleep, muscle tension and the way the body’s signals are noticed. This is not evidence that every bodily change has a psychological cause. A careful conversation can hold both possibilities: the need for medical assessment where appropriate and the possibility that worry, fear or avoidance may be adding to distress. CBT informed support may discuss thoughts, behaviours, physical sensations and current safety considerations. For example, an assessment may explore whether checking, reassurance seeking, avoiding activity, searching for symptoms or changing routines has become part of a difficult cycle. Whether these ideas are relevant depends on the person, their health context and the medical information available. No webpage can safely prescribe an exposure exercise, breathing practice, activity change or between session task. Exposure informed work involving physical sensations should be discussed only after appropriate assessment of medical and safety factors. The pace, focus and boundaries of any therapeutic work should be agreed individually and reviewed as more becomes clear. Sanah Younis is a BABCP accredited CBT therapist and clinical lead at The Lyceum Clinic. BABCP accreditation reflects professional CBT training and ongoing standards. It does not determine the cause of a physical symptom, replace medical assessment or guarantee a particular treatment route or outcome. Face to face arrangements can be discussed in Chiswick, Ealing and the Richmond venue, and online options can be discussed where appropriate. The published fee is £110 for an online session and £140 for a face to face session. Current availability, accessibility, format and suitability should be checked directly. If you use insurance or a cash plan, confirm eligibility, any referral or authorisation requirements, payment route and reimbursement terms directly with the relevant provider. The clinic cannot determine a provider’s decision. Before making a decision, you may want to ask what information is needed at an assessment, how medical concerns are handled, whether online or face to face arrangements can be discussed and what happens if your circumstances change. It is reasonable to take time after a conversation to consider the information, speak with someone you trust or decide that another form of support is more appropriate. The purpose of a guide is to help organise questions, not to substitute for examination, investigation or urgent care. A physical symptom may be distressing even when its cause is not yet clear. Both the uncertainty and the need for a careful response deserve to be taken seriously. You do not need to solve that uncertainty alone or immediately, and asking for appropriate help is reasonable. If you are in immediate danger or need urgent help, use an appropriate emergency or urgent service rather than relying on this guide or an enquiry form.