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There are many physical signs and symptoms of an anxiety disorder which are caused by the fight or flight stress response.

Our bodies' stress response process is known as allostasis, and it can be short-term or chronic. 

The acute stress response that we are all most familiar with is the “fight or flight” reaction that is triggered when you feel under threat. Here, the stress response leads the body to release several stress hormones into the bloodstream (primarily adrenaline and cortisol) which accentuate concentration levels, reaction time, and physical strength. After you have dealt with the short-term stress, your body, including heart rate and blood pressure, return to normal. Our bodies produce more hormones to enable us to relax which can initially cause shaking as our muscles return to normal. Once the event has passed, so do all our sensations.

Chronic or long-term stress, however, is problematic. If you are continually under stress, your body is constantly producing higher levels of hormones and isn't afforded any recovery time. What can then happen over time is that stress hormones such as adrenaline and cortisol are repeatedly released in non-threatening situations or by inappropriate triggers. This continuous activation of your autonomic nervous system (albeit by false alarms) means it becomes unable to switch off and return to normal. This build up of stress hormones in the blood over time can cause serious health and mental health issues.

Early physical signs of chronic stress include:

  • Excessive tiredness
  • Gastric complaints or frequent minor illnesses
  • Headaches
  • Back or neck pains
  • Difficulties with sleeping
  • Appetite changes
Research indicates that chronic stress is linked to the development of anxiety disorders. A meta-analysis found that when chronic stress is not addressed it can lead only only to acute anxiety but also the development of anxiety disorders.

What are the physical signs or symptoms that might indicate an anxiety disorder?

  • Shortness of breath. The shortness of breath that is associated with panic attacks and anxiety results from a change in normal breathing; it is known as hyperventilation. When we feel anxious or panicky, our breathing usually becomes more shallow but we may not be aware of it. Therefore rather the lungs being filled, short and shallow breaths mean that carbon dioxide levels in the blood decrease. This can result in many physical symptoms, such as tingling and numbness, chest pain and dry mouth.
  • Feeling dizzy or light-headed. Hyperventilation can also cause someone to feel faint, dizzy, lightheaded, and confused. Hyperventilation can lead someone to start taking rapid intakes of breath; although some may simply experience coughing and fast breathing.
  • Palpitations (thumping in the chest) or tachycardia (fast heartbeat). Part of the stress response changes in fight or flight include stimulation of the heart rate to circulate blood around the body to enable fast and efficient response.
  • Anxiety can cause chronic pain through muscle pain or tense muscles. Tightness in the chest is one example of this that is commonly experienced in anxiety. When we’re stressed, the body secretes stimulant stress hormones into the bloodstream. One of the consequences of stress hormones is a contracting or tightening of muscles in the body. Where this response is caused by anxiety rather than actual physical threat, this tightening of the muscles can be in places such as the back where it causes pain.
  • Needing to urinate/defecate. This is a common anxiety reaction when anxious or stressed. The stress hormones lead the body to eliminate waste as quickly as possible to enable you to move faster and also to ensure you don't need to stop to do so when in flight or fight.
  • Shaking. Hormone secretion such as adrenaline causes activation of the nervous system and increased blood flow to extremities. When the body does not have the natural opportunity to disperse/use up these hormones through physical activity, the increased blood and adrenaline sit in the muscles and cause this tremor reaction. The feeling of “jitteryness” is thought to be caused by epinephrine, another hormone involved in the stress response.
  • Perspiring. Sweating is common in anxiety. Again, it is part of the fight-flight response. From an evolutionary perspective, it may have been to assist with escape from danger, or to warn others of imminent danger.
  • Dryness in the mouth or difficulty swallowing. Anxiety and stress can have an effect on salivary flow rate and this is why this is a common symptom experienced when anxious.
  • Visual disturbances such as blurred vision. The stress response involves dilation of pupils, which is designed to get more light into your eyes so potential threats can be clearly seen. However long-term stress and the resultant constant dilation can cause light sensitivity and also tightening of the muscles around the eyes leading to twitching.
  • "Butterflies" or “churning” in the stomach or feeling nauseous. There is increasing recognition of the “brain-gut connection”. Both the brain and gut are full of nerves: in fact the gut comprises the largest area of nerves after the brain, and the digestive tract and brain share most of the same nerve pathways. The hormones and chemicals released by your body have a deleterious effect on the microorganisms in the digestive tract and lead to long term gastrointestinal problems.
  • Restlessness. This is something people with anxiety commonly report and is often observed in agitated or fidgety behaviors. Someone may be unable to be still and may be observed pacing or wringing their hands, for example. Again, the adrenaline “rush” that the fight or flight response stimulates, is not used up in modern-day life and so leads a person to be constantly “charged”.
  • Those with an anxiety disorder often experience difficulties getting to sleep, staying asleep or early wakening. They may also report extreme fatigue which may be due to poor quality of sleep or result from being in a perpetual state of arousal with all its physical manifestations. It may also result from the excessive production of the stress hormones themselves, such as cortisol, which can also lead to excessive yawning.

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