Personal care treatments

Somatic Anxiety: Symptoms, Treatments and How to Cope

Anxiety affects every system in your body, which can lead to headaches, tenseness, or dizziness.

We all know about the stroke and worrying thoughts associated with anxiety. But did you know that anxiety can also manifest in your physical body?

When you are anxious and stressed, your fight or flight response speeds up, releasing chemicals that can cause tension and pain in your body.

Anxiety that manifests in your body is called somatic anxiety. It may feel like a headache, tight shoulders, or an upset stomach. There are several things you can do to help release this body tension.

Somatic anxiety, or somatization, occurs when symptoms of anxiety manifest in the physical body. Somatic means relating to the body.

Somatic anxiety is common. A study 2020 health professionals during the COVID-19 pandemic found that among people with anxiety, 22.9% had somatic symptoms.

Anxiety affects all systems in the body, including the following:

  • musculoskeletal system
  • respiratory system
  • digestive system
  • cardiovascular system
  • endocrine system
  • the nervous system
  • reproductive system

Anxiety and stress can also contribute to or worsen chronic pain disorders, such as chronic fatigue syndrome or arthritis, making it harder to function.

The most common somatic anxiety symptoms are:

  • abdominal pain or upset stomach
  • fast, pounding, or irregular heartbeat
  • chest pain
  • fatigue
  • dizziness
  • insomnia
  • headache, muscle aches, or tension
  • tremble or shake
  • dry mouth
  • sweat
  • shortness of breath
  • feel pins and needles

Specific anxiety disorders may have additional symptoms. Symptoms of panic disorder can also include:

  • feel like you’re suffocating
  • tingling sensations
  • becoming overheated or cold

Symptoms commonly associated with anxiety and other psychiatric disorders, such as fatigue, dizziness and headaches, are among the most common reasons for almost half of all primary care visits in the general population.

Unfortunately, evidence suggests high rates of missed and misdiagnosed generalized anxiety disorder (GAD) and panic disorder because symptoms are often attributed to physical causes.

Among 1,000 people in primary care, one senior 2000 study found that 38% had at least one somatic symptom commonly seen with anxiety, but only 16% ended up being diagnosed with an organic disease within 3 years.

If you are experiencing one or more symptoms without knowing what is causing them, anxiety could be at play. Consider talking to a medical professional to determine if an anxiety diagnosis is right for you.

Treatment for anxiety symptoms may involve medication or psychotherapy.

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) is the most widely used evidence-based treatment for anxiety disorders.

The goal of CBT is to help you identify and change difficult or distorted thought patterns. Not only is CBT good for changing anxious thoughts, it can also help people cope with physical pain.


Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the first-line medications for adults with GAD. GAD is a common anxiety disorder, and it often presents with somatic symptoms.

FDA-approved SSRIs for anxiety include sertraline (Zoloft) and immediate- and extended-release paroxetine (Paxil, Paxil CR).

However, a test 2016 SSRI paroxetine found that although it improved cognitive symptoms, it did not appear to improve somatic symptoms of anxiety and depression.

FDA-approved SNRIs for anxiety include venlafaxine (Effexor) and duloxetine (Cymbalta). Duloxetine is also approved to treat musculoskeletal pain.

GABAergic drugs

GABAergic drugs act on the body’s GABA (γ-aminobutyric acid) system. GABA is the main inhibitory neurotransmitter of the nervous system.

GABAergic drugs include agents such as benzodiazepines (Xanax, Ativan), pregabalin (Lyrica) and gabapentin (Neuraptin).

Although benzodiazepines are effective in reducing anxiety symptoms, their use is strictly limited due to the risk of misuse and serious side effects.


Beta-blockers, such as propranolol (Inderal LA), help block the effects of adrenaline and noradrenaline, chemical messengers that increase your heart rate and make you sweat or shake.

Along with professional treatment, self-care strategies that focus on stress reduction and the well-being of your body can help relieve symptoms of somatic anxiety.

1. Stretch

You can often reduce muscle tension or pain triggered by anxiety with gentle stretches.

Consider getting a yoga mat and doing easy stretches, like touching your toes or clasping your hands behind your back, several times a day.

Focus on the parts of the body that feel the most tension. Try to take slow, mindful breaths throughout the stretching session.

2. To take a walk

If possible, take a brisk walk or jump on a treadmill. To research shows that physical activity can reduce symptoms of GAD and panic disorder.

3. Butterfly hug

This is an anchoring technique to use when you feel overwhelmed. Cross your arms across your chest with your fingers resting on your arms or shoulders. Take a deep breath through your nose, then slowly tap your hands on your arms alternately.

4. Body Scan Meditation

Lie down and mentally analyze the tension or anxiety in your body, one part at a time.

Anxiety in your body may feel like an upset stomach, a clenched fist, a headache, or tight shoulders. Pause on each part of the body and observe if you feel any tension.

If you do, practice releasing the tension and then relaxing that part of the body.

5. Green tea or herbal tea

Few things are more soothing than a hot cup of tea when you’re feeling nervous. Consider choosing a tea that has anti-inflammatory properties, such as green tea or ginger tea.

Somatic anxiety is the physical manifestation of anxiety. It may feel like a headache, tight shoulders, upset stomach, or tiredness.

These symptoms are caused by the constant activation of your body’s fight or flight response. This releases chemicals that can cause pain and tension in your body, especially when they occur over a long period of time.

Somatic symptoms can be painful, but with the right treatment they can be reduced and even completely relieved.