Anxiety is a term widely used to indicate a complex of cognitive, behavioural and physiological reactions. It occur following the perception of a stimulus considered threatening and towards which we do not consider ourselves sufficiently capable of reacting. Anxiety itself, however, is not an abnormal phenomenon. It is a basic emotion, which involves a state of activation of the organism when a situation is subjectively perceived as dangerous.

Anxiety symptoms

Cognitive symptoms of anxiety

From a cognitive point of view, the typical symptoms of anxiety are:

  • the sense of mental emptiness
  • a growing sense of alarm and danger
  • the induction of negative images, memories and thoughts
  • the implementation of cognitive protective behaviors
  • the marked sensation of being observed and of being at the center of other people’s attention.

Behavioral symptoms of anxiety

In the human species, anxiety translates into an immediate tendency to explore the environment, in the search for explanations, reassurance and escape routes. The main instinctive strategy for managing anxiety is also the avoidance of the feared situation (strategy “better safe than sorry” – “better to prevent than to cure”). Protective behaviours (being accompanied, taking anxiolytics as needed, etc.), unassertive and submissive behaviours are also frequent.

Physical symptoms of anxiety

Furthermore, anxiety is often accompanied by physical and physiological manifestations such as:

  • voltage
  • tremor
  • sweat
  • palpitation
  • increased heart rate
  • dizziness
  • nausea
  • tingling in the extremities and around the mouth
  • derealization and depersonalization.

Below we will better describe some physical symptoms of anxiety, how they manifest themselves and what are the possible consequences:


It is necessary, as far as possible, to distinguish different conditions referable to palpitations: heart palpitations, tachycardia and arrhythmia.

The latter, for example, often occurs with irregular heartbeats even in healthy people, during their daily activities and is more likely to show up when the person is anxious.

It can be induced by a number of agents such as nicotine, caffeine, alcohol and electrolyte imbalance.

Often the interpretation given to this physical symptom during an anxious state is linked to the idea of ​​having a heart attack. This even if at the base there is an increased electrophysiological excitability of the heart muscle which has no negative consequences from a medical point of view.

Chest pain

It is a physical symptom that can occur during periods of high anxiety in the absence of a heart disorder.

It can therefore derive from different sources such as chest breathing and gastrointestinal disorders (eg oesophageal reflux or oesophageal spasms). When the person catastrophically interprets the benign causes of pain, it is possible that the anxiety state increases, leading to panic as well .

But we actually know that when a very high anxiety state arises, the body secretes adrenaline which causes the heart rate to increase and the body works faster. It is an evolutionary way to better prepare the person to handle dangerous situations.

If adrenaline damaged the heart, how could man have survived to this day? Therefore, the acceleration of the heartbeat due to anxiety does not cause heart attacks; there must be something pathological for this to happen.

Feeling of shortness of breath

Breathing is an action that works regardless of what a person thinks or does, it is automatically controlled by the brain. In fact, brain controls also work when you try to stop breathing. The feeling of shortness of breath is very common in anxiety disorders and results from prolonged and repeated thoracic (pectoral) breathing. In fact, a physical response to stress is the relative dominance of thoracic breathing over the abdominal one, which however leads to fatigue of the intercostal muscles, which strain and have spasms that cause discomfort and pectoral pains by inducing the lack of sensation of breath. If one fails to understand that these sensations are induced by chest breathing, then they will seem sudden, frightening, leading the person to further alarm.

Nausea or abdominal discomfort

The stomach contracts and relaxes on a regular and constant basis. When this rhythm is disturbed, nausea occurs. Several factors can lead to this physical sensation such as the ingestion of certain foods, vestibular disturbances, postural hypotension or even previously neutral stimuli. The function of nutrition and digestion are the first to stop during a state of alert, but if the person misinterprets nausea as a sign of impending vomiting, anxiety is more likely to increase and lead to panic. But luckily, nausea leads to vomiting rarely happens, people are more likely to overestimate this eventuality.

Tremors and sweating

The former are involuntary, oscillatory and rhythmic movements of one or more parts of the body, caused by the alternating contraction of opposite muscle movements. Sweating, on the other hand, helps to control body temperature, which rises when you have been anxious. In fact, stress stimulates the sympathetic nervous system with an increase in the levels of adrenaline and noradrenaline which stimulate an increase in metabolism, thus increasing the production of heat and the consequent sweating useful for lowering body temperature. Again, the more attention and catastrophization of these physical symptoms the more likely they are to increase in intensity.


Dizziness is the product of the illusion of movement of oneself or of the environment. They consist of feelings of confusion or spinning, dizziness or lightheadedness. Vertigo occurs when information from the balance system (visual, somatosensory and vestibular systems) collide. Balance problems and associated physical symptoms (instability, anxiety, cold sweat, palpitations) can also occur as a result of anxiety, hyperventilation, and common stress reactions such as clenching of the jaw and teeth. Obviously the intensity of dizziness may increase if more attention is paid to these sensations.

Derealization or depersonalization

Depersonalization (feeling of unreality) or depersonalization (feeling detached from oneself), are experiences that can be induced by fatigue, sleep deprivation, meditation, relaxation or the use of substances, alcohol and benzodiazepines.

There are also other more subtle causes linked to short periods of sensory deprivation or reduction of sensory inputs, such as staring at a point on a wall for 3 minutes.

The curious aspect is that, even here, the vicious circle is established based on the interpretation given to these physical symptoms. When you experience depersonalization or derealization (an experience that a third of the population has experienced) the more a person gets scared, the more they breathe, the more they become charged with oxygen (eliminating carbon dioxide) the more the feeling of depersonalization or derealization increases.

Fear of fear

The physical symptoms of anxiety often frighten by generating vicious circles, or the so-called “fear of fear”. However, they depend on the fact that, assuming that it is in a situation of real danger, the anxious organism needs the maximum muscular energy available, in order to escape or attack as effectively as possible, avoiding danger and guaranteeing survival.

Anxiety, therefore, is not only a limitation or a disorder, but it is an important resource . It is in fact a physiological condition that is effective in many moments of life to protect us from risks, maintain a state of alert and improve performance (eg, under examination).

When the activation of the anxiety system is excessive, unjustified or disproportionate to the situations, however, we are faced with an anxiety disorder, which can greatly complicate a person’s life and make them unable to deal with even the most common situations.

Anxiety Disorders

The known and clearly diagnosable anxiety disorders are the following (click for more details):

  • Specific phobia (airplane, enclosed spaces, spiders, dogs, cats, insects, etc.)
  • Panic disorder and agoraphobia (fear of being in situations from which there is no quick escape)
  • Obsessive Compulsive Disorder
  • Social phobia
  • Post-traumatic stress disorder
  • Generalized anxiety disorder

These disorders are among the most frequent in the population, they create great invalidation and often do not respond well to pharmacological treatments. It is therefore necessary to intervene effectively on them with targeted brief psychotherapeutic interventions of cognitive-behavioural orientation, which have shown high efficacy in hundreds of scientific studies.

By clicking on the individual disorders it is possible to deepen their knowledge and learn about the scientifically valid treatment methods.

Anxiety Cure and Remedies

When anxiety becomes extreme and uncontrollable, leading to one of the aforementioned anxiety disorders, professional intervention is needed that can help the person manage the annoying and disabling symptoms.

Psychotherapy for anxiety

Psychotherapy for anxiety disorders is undoubtedly the main treatment and from which it is difficult to ignore. In particular, cognitive behavioural therapy has shown very high efficacy rates and has established itself in the scientific community as the first choice strategy in the treatment of anxiety and its disorders.

The intervention usually takes a few months, with weekly sessions, and it is extremely rare that it is provided by public services.

It is therefore necessary to turn to a serious private center for cognitive behavioral psychotherapy, which guarantees high quality and seriousness of professionals.

Drug therapy of anxiety

The anxiolytic drugs, especially the “famous” benzodiazepines, are widely used but are useful only if used occasionally and for very short periods. Otherwise they present major problems of addiction and withdrawal that worsen the situation rather than improve it.

Even the latest generation antidepressant drugs are easily prescribed with anxiolytic function in the treatment of anxiety disorders. They have a certain efficacy, which however is usually lost when therapy is discontinued, as well as very often presenting side effects (drowsiness, sexual dysfunction, gastrointestinal problems, weight gain, etc.).

Remedies of another nature

Anxiety, especially when it does not reach the extreme levels typical of a real anxiety disorder, can be managed with relaxation techniques, mindfulness meditation strategies and natural remedies, such as valerian or other calming herbal products. These remedies for anxiety can be helpful and adjuvant to a psychotherapeutic treatment, but they are hardly conclusive.

Then there are other types of anxiety problems, which are not part of the anxiety disorders in the strict sense. For example, fear of flying, fear of driving, separation anxiety disorder , which is often associated with panic attacks and / or agoraphobia.  Or performance anxiety, very present in sexual disorders, but also in social phobia and in some personality disorders .

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