When racing thoughts lead to sleepless nights.

By Sara Coughlin
Updated Mar 03, 2020 @ 4:00 pm
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Anxiety disorders, which affect 40 million U.S. adults every year, are often characterized by nervousness, near-constant worry, racing thoughts, and other consuming mental health symptoms. But anyone who lives with anxiety knows that it not only affects their mental well-being but their physical comfort, too, from their digestion to their likelihood of getting a decent night’s sleep.

Here, we’ll look at some of the ways in which anxiety can affect your physical health — and what you can do to reduce its impact on your everyday life.

Digestion

Gastrointestinal issues, such as indigestion, nausea, diarrhea, cramping, or heartburn, are some of the most common ways in which anxiety manifests itself physically, explains Rebecca Hedrick, M.D., a psychiatrist at Cedars-Sinai. Anxiety triggers the same fight-or-flight reaction in the brain that mortal danger triggered in our prehistoric ancestors, and when those instincts kick in, more blood flows to our muscles and away from our GI tract. As a result, our normal digestive processes slow down or stop. Back in the prehistoric era, we’d have a chance to return to a state of rest after confronting a stressor like a predator, but nowadays our stressors come in the form of social media, the 24-hour news cycle, or financial woes — they’re “chronic,” as Dr. Hedrick describes them, and can be too prevalent to avoid.

In addition to chronic gut issues caused by existing in this constant state of responsiveness, rather than rest, there's another factor at play. Digestive issues can also spike with anxiety because when the body’s main stress hormone, cortisol, increases in production, so does stomach acid, explains Michael E. Ford, M.D., an internal medicine physician with NewYork-Presbyterian Medical Group Hudson Valley. Taking an antacid (like Pepcid) should help mitigate this issue, Dr. Ford says.

Sleep

Again, anxiety’s effect on sleep is closely tied to that fight-or-flight response — when the body is in survival mode, sleep is not a priority. And, as described earlier, living with anxiety means that you shift into that mode pretty easily, and have a hard time shifting out of it. “The brain is turned on to either fight or escape, and patients often times awake with ruminative or excessive worry about events in their life, preventing them from falling back asleep,” Dr. Ford explains.

Naturally, sleep disturbances can lead to excessive tiredness when you’re awake, and that’s on top of the fatigue that mental distress naturally causes. “Anxiety takes a lot of brain power. It burns a lot of calories; it uses a lot of energy to have all of those anxious thoughts,” Dr. Hedrick says. She points out that many people will try to address this problem with caffeine, which only makes their anxiety worse. Instead, she suggests practicing healthy sleep habits like avoiding caffeine, alcohol, and screens before bed, and using a sleep mask or earplugs if needed.

Menstruation and Reproductive Health

According to Jessica Chan, M.D., an assistant professor and ob-gyn specializing in reproductive endocrinology at Cedars-Sinai, anxiety can contribute to irregular periods, fertility issues, and even worse symptoms of menopause. Its impact on menstruation in particular is once again due to the fight-or-flight response that awakens when we feel anxious. That same increase in cortisol that messes with our GI tract also decreases our levels of reproductive hormones, which leads to a lack of ovulation and, in turn, irregular periods, Dr. Chan explains. She adds that if your period has been irregular for three months, you should get in touch with your gynecologist.

The relationship between anxiety and fertility is more complex, Dr. Chan says. On one hand, research shows that people dealing with fertility experience anxiety, stress, and depression at higher rates than those who aren’t. On the other hand, Dr. Chan believes pre-existing anxiety can lead to issues with fertility, considering anxiety’s effect on ovulation and menstruation, for one thing. Beyond that, she notes that anxiety can have a negative impact on couples’ relationships and even lower sufferers’ libidos, which makes simply having sex, the initial step to conceiving, difficult.

Finally, anxiety can intensify such menopausal symptoms as sleep disturbances and hot flashes (which, Dr. Chan says, can feel very similar to an anxiety attack), as a result of the reproductive hormones estrogen and progesterone decreasing in production. Dr. Chan also says people who had been living with anxiety prior to transitioning into menopause may notice that their anxiety worsens at this point.

Rapid Heart Rate

This symptom usually crops up as soon as a bout of anxiety begins — and it can set off a vicious cycle that only makes those feelings of anxiety worse. “Once somebody’s heart rate starts racing, a lot people will have palpitations — they feel the fluttery feeling of their heartbeat — and that feeling itself can trigger worsening anxiety, which can trigger a full panic attack,” Dr. Hedrick says. This is yet another side effect of the body’s survival mode, which can be addressed with therapy and practiced relaxation — more on that below.

What You Can Do to Manage Anxiety and its Accompanying Symptoms

Right off the bat, Dr. Hedrick says to get in the habit of practicing any of the following relaxation techniques: diaphragmatic breathing, where you breathe into your belly as opposed to your chest; progressive muscle relaxation, where you tense and relax your main muscles one at a time; body scanning, where you simply observe the sensations surrounding your body from head to toe; and, finally, mindfulness, in which you observe your feelings and environment in the moment without judgment. Try them out when you don’t feel particularly stressed, so that when your anxiety does rise to the surface, you have these techniques down pat.

It’ll be incredibly useful to have these tools in your back pocket, but you should also make an appointment with a mental health care professional to learn more about the roots of your anxiety. And, if you’re experiencing these physical symptoms on top of anxious thoughts, visit your primary care provider as well as a therapist. Even though anxiety can contribute to issues around sleep, menstruation, and digestion, it’s important to make sure there isn’t an underlying physical condition or illness that’s causing them, too.