Somatic Anxiety: Symptoms & Tips for Coping

What Is Somatic Anxiety?

Somatic anxiety encompasses everything that happens in your body when you’re feeling anxious and may affect people with different types of anxiety disorders. You may be familiar with the racing thoughts, irritability, and insomnia that come with anxiety, but it also affects your whole body. According to polyvagal nerve theory, the vagus nerve has two branches that start in your brain stem and run down the length of your torso, interacting with every organ system on the way down.¹ When we talk about the “mind-body connection,” the vagus nerve is a part of that connection.

When we encounter something that feels like it might put us in danger, our brain communicates with the vagus nerve to start preparing to run or fight. This can result in increased heart rate and breathing, tensed muscles, and diverted blood away from digestion and into the muscles so that you’ll be better able to defend yourself against danger.

When we feel anxiety, it’s often due to social situations, work, and financial stress, or feeling overly scheduled. If an individual is chronically in this “fight or flight” state, it can take a toll on physical health.²

Parts of the Body Affected by Somatic Anxiety

Somatic anxiety can have a significant impact on both your short and long-term health and well-being. It’s also common for people to feel these physical symptoms and then become even more anxious because of them, fearing that they might be physically ill. It can negatively impact your quality of life.

Parts of the body that are affected by somatic anxiety include:

• musculoskeletal system
• respiratory system
• gastrointestinal system
• cardiovascular system
• endocrine system
• nervous system
• reproductive system

General Anxiety Vs. Somatic Anxiety?

General anxiety is diagnosed when someone worries about many different things on most days for at least six months and has difficulty controlling their worries. General anxiety disorder (GAD) may include somatic symptoms, such as muscle tension, sleep disturbances, and fatigue.³ It’s possible to have somatic anxiety without GAD. For example, someone may be worried about one issue for a few weeks, which may result in tight muscles and stomach aches during those weeks. They wouldn’t meet the criteria for GAD, but they would be having somatic anxiety.

Symptoms of Somatic Anxiety

Common symptoms of somatic anxiety include:

• Trouble breathing or shortness of breath
• Stomach aches or digestive upset
• Shaking, muscle tension
• Dry mouth
• Shaking or trembling
• Racing heart
• Headache
• Insomnia
• Grinding teeth
• Excessive sweating

Causes & Triggers of Somatic Anxiety

Many things can trigger somatic anxiety, including chronic stress. When we’re constantly running from one task to the next, especially if we are worried about failure or a bad outcome, the stress of this can build up in your body and cause these symptoms of anxiety.

Those with a history of trauma or a genetic predisposition or neurobiological imbalance may be especially at risk for having a somatic response to stress because their nervous system may already be hypersensitive. Somatic symptoms of anxiety can also be aggravated by lifestyle, such as lack of exercise, poor diet, excess use of alcohol or other drugs, and insufficient sleep. It can be difficult for many people to make the necessary lifestyle changes due to financial pressures, family responsibilities, or lack of access to healthy foods.

The Role of Stress & Trauma in Somatic Anxiety

When we experience trauma or long-term stressors, our bodies can become habitually predisposed to a fight or flight state. If you’ve experienced threatening situations, it makes sense that your nervous system would stay on high alert. It’s trying to protect you from getting hurt again, but sometimes, it ends up doing more harm than good by causing your symptoms of somatic anxiety.

Diagnosing Somatic Anxiety

It’s crucial to see a medical provider to rule out any physical causes of your symptoms. If there’s no medical cause, the next step is to see a therapist who can talk to you about your symptoms and administer a thorough psychological evaluation, including using anxiety screening tools and questions about your current and historical mental health symptoms.

By getting a thorough understanding of your mental health and anxiety symptoms, they may be able to help you isolate certain times of day or situations that cause your symptoms to flare up so that you can prepare for those situations, avoid them, or learn skills to cope with them better.

How to Cope With Somatic Anxiety

Ways to cope with somatic anxiety include:

When possible, reducing stressors in daily life can be a very effective way of reducing somatic anxiety. This isn’t always possible, but it can be worthwhile to look at the things that are causing you stress and consider if any of them can be reduced or eliminated. It can also be helpful to consider what enjoyable activities you can increase in your life. Is there a hobby you love but haven’t been making time for, friends you could see more often? Prioritizing things you love can help reduce anxiety and the somatic symptoms that come with it.

Meditation

My clients often tell me they can’t meditate because “they can’t make their minds stop.” I say, “Welcome to being human!” The good news is that meditation isn’t about making your thoughts stop. That’s impossible. It’s not even about focusing, it’s about refocusing. It’s natural for human minds to jump from topic to topic. Meditation is the practice of noticing when that has happened and gently redirecting your thoughts back to your breath, mantra, or movement you’ve chosen. Here are a few meditation for anxiety practices to help get you started.

Herbal or Green Tea

Herbal teas have been used for healing for centuries, and tea for anxiety can have profound benefits. Many types of teas can help ease some of the somatic symptoms of anxiety, for example, peppermint tea can help ease indigestion, and chamomile tea can aid in relaxation and sleep.⁴ Green tea has also been proven to be effective in improving mood and reducing anxiety.⁵ However, it does contain caffeine, which can increase anxiety, so green tea should be used in moderation.

Exercise

Exercise has been shown to reduce anxiety by releasing chemicals in the brain that increase a sense of calm, increase self-efficacy, and give your brain a break from anxious thoughts.⁶ Exercise can also increase self-confidence and be a great opportunity to socialize with others and be part of a team or fitness group. There are many positive ways in which exercise affects mental health.

Breathwork

You already have access to a great tool for coping with the symptoms of somatic anxiety: your breath. When we’re feeling anxious, our breath often becomes shallow and fast. By consciously taking slow, deep breaths, you send the message to your body that you’re safe, and it will start to relax.⁷ One very helpful technique is the 4-7-8 breath, in which you inhale for 4 seconds, hold the breath for 7 seconds, and then exhale slowly for 8 seconds.

Therapeutic Approaches for Somatic Anxiety

The good news is that there are many types of anxiety therapy that can be useful in treating somatic anxiety. Some of them are what we call “top down,” meaning that they start with addressing your thoughts, which can calm your anxiety and improve physical symptoms, while other methods are “bottom up,” starting with emotions and physical sensations, which then reduces anxious thoughts. Different approaches are most effective for different people.

Treatment for Somatic Anxiety

Treatment options for somatic anxiety include:

• Cognitive behavior therapy (CBT): CBT for anxiety could help somatic anxiety by aiding you in interrupting or challenging habitual thought patterns. CBT also teaches self-care strategies that aid in reducing anxiety symptoms.
• Eye Movement Desensitization and Reprocessing (EMDR): EMDR is best known as a trauma treatment. However, it can also be useful for anxiety, whether you’ve experienced trauma or not. EMDR for anxiety focuses on body sensations and emotions and helps your brain to form new neural pathways and belief systems.
• Acceptance and Commitment Training (ACT): The premise of ACT is that you don’t need to change your thoughts or yourself but instead accept them and learn how to prevent your symptoms from getting in the way of living a life you value. ACT for anxiety could help.
• Psychodynamic Therapy: Psychodynamic therapy explores your past and how past conflicts and childhood experiences have led you to where you are now. It helps you to understand the unconscious thought patterns that are contributing to your current behavior.
• Mindfulness: Mindfulness therapy helps you to become more aware of your thoughts, feelings and behaviors in order to reduce automatic reactions. It helps you make more deliberate choices about how you would like to respond to a situation. Mindfulness for anxiety could help you to cope with the effects.
• Somatic Therapy: There are many types of somatic therapy, including Somatic Experiencing, Sensorimotor Psychotherapy, and Hakomi, among others. They all focus on understanding and releasing the ways that mental illness and trauma manifest in the body.

Lifestyle Changes & Self-Care Strategies

There are many changes you can make in your daily life that can help with somatic anxiety. Socializing regularly, getting enough sleep and physical movement, and reducing alcohol can all help lower your anxiety and help your body be more resilient. Eating a healthy, well-balanced diet can also help manage anxiety.⁸

Sometimes, we all need to indulge in a lazy day on the couch or a glass of wine after a long day. These things can be helpful occasionally, and they feel good in the short term. But, real self-care includes things like going to bed early, exercising, and meditating, even when you don’t feel like doing any of these things. It can be difficult to motivate yourself, so start with small, manageable lifestyle changes. If you never work out, consider starting with a 10-minute walk. If you tend to stay up late, try moving your bedtime up half an hour and gradually make it earlier a little bit at a time.

Medication for Somatic Anxiety

There are many options available for someone who is considering anxiety medication. Taking medication can help resolve symptoms more quickly. In some cases, it can improve your symptoms enough that you’ll be able to make the lifestyle changes needed to address your symptoms and may eventually be able to come off the medications. It’s a very personal decision and one that is best discussed with your healthcare provider.

Some medications that can help with somatic symptoms of anxiety are commonly thought of as antidepressants, including Zoloft and Lexapro. These need to be taken daily to be effective. There are also medications you can take on an as-needed basis, these include hydroxyzine, busbar, or beta-blockers, like propranolol. People often think of benzodiazepines, including Xanax and Valium, as a first line of defense against anxiety. These can be helpful but are very addictive and should be used with caution and only for short periods of time.⁹

When to Seek Professional Help

If your symptoms are impacting your ability to work, complete household tasks, or enjoy your life, and you’ve unsuccessfully attempted to make lifestyle changes on your own, it may be time to seek professional help. Depending on where you live and your financial situation, finding professional help for your somatic anxiety may be difficult, but when possible, it’s better to do so sooner rather than later.

You can use an online therapist directory to help find a good therapist in your community. Or, if you’re having trouble finding someone locally, you may want to consider online therapy for anxiety. Once you’re connected to a therapist, they can help you decide if medication might be right for you and help connect you to a psychiatrist who can prescribe. You can also consider online psychiatrist options, which may be more easily accessible for you.