Anxiety

Anxiety is typically accompanied by both emotional and physical symptoms. Emotional signs like nervousness, restlessness, and being easily distracted often coincide with physical symptoms such as dry mouth, nausea, or sweaty hands. These physical symptoms can intensify the feelings of anxiety. However, when anxiety becomes more severe, it can lead to disruptive physical symptoms that interfere with daily life.

Profound anxiety can manifest as a range of physical symptoms, including dizziness, diarrhea, and intense panic accompanied by a rapid heartbeat and difficulty breathing. Jacqueline Bullis, an assistant psychologist at Harvard-affiliated McLean Hospital, explains that experiencing lightheadedness, a racing heart, and chest tightness can contribute to a heightened sense of impending doom.

Nevertheless, Bullis emphasizes that the physical symptoms themselves are not the main issue. It is more about how individuals respond to these symptoms. The goal is to help people understand that these distressing physical sensations are not dangerous, and they can learn techniques to tolerate and manage them effectively.

Hitting the panic button
Anxiety can serve a useful purpose in certain situations, motivating us to prepare for important events like work presentations. When anxiety is at an optimal level—not too overwhelming or suppressed—it can provide the necessary drive to accomplish tasks. Jacqueline Bullis explains that without any anxiety, we would struggle to be productive.

However, extreme physical sensations experienced during anxiety stem from the body's fight-or-flight response. In these moments, our reaction to perceived threats, such as public speaking, can be similar to how we would respond to genuine danger like a home intruder. During an anxiety attack, symptoms can become so intense that individuals may mistakenly believe they are having a heart attack or stroke.

Dr. Arthur Barsky highlights that people experiencing severe anxiety attacks often feel as though they are on the verge of death. They interpret the experience as a serious medical emergency rather than just anxiety, which can further exacerbate their distress. This perception can create a self-fulfilling prophecy, intensifying their anxiety.

If you experience symptoms such as chest pain or shortness of breath, it is important to consult a doctor to rule out any potential medical concerns. Once anxiety is confirmed as the underlying cause, it is crucial to learn how to respond effectively in situations that trigger anxiety. While many people tend to avoid such scenarios and withdraw from potentially uncomfortable interactions to prevent anxiety, Harvard experts emphasize that this approach is incorrect.

CBT: The gold standard

What’s the best path to overcome severe anxiety? Cognitive behavioral therapy (CBT) is considered the gold standard, effective in many cases. Often, people wait too long — even decades — only to be astonished how quickly they can gain control of symptoms using CBT, Bullis says. Results typically take four to six months.

A form of CBT called exposure therapy engages you in activities designed to provoke uncomfortable physical sensations, causing you to become breathless or feel momentarily panicked. "We’re going to be confronting things you’ve gotten good at avoiding," Bullis says. "The more you do it, the more used to it you get. It’s kind of like a vaccine — by repeatedly and deliberately exposing yourself to these scary physical sensations, you can reduce the impact they have on you in the real world."

Short-acting medications, such as beta blockers or benzodiazepines, can be used for situational anxiety to calm extreme physical reactions. But "the problem with these medications is they may reinforce the idea that these symptoms are dangerous," Bullis says. "And many people don’t like being reliant on something to help them cope."

A combination of therapies may be needed for severe cases.  seeking a therapist trained in CBT and asking what approaches he or she would use in your treatment