11 Physical Signs You're Having An Anxiety Attack

And how to deal.

by Kyli Rodriguez-Cayro and Kathleen Ferraro
Originally Published: 
11 physical signs you're having an anxiety attack, according to experts.
Getty Images/AleksandarNakic

Anxiety attacks can be confusing, scary, and physically distressing, especially if you don't understand that you are having one. Though over 40 million adults in the United States are diagnosed with an anxiety disorder, including panic disorder, there are still some major myths surrounding anxiety attacks. Though you may envision anxiety attack symptoms like crying, screaming, or breathing into a paper bag (and that can be true) there are actually a lot more physical signs of anxiety attacks than you may know about.

If you have anxiety, you’re not alone: Nearly a third of American adults experience an anxiety disorder at some point in their lives, according to the National Institutes of Health (NIH). And anxiety levels have peaked during the pandemic, with nearly half of Americans reporting feeling anxious in the last two weeks, according to the American Psychological Association’s Stress in America 2021 report. “Anxiety is when your brain is telling you that you don't have control over something,” says licensed counselor Nawal Alomari. “The flight or fight response kicks in, which is your brain telling you to attack this thing and handle it or run away. When that happens, you get physical symptoms.”

If anxiety is so common, then it must be easy to spot those symptoms, right? Not necessarily, says Alomari. Anxiety attacks (just like anxiety in general) can vary from person to person, she says. One person might feel sweaty and dizzy, while another might get a stomachache. And anxiety attacks differ from a panic attack in that they don’t always come on as suddenly or as strong, says Kanani Stephens, registered nurse and co-founder of hemp wellness brand Plant Love Naturals. That’s why you might feel the symptoms of an anxiety attack for hours or even days before understanding what’s causing your discomfort, as opposed to the typically sudden and intense surge of panic attack symptoms like crying, trouble breathing, and overwhelming fear.

So whether you’re unsure if that chest pain you experienced was COVID or anxiety or you just want to get to the bottom of how your mental health is impacting you physically, being aware and educating yourself on the physical symptoms that accompany your anxiety can help you better navigate panic attacks. Here are 11 common physical symptoms of an anxiety attack that are completely normal, and why they occur in the first place.


Heart Palpitations Or A Racing Heartbeat

Your heart may normally skip a beat every now and again when something makes you nervous or excited. But a racing heart or persistent heart palpitations are common signs that you’re dealing with more than just your run-of-the-mill nerves, says Stephens. If your heart feels like it’s going a mile a minute or beating out of your chest, then underlying anxiety may be to blame. Once you recognize this symptom, make an effort to slow down your breathing or, if you use it, take your anxiety medication to help ease the attack.


Shaking Or Trembling

You might also notice your hands are trembling or your body feels shaky. This is another common signal that your body is in fight-or-flight mode in response to something that stressed you out, be that a stressful day at work or an awful breakup, says Alomari.

Everyone has a fight-or-flight response, and it can come in handy when you need to make quick decisions in life-or-death situations by pumping hormones like adrenaline and cortisol through your body so you can take action. But when your body stays in fight-or-flight mode during situations that are stressful but don’t immediately threaten your survival, symptoms like this can kick in as hormones circulate in your body with no release.



That influx of stress hormones you get during fight-or-flight response can also cause sweating in response to anxiety — cold sweats, hot sweats, sweaty palms or all of the above, says Alomari. As with many symptoms of an anxiety attack, people often mistake this sign as something else, she adds. Maybe you blame it on the weather or what you’re wearing. Regardless, if you notice you’re sweating when you shouldn’t, Alomari recommends taking stock of what happened over the last day to see if there’s something that may have triggered your anxiety. And, to help, there are many ways to reduce sweating caused by anxiety attacks, including staying hydrated.


Chest pain

Another common physical symptom of an anxiety attack is chest pain. And these days, experiencing chest pain can spark even more anxiety since it’s also a symptom of COVID, says Stephens. While it’s always wise to play it safe if you have signs of the virus, if it’s COVID, you’ll likely experience other cold- or flu-like symptoms as well. Anxiety-induced chest pain can also be mistaken for a heart attack. Luckily, if anxiety is to blame for your discomfort, it’s not life threatening. However, chronic stress is linked to an increased risk of developing heart disease down the line, so it's important to be aware of this stress response.


GI Problems

Ever get nervous tummy before a big presentation or a first date? Your gut and your brain (and by extension, your mental health) are closely connected, which is why you may feel stress in your stomach. The same goes for anxiety attacks, says Stephens. You may notice stomach pain, stomachaches, cramps, nausea, constipation, or diarrhea when you have an anxiety attack due to elevated levels of the stress hormone cortisol, which your body pumps out while you’re in fight-or-flight mode.


Difficulty Breathing

A scary symptom of anxiety attacks is feeling like you’re short of breath or having trouble breathing altogether, says Stephens. When you’re stressed, your breathing can change: Instead of full, deep breaths, you might start taking short, shallow breaths. This can reduce the amount of carbon dioxide in your blood, which makes you feel like you’re choking or can lead to other anxiety attack symptoms like a racing heart, feeling numb, or having a dry mouth. Taking control of your breath through breathing exercises or diaphragmatic breathing can help.

Like chest pain, experiencing shortness of breath these days can be even more anxiety provoking since it’s a common symptom of COVID, adds Stephens. Anxiety breathing will likely pass and you should still be able to take a deep breath if you try, whereas COVID breathing trouble will likely get worse for a time.


Feeling Faint Or Dizzy

Those short, shallow breaths you take when you hyperventilate can sometimes make you feel like you’re going to pass out during an anxiety attack, adds Stephens. And even if your breathing is relatively regular, the rush of stress hormones you can experience may deplete your energy and make you feel exhausted or faint. If you frequently experience lightheadedness or dizziness during an anxiety attack, be sure to find a comfortable seat and stay sitting until the dizzy spell passes.


Numbness, Burning, Or Tingling

Numbness or a burning or prickling sensation in different parts of your body, especially in your arms or legs, are another common sign that you’re having an anxiety attack, says Alomari. This is another side effect of your body going into fight-or-flight mode: Blood can drain from your extremities as your body channels it towards the parts that will help you attack or run.


Skin Rashes

Ever notice that you break out in red, bumpy hives when you’re stressed? That could also be a sign you’re having an anxiety attack. Research shows that stress can trigger a rash in your skin. That’s in part due to higher cortisol levels, which can cause inflammation that leads to hives. Antihistamines or cold compresses can help relieve your skin woes.


Dry Mouth

Dryness in your mouth, also called cottonmouth, is common during an anxiety attack. It can happen if you’re prone to acid reflux (which affects the salivary glands) or from breathing with your mouth open. The main way to tackle this symptom? Hydrate, hydrate, hydrate. But it can also be a side effect of some anxiety and depression medications, so if you notice this happening more than usual after starting meds, check in with your doctor if it’s causing discomfort.


No Symptoms At All

Everyone who has an anxiety or panic disorder has symptoms manifest in their own unique ways. Some people, especially while in public or with friends, may not display any visible signs that they are having an anxiety attack. But "silent" anxiety attacks aren’t any less debilitating or real, and serve as a reminder that nobody experiences anxiety the exact same way.

Similarly, you don’t have to experience a massive stress event to have an anxiety attack, says Alomari. “Sometimes it's just something that lingers under the water in your brain, like a comment someone made that threw you off,” she tells Bustle. “It’s helpful to be mindful about what's frustrating you and giving your brain the room to think about those things so it doesn't pile up.” Anxiety attacks can be frightening, but recognizing the physical symptoms could help you mitigate the fear of the attack and better understand how your body responds to stress, says Stephens.

Studies referenced:

Alijaniha, F. (2016). Relationship Between Palpitation and Mental Health. Iranian Red Crescent Medical Journal, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884607/

Cackovic, C. (2020). Panic Disorder. StatPearls, https://www.ncbi.nlm.nih.gov/books/NBK430973/

Clapp, M. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/

Daly, C. (2016). Oral and dental effects of antidepressants. Australian Prescriber, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919175/

Deacock, S. (2008). An approach to the patient with urticaria. Clinical and Experimental Immunology, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2492902/

Dimsdale, J. (2008). Psychological Stress and Cardiovascular Disease. Journals of the American College of Cardiology, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633295/

Folgering, H. (1999). The pathophysiology of hyperventilation syndrome. Monaldi Archives for Chest Disease, https://pubmed.ncbi.nlm.nih.gov/10546483/

Goldstein, D. (2010). Adrenal Responses to Stress. Cellular and Molecular Neurobiology, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056281/

Keeton, C. (2008). Sense of Control Predicts Depressive and Anxious Symptoms Across the Transition to Parenthood. Journal of Family Psychology, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834184/

Konturek, P. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Physiology and Pharmacology, https://pubmed.ncbi.nlm.nih.gov/22314561/

Musey, P. (2018). Anxiety Associated With Increased Risk for Emergency Department Recidivism in Patients With Low-Risk Chest Pain. The American Journal of Cardiology, https://www.sciencedirect.com/science/article/abs/pii/S0002914918313365

Tipton, M. (2017). The human ventilatory response to stress: rate or depth?The Journal of Physiology, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577533/

Urita, Y. (2007). Salivary gland scintigraphy in gastro-esophageal reflux disease. Inflammopharmacology, https://pubmed.ncbi.nlm.nih.gov/17701015/


Nawal Alomari, L.C.P.C., a licensed clinical professional counselor and life coach based in Chicago

Kanani Stephens, R.N., a nurse and co-founder of hemp wellness brand Plant Love Naturals

This article was originally published on