A client once told me she was convinced she was having a heart attack. Her chest was tight, her pulse was racing, her hands had gone cold and numb. She sat in the emergency room for three hours before a cardiologist gently explained that her heart was perfectly fine. What she was experiencing was anxiety — not imagined, not invented, entirely real, and entirely physical.
I’ve heard versions of this story hundreds of times in my clinical practice. And every time, I notice the same mixture of relief and confusion on a person’s face when they realize the source. Relief that nothing is structurally wrong. Confusion because the body felt so genuinely, undeniably sick.
That confusion makes complete sense. We’ve been culturally trained to separate mental and physical health as though they occupy different rooms in a building that never shares walls. They do not. They are in the same room.
What is actually happening in the body
When the brain perceives a threat — whether that’s a real danger or a looming deadline or a difficult conversation you’ve been avoiding — it activates the sympathetic nervous system. Adrenaline and cortisol flood the bloodstream. Heart rate increases. Breathing becomes shallow. Blood redirects away from the digestive system toward large muscle groups. This is the stress response, and it evolved to help us survive.
The problem is that modern anxiety doesn’t always have a lion to run from. The threat is abstract — a relationship, a financial worry, a sense of impending failure — but the body responds with the same ancient urgency. And when that activation becomes chronic, or when it fires without an obvious external cause, the physical symptoms can feel completely disconnected from any emotional state.
The most common physical manifestations I see in my clients include chest tightness, shortness of breath, gastrointestinal disturbances like nausea or irritable bowel flares, headaches, muscle tension in the shoulders and jaw, dizziness, fatigue, and that particular skin-crawling restlessness that makes it impossible to sit still. Some people experience tingling in their extremities, excessive sweating, or a persistent lump-in-the-throat sensation. Others wake repeatedly at night with a pounding heart and no memory of a nightmare.
Why this matters for how we approach support
Understanding that anxiety has a physical signature isn’t just academically interesting — it changes how we treat it and how people understand themselves. Someone who recognizes that their chronic stomach problems are anxiety-related will approach both their gastroenterologist and their psychologist differently. Someone who understands their insomnia is driven by nervous system hyperarousal can stop blaming their character and start addressing the underlying pattern.
This is part of why I built AI mental health support into Dzeny’s approach — because people often first notice something is wrong through their body, and they need access to grounded, psychologically-informed guidance at the moment of that noticing, not weeks later when an appointment finally opens.
What actually helps
From a clinical standpoint, the most effective interventions target the nervous system directly. Diaphragmatic breathing — slow, deliberate exhales that are longer than the inhale — activates the parasympathetic system and begins to counteract the physical arousal response. It’s not a metaphor or a platitude. It is a physiological interrupt.
Progressive muscle relaxation, which involves systematically tensing and releasing muscle groups, helps people identify and release the chronic tension they’ve often stopped consciously noticing. Movement, particularly rhythmic movement like walking or swimming, processes the stress hormones the body prepared but never used.
Longer-term, psychotherapy — particularly approaches that integrate body awareness — helps people recognize the early warning signals their nervous system is sending before a full anxiety episode takes hold. That kind of self-knowledge is genuinely protective.
If your body has been telling you something your mind hasn’t quite articulated yet, I want you to know: that’s not weakness, and it’s not mystery. It’s your nervous system doing exactly what it was designed to do. The work is learning to listen, and respond, with skill.
By Valentina Lipskaia, Clinical Psychologist & Founder of Dzeny
This article is just for knowledge purpose.