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Prolonged anxiety is often associated with an elevated stress response, leading to excessive worry, avoidance, and physical symptoms. This blog explores in-depth the physical symptoms of anxiety and how Somatic Approaches can be used to reduce the physiological impact of anxiety.
Anxiety and the Body
Anxiety manifests in the body through various physiological responses, primarily due to activation of the sympathetic (“fight-or-flight”) system. When the sympathetic nervous system (SNS) is activated, the body starts to prepare to react to threats. You can almost think of this process as your body stepping on the gas pedal, preparing for action. The amygdala (the brain’s emotional processing center) detects a potential threat (real or imagined) and through sending distress signals across the brain, it activates the SNS, sending adrenaline into the bloodstream. When this happens, the body is ready to do what it needs to protect itself. For example, this could look like having impulses to shout and throw punches (fight) or escape the threat altogether (flight). This process is associated with many physiological changes to prepare the body for action.
Common physical symptoms of SNS (gas pedal, fight/flight) activation and their purposes for survival include the following:
System | Response | Purpose |
Heart | Heart rate increases | Helps pump more oxygen and nutrients into the muscles |
Lungs | Rapid, shallow breathing (can feel like shortness of breath) | Increases oxygen intake for energy |
Digestive | Slows down (can lead to nausea, stomach pain, irritable bowel) | Redirects energy to muscles instead of digestion |
Muscles | Tense up, blood flow increases(can lead to shaking, trembling arms or legs, chest tightness, restlessness) | Prepares for quick movement and strength |
Neurological | Hypervigilance, difficulty concentrating | Focus shifts to detect threats |
Sweat glands | Increase sweat production | Regulates and cools body temperature during stress |
If the threat persists (real or imagined), the body starts to release cortisol and this prolongs the fight-or-flight response, keeping the body alert and energized. With repeated and prolonged activation of the SNS, these physical symptoms can manifest as:
- Cardiovascular: Hypertension and heart disease
- Gastrointestinal: Irritable bowel syndrome, weight gain, acid reflux, ulcers
- Immune System: Increased inflammation (worsening conditions like eczema, asthma, and IBS)
- Musculoskeletal: Muscle stiffness, migraines, jaw clenching, chronic pain
- Neurological: Impaired memory, brain fog, sleep difficulties
Somatic Approaches for Anxiety
Somatic approaches are one way to help regulate the nervous system and alleviate physical symptoms and other manifestations of anxiety. For more information on alternative evidence-based coping strategies, see our previous post
How Do Somatic Approaches Work?
Somatic approaches rely on present-focused body awareness and physiological regulation to reduce symptoms of anxiety. Using nervous system regulation, somatic therapies recognize that psychological stress is stored in the body and are not just mental experiences.
Somatic therapy for anxiety helps by engaging the parasympathetic nervous system (PNS), which is responsible for calming the body after stress, promoting relaxation, digestion, and recovery. You can almost think of PNS activation as your body stepping OFF the gas pedal and onto the brakes. This is why with somatic therapies for anxiety we want to target PNS activation, to reduce those physical symptoms of anxiety associated with a prolonged SNS (fight-or-flight) response. Using somatic therapies, we can activate the PNS (calm) response and reduce the SNS (fight/flight) response.
Physical symptoms of PNS (gas pedal, rest/digest) activation and their purposes for survival include the following:
System | Response | Purpose |
Heart | Heart rate decreases | Conserves energy, supports relaxation |
Lungs | Slow, deep breathing | Promotes calmness and oxygen efficiency |
Digestive | Activates (helps break down food, maximize energy, and support immune function) | Supports nutrient absorption, gut health, and energy storage |
Muscles | Relaxed (can feel like less tightness/stiffness, and less pain and tension) | Conserves energy, promotes recovery, and allows for deep rest |
Neurological | Mental clarity and emotion regulation | Promotes presence and social engagement |
Regulating with Somatic Exercises
1) Grounding “5 & 3” Sensory Awareness
Best for: Feeling disconnected, overwhelmed, or anxious
- Take a slow, deep breath
- Notice and name:
o 5 things you see (e.g., “the pillow, my dog, a tree…”)
o 5 things you hear (e.g., “birds outside, my breath, tapping in the distance…”)
o 5 things you feel (e.g., “my hand on my lap, my back on the couch …”)
- Next, find:
o 3 additional things you see (that you haven’t mentioned yet)
o 3 additional things you hear (that you haven’t mentioned yet)
o 3 additional things you feel (that you haven’t mentioned yet)
2) Body Scanning
Best for: Releasing tension from stress or anxiety
- Find a comfortable seat or lie down, noticing your body’s points of contact with the surface you are resting on
- Close your eyes and take slow breaths
- Bring your attention to your feet – notice any tension, warmth, tingling
- Slowly move your focus up through your legs, hips, stomach, back, arms, shoulders, face, and head
- If you feel tension, imagine breathing into that area (maybe visualizing a white light as you do so) and gently releasing it on the exhalation
- Continue for 2–5 minutes
3) “Voo” Sound Exercise
Best for: Calming the nervous system, reducing panic, releasing trapped energy
- Take a deep inhale through your nose
- On your exhalation, make a long, low “Voo” sound like a foghorn
- Feel the vibration in your chest and belly
- Repeat 3-5 times
4) Orienting Exercise
Best for: Hypervigilance, dissociation, or feeling overwhelmed/stuck in anxious thoughts
- Slowly look around the room and name a few things you notice
- Notice what your eyes are drawn to and what you become aware of
- Now, take a deep breath and check in to your internal environment as you receive info from your external environment. Are you feeling a little safer now?
5) Shake It Out
Best for: Releasing tension in the body (jaw, shoulders, stomach)
- Stand up
- Shake out your arms, legs, and shoulders (whole body) for about 1 minute
- Be playful – Wiggle, bounce, or even hum while you shake!
- Afterward, stand still and pause. Notice how your body feels.
Benefits of using these strategies:
· Regulating the nervous system (shifting from fight-or-flight to rest-and-digest)
· Orienting you into the present moment
· Increase awareness of where anxiety is stored in your body
· Releasing stored tension and trauma (reducing physical symptoms of anxiety)
· Increasing interoception (which is the awareness of our own bodily sensations) for self-regulation
· Encouraging grounding and safety (helping the brain recognize that it’s not in danger)
Final Thoughts
Anxiety is associated with an activated SNS (fight/flight). Somatic Approaches can help activate the PNS (rest/digest). Practicing present-focused somatic exercises might be one way to reduce the physical symptoms associated with anxiety. At Noia Wellness, we offer somatic approaches to support nervous system regulation.
References
American Psychological Association. (2018, November 1). Stress effects on the body. American
Psychological Association. https://www.apa.org/topics/stress/body
Craske, M. G., Rauch, S. L., Ursano, R., Prenoveau, J., Pine, D. S., & Zinbarg, R. E. (2011). What is an
anxiety disorder?. Focus, 9(3), 369-388.
Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing–effectiveness and key factors of a body-oriented trauma therapy: a scoping literature review. European journal of psychotraumatology, 12(1), 1929023.
Levine, P. A., & Frederick, A. (1997). Waking the tiger: healing trauma: the innate capacity to transform overwhelming experiences. Berkeley, CA: North Atlantic Books.
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