Anxiety is one of the most common emotional experiences people encounter throughout their lives. Almost everyone has felt anxious before an important event, such as an examination, job interview, medical appointment, or public presentation. In these situations, anxiety is a normal and often helpful response that prepares the mind and body to deal with challenges.
For some people, however, anxiety becomes more than an occasional feeling. It can become persistent, intense, and difficult to control, affecting daily life, relationships, work, education, and physical health. Understanding what anxiety is, why it occurs, and how it presents itself is the first step towards recognising when it is a normal part of life and when it may require additional support.
Anxiety affects the entire body, and its symptoms can vary considerably from person to person. The symptoms may also change depending on the situation or level of stress being experienced. Symptoms can be split into the four categories of emotional, physical, cognitive, and behavioural. It is worth remembering that many people experience a combination of these.
Emotionally, anxiety may present as persistent worry, feeling nervous or constantly on edge, apprehension, irritability, restlessness, feeling overwhelmed, increased sensitivity to stress, a sense of impending doom, and difficulty relaxing. An emotional anxiety experience may be waking up in the morning and feeling dread about the day ahead. The different anxious feelings may fluctuate throughout the day or become more intense during periods of heightened stress.
Physically, anxiety activates the body’s natural stress response, producing a wide range of symptoms. Many people experience a rapid heartbeat, palpitations, chest tightness, or a rise in blood pressure as the body prepares itself for action. Breathing may become faster or more shallow, leading to shortness of breath or the feeling of being unable to take a satisfying breath. Muscle tension is also common and can cause neck and shoulder pain, jaw clenching, trembling, and general muscle aches. When having a massage, I was told about the knots in my shoulders caused by tension in my body from anxiety. The digestive system is particularly sensitive to stress, meaning anxiety may result in nausea, bloating, diarrhoea, constipation, or changes in appetite. This can include comfort eating when feeling particularly anxious or feeling too sick to eat anything. Other physical symptoms include dizziness, light-headedness, headaches, sweating, and feeling shaky. A common symptom is the tense head whilst thinking about a situation you feel anxious about. Sleep is often affected, with people experiencing difficulty falling asleep, frequent waking, restless sleep, nightmares, or waking earlier than intended. Lying in bed with thoughts racing through your mind is often spoken about in relation to anxiety.
Anxiety also influences the way we think. Racing thoughts, excessive worrying, difficulty concentrating, forgetfulness, indecisiveness, constant “what if” thinking, catastrophising and expecting the worst are all common cognitive symptoms. Many people describe feeling as though their mind never switches off. People who have experienced anxiety explain how their mind jumps from one ‘what if’ thought to another, and from one worry to another.
Behaviour can also change as people try to reduce their distress. This may include avoiding situations they fear, seeking constant reassurance, repeatedly checking things, procrastinating, struggling to make decisions, withdrawing socially, becoming restless, over-preparing for events, or repeatedly searching for information. While these behaviours often provide short-term relief, they can unintentionally reinforce anxiety and make it more difficult to overcome in the long term. For example, procrastinating about a decision and putting it off, can lead to greater anxiety.
No two people experience anxiety in exactly the same way. Some primarily notice physical symptoms, such as a racing heart or dizziness, while others experience overwhelming worry with relatively few physical sensations. Some people become irritable, whereas others withdraw from social situations. These differences are influenced by a combination of factors including genetics, brain chemistry, personality, life experiences, and lifestyle.
Research suggests that anxiety disorders can run in families, meaning that having a close relative with anxiety may increase a person’s risk, although genetics alone do not determine whether someone will develop anxiety. Brain chemistry also plays an important role. Chemical messengers known as neurotransmitters regulate mood and emotional responses. Imbalances within these systems may contribute to anxiety.
Certain personality traits, such as perfectionism, a tendency to overthink, or difficulty coping with uncertainty, can also make some individuals more vulnerable to anxiety. In addition, life experiences including trauma, abuse, bereavement, major life changes, or prolonged periods of stress may trigger or worsen anxiety. Lifestyle factors can also have a significant impact. Poor sleep, excessive caffeine intake, alcohol misuse, recreational drug use, lack of regular exercise, and ongoing stress can all increase the likelihood or severity of anxiety symptoms.
Despite being so common, anxiety is still surrounded by misconceptions. One of the most persistent myths is that anxiety is simply a matter of worrying too much. In reality, anxiety affects the brain, nervous system, hormones, thoughts, emotions, behaviour, and physical health. Another misconception is that people with anxiety should simply “calm down.” However, anxiety is an automatic biological response that cannot be switched off through willpower alone. Some people also believe that anxiety is a sign of weakness, when in fact it is a common human experience that affects people of every age, background, and level of resilience. Finally, while many assume anxiety must always have an obvious cause, it often develops through a combination of biological, psychological, and environmental factors, and sometimes there is no single identifiable trigger.
Although anxiety can feel overwhelming, it does not have to define a person’s life. Many people learn to manage their anxiety successfully through education, therapy, healthy routines, supportive relationships, and practical coping strategies. Recovery does not necessarily mean never feeling anxious again. Rather, it involves developing the confidence and skills to respond to anxiety without allowing it to control decisions, relationships, or aspirations.
Understanding how anxiety works can reduce fear of the symptoms themselves. When people recognise that many of the physical sensations of anxiety are simply the body’s normal stress response rather than signs of immediate danger, they are often better equipped to manage them with confidence.
Now that we have explored what anxiety is and how it can affect both the mind and body, the next article in this series will examine the science behind anxiety.