Anxiety is often referred to as a tempest of thoughts: ceaseless apprehension, disastrous what-ifs, or simply an inability to quiet a restless mind. But anyone who has lived with anxiety becomes accustomed to the fact that it doesn’t stay just in the head. The body shakes. The chest tightens. The stomach flips. Muscles become fatigued as if one ran a marathon, even though one has done nothing but sit in a chair. These physical vestiges of anxiety remind us that mental health is inextricably linked to the body that contains it. If we really want to come to terms with chronic anxiety, we need to look at its somatic foundations, how the nervous system, trauma and the embodied memory of the body determine how fear lives inside us.
The Mind-Body Connection
For centuries, Western medicine considered the mind and body to be separate entities. It was believed that mental illness had to do with thinking processes and emotions, while physical illness meant some dysfunction of a mechanical nature. However, ongoing investigations in contemporary neuroscience and psychology consistently indicate that the mind and body are inseparable (van der Kolk, 2014).
Anxiety disorders provide some of the most pronounced examples of this connection. When an individual becomes aware of impending danger, the brain’s amygdala stimulates the autonomic nervous system to engage the fight-or-flight response. During an event such as a car accident, adrenaline and cortisol are released into the bloodstream, heart rate increases, and the muscles are made ready to act quickly.
This is adaptive when responding to a real-world threat; an individual swerves to avoid a bicycle collision. However, in chronic anxiety, the body continues to operate as though danger is always real, even in the absence of a physical risk. Chronic anxiety conditions change the body’s baseline state and duration of heightened arousal, and individuals are left feeling shaky, exhausted, and trapped in cycles of physiological arousal (Kuhfuß et al., 2021).
Read More: The Essential Role of Mind-Body Techniques in Mental Health
Somatic Roots of Anxiety
Chronic anxiety is more than just a mental loop of worry; it is a profoundly embodied experience. Various somatic roots help explain why it persists.
1. Dysregulated Nervous System
There are two main branches of the autonomic nervous system: the sympathetic (action and fight/flight) and the parasympathetic (rest, digest, and repair) systems. When the autonomic nervous system is functioning normally, these systems are like a pendulum that swings back and forth between activation and relaxation. In cases of chronic anxiety, this pendulum becomes stuck in sympathetic activation, making the body always be in a state of readiness in case it needs to fight, flee, or freeze, even while in usually safe, ordinary moments (Porges, 2011).
2. Trauma and Embodied Memory
Experiencing traumatic events – acute incidents like an accident, to chronic miseries like neglect – can leave a mark on the body. As van der Kolk (2014) explains, trauma can change the brain’s alarm system, meaning that the body will easily sense threat, no matter the environment. Even many years later, the body may “remember” trauma through tightness in the muscles, shaking, or visceral instincts when it sinks in. Chronic anxiety can result from the baggage of unprocessed trauma.
Read More: How your body responds to Trauma
3. Interoception and Misinterpretation
Interoception refers to the body’s ability to sense and report relatively non-conscious internal bodily states—heartbeat, breathing patterns, stomach sensations, etc. Individuals with anxiety often experience an enhanced level of interoceptive awareness, whereby they notice almost every flutter or twitch occurring internally in their body. Although this sensitivity serves a useful purpose for some, the anxious person can interpret hazards from harmless alterations in bodily states (e.g., climbing staircases quickly, causing an increase in heart rate to harm). Studies have shown that patients with anxiety disorders and somatic symptom disorders exhibit increased interoception and distorted interpretations of bodily signals (Wolters et al., 2022).
4. Genetic and Biological Factors
Even though environment and trauma play an important role, biology has a role to play, too. Some genetic profiles increase vulnerability to the dysregulation of your nervous system, and hormonal or gut imbalances can increase somatic anxiety (van der Kolk, 2014). Biological vulnerabilities can behave as life experiences do, creating fertile ground for anxiety or chronic anxiety.
How Chronic Anxiety Manifests in the Body
When anxiety appears as a physical manifestation, so do the symptoms. Some typical somatic presentations of anxiety include tremors, muscle tension, tightness in the chest, abdominal distress, shallow breathing, and fatigue. Often, these somatic presentations lead people to medical clinics to try to find answers. While it is often important to get medical evaluations, having tests come back negative repeatedly can add to the distress as someone tries to make sense of why they still feel this way. The answer has to do with the somatic roots of the anxiety itself (Kuhfuß et al., 2021).
Why the Body Remembers
Chronic anxiety is very confusing because it does not stop. The mind might literally know, “all is well,” but the body continues to tremble. Polyvagal theory clarifies this. Porges (2011) explains that the vagus nerve is key in determining if we feel safe or threatened. When the vagus nerve detects danger, real or imagined, the human (physically) moves into survival mode: fight, flight or freeze. In chronic anxiety, the vagus nerve may be hyper-sensitised to perceived danger and may misperceive neutral cues as danger.
Research on trauma provides additional insight into how the body “remembers.” Unresolved trauma keeps the nervous system in a continuous state of survival. In the aftermath of trauma, the body stores memories, not as stories, but as sensations, tremors, nausea, and cold sweats. As van der Kolk (2014) writes, those who have been traumatised often feel a chronic sense of insecurity within their own bodies, long after the trauma and the threat have passed.
Approaches to Healing the Body of Anxiety
Knowing the somatic origins of anxiety expands avenues for healing. Talk therapy and medication can be exceptionally useful, but many find relief in treatments that also address the body.
1. Somatic Experiencing (SE)
SE is a type of body-centred therapy intended to assist individuals in finishing biological stress responses by working with body sensations gently. In a randomised controlled trial, SE resulted in significantly lower levels of PTSD and depression severity than control conditions (Brom et al., 2017). A scoping review identified initial support for the beneficial effects of SE on PTSD, somatic symptoms, and overall well-being (Kuhfuß et al., 2021).
2. Mindfulness and Interoception.
Mindfulness interventions enhance interoceptive awareness to reduce reactivity to bodily sensations. A randomised trial with veterans has shown that interoceptive brain responses mediated symptom reduction following mindfulness-based stress reduction (Kang et al., 2020)
3. Breathwork, Grounding, and Movement.
Approaches such as diaphragmatic breathing, yoga, and tai chi are beneficial for discharging excess energy and signalling to the body that it is safe. These approaches are also consistent with research that indicates strategies that use the body can help re-establish a state of balance in the organisation of the nervous system (van der Kolk, 2014).
4. Safe Relationships and Co-Regulation.
The human nervous systems regulate through connection. When an anxious person is around peaceful, supportive people, they can borrow that regulated state. Being with people feels safe relationally and is crucial to healing trauma-based anxiety (Porges, 2011).
5. Integrative Care.
When used alongside somatic or talk treatments, medical assessments, medication, nutrition, and sleep hygiene might aid recovery. Studies of SE alongside usual care in people with PTSD and chronic pain showed greater benefit than usual care alone (Andersen et al., 2017).
Read More: Why Is Exercise And Good Nutrition So Important For A Healthy Brain?
Conclusion
When the body shakes as a function of chronic anxiety, it is not betraying us; it is communicating with us. The shakes, racing heart, and tight chest are messages from the nervous system experiencing overwhelming stress, trauma, or imbalance. When we understand anxiety as a somatic experience rather than a weakness, we allow pathways for healing to emerge that honour both mind and body.
Listening to the body via breathing, movement, co-regulation, and somatic therapies can help us to start seeing trembling not as a source of anxiety, but as a signal to move towards recovery. Chronic anxiety doesn’t have to mean endless worrying; it can mean an invitation to use the same care for our bodies as we would for our minds, and from that care comes the possibility of calm.
References +
Andersen, T. E., Lahav, Y., Ellegaard, H., & Manniche, C. (2017). A randomised controlled trial of Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms. European Journal of Psychotraumatology, 8(1), 1331108. https://doi.org/10.1080/20008198.2017.1331108
Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic Experiencing for posttraumatic stress disorder: A randomised controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312. https://doi.org/10.1002/jts.22189
Kang, S. S., Sponheim, S. R., Lim, K. O., Macdonald, A. W., & Strauss, G. P. (2020). Interoception underlies the therapeutic effects of mindfulness meditation for post-traumatic stress disorder: A randomised clinical trial. Psychological Medicine. Advance online publication. https://doi.org/10.1017/S0033291720003420
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), 1929025. https://doi.org/10.1080/20008198.2021.1929025
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.
van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
Wolters, C., Gerlach, A. L., & Pohl, A. (2022). Interoceptive accuracy and bias in somatic symptom disorder, illness anxiety disorder, and functional syndromes: A systematic review and meta-analysis. PLOS ONE, 17(7), e0270612. https://doi.org/10.1371/journal.pone.0270612
