chronic fatigue, tiredness, lack of motivation

This is possibly caused by the increased HPA (hypothalamic-pituitary-adrenal) activity experienced during anxiety. The hypothalamus, pituitary gland and adrenal glands work in combination to stimulate the release of adrenalin into the blood and play a major role in the link between psychological stress and physical conditions. HPA dysfunction is thought to be a contributing factor in conditions like Chronic Fatigue Syndrome (ME).

Anxiety causes the sufferer to be continually thinking about what they are doing, what they are feeling and what might happen in the future. Another possible explanation is simply that the increased mental activity we experience at times of heightened anxiety uses up a lot of energy.

Tiredness after an episode of anxiety may be caused by the body's attempts to regulate the blood-sugar level which has been temporarily boosted by the release of adrenalin.

If anxiety is affecting your sleep pattern or the quality of the sleep you are getting, this will also cause you to feel tired during daytime hours.

Tiredness can also be a side-effect of certain medications.

Panic Attacks have been linked in some circles to a heart condition called MVP (mitral valve prolapse), which can also be responsible for spells of fatigue. This is a condition that affects roughly 5% of the population and very often sufferers display no symptoms at all. It can be diagnosed by your GP with a simple stethoscope examination (information from the British Heart Foundation website).

---

indigestion, heartburn, nausea, belching, butterflies

One of the first things the brain does when we become anxious is to divert blood away from the internal organs and towards the major muscles in the arms and legs to equip us for a 'fight or flight' response. The digestive system is not considered to be a priority at these times and so it receives less blood, making it much less efficient.

Indigestion can sometimes be mistaken for sensations that you might think are heart-related.

The digestive system is also responsible for the production of saliva and one of the first indications that anxiety is affecting your digestion may be a dry mouth.

---

constriction of the throat

This is technically known as globus hystericus and is a very common effect of anxiety. Some people put this down to increased muscular tension but there is a theory that, as the digestive system receives less blood, the eosophageal sphincter muscles become weakened and the stomach's acids start to rise into the throat.

---

racing heart, pounding heart, palpitations

Adrenalin in the blood binds to the beta-receptors of the heart causing it to beat faster and more powerfully in order to supply the major muscle groups with more blood. During these times it is quite usual to experience 'missed beats' or an irregular heart-rate.

---

hyperventilation, shortness of breath, feelings of suffocation

Receptors in the lungs also respond to the increased adrenaline and the lungs start to work harder to supply oxygen to the muscles. This can lead to feelings that you can't get enough air into your lungs.

REMEMBER: in an average sized room, even if all the doors and windows were sealed air-tight, the air would last for hours before it ran out.

---

sweating

Sweating is a natural reaction to anxiety and serves to cool the body down because it is expecting some kind of physical exertion. Sweating may occur on the palms of the hands, the feet, the forehead or the armpits; sometimes one armpit more than the other.

Sweating can also be a side-effect of certain medications.

---

shaking

Shaking is caused by a rapid contraction and relaxation of the muscles which severs to keep the blood flowing faster and increase muscle tone.

Shaking can also be a side-effect of certain medications.

---

muscular aches, joint pains

Adrenaline causes the muscles to adopt a 'standby' state whereby they are partially tensed in readiness for action. This can be exaggerated by prolonged periods of inactivity in which the muscles are tensed in the same position for a long time.

---

confusion, depersonalisation, derealisation

There are various theories about what causes these feelings but they are a very common accompaniment to anxiety.

The general consensus seems to be that they are caused by either an increase or a decrease in the amount of blood (and therefore oxygen) reaching the brain at times of panic. The evolutionary purpose would have been to heighten our senses at times of danger but many people feel the opposite effect and feel that their senses are diminished at these times.

Another theory is that when we experience anxiety, our heightened vigilance causes a sensory overload as we are trying to take in and process as much information as possible.

It may be that the mind reduces the acuity of the senses at times of anxiety to lessen the effects of trauma.

---

numbness, tingling, pins & needles

Again, there are differing theories about why this happens. We know that blood is diverted to the major muscles at times of anxiety and the fact that it makes you appear pale would suggest that the amount of blood going to the skin is reduced. This is no different from the lack of sensation you would experience if your hands were very cold or if your feet went numb because you had been sitting with them underneath you.

We also know that anxiety is associated with imbalances of certain neuro-transmitter chemicals such as serotonin. Because these chemicals are responsible for conveying nerve impulses within the brain, it is possible that an imbalance will affect the way the brain interprets kinaesthetic sensations.

---

anything else?

If you have any physical sensations that are not covered above, mail us and we'll try and get to the bottom of them.