Anxiety and Nausea

Anxiety disorders often create many different emotional and physical symptoms that can cause challenges in daily and professional functioning. One of these symptoms is nausea, which can become overwhelming and distressing when it occurs regularly and can make it difficult to cope with anxiety.

What is anxiety nausea?

Most people feel anxious from time to time, such as when faced with big life changes or an important presentation at work. However, for some people, this anxiety can be more severe and persistent and may be due to an anxiety disorder ^[1].

When people feel anxious, they commonly experience several physical sensations along with the emotional symptoms of anxiety. This might include a few minutes of feeling ‘butterflies in the stomach’ in anticipation of an anxiety-provoking situation or could be a more intense feeling of nausea or churning in the stomach, which is often known as anxiety nausea.

Research shows that the stomach and brain are intrinsically linked to one another, so emotional changes can often affect the stomach and vice versa. For people who often experience anxiety nausea, it can be common for nausea that occurs for other reasons to bring on emotional symptoms of anxiety, thus creating a worsening cycle of anxiety nausea ^[2][3].

Symptoms of anxiety nausea

Anxiety can cause symptoms such as excessive or uncontrollable worrying, sleep disturbances, concentration issues, and mood changes, as well as many physical symptoms, such as a rapid heart rate, dry mouth, and shaking ^[1].

Along with these symptoms, some people may experience gastrointestinal issues such as ^[1][4]:

• Feeling nauseous
• Vomiting
• Dry heaving without vomiting
• Stomach pain or discomfort
• Churning in the stomach
• Diarrhea

Why does anxiety cause nausea?

Anxiety and stress cause the body to release several chemicals, such as adrenaline, which causes what is commonly known as the ‘fight or flight’ response. This response occurs when the brain recognizes a potentially dangerous situation and releases certain neurotransmitters and hormones to provide the energy required to either fight or run away from the situation ^[5].

Due to the chemicals released, heart rate, pulse, blood pressure, and breathing are increased, which provides more oxygen to the muscles, heart, and brain, creating the energy needed to respond to danger, while also increasing alertness. Some of these chemicals also create changes in other areas of the body, such as the digestive system and immune system ^[6][7].

This reaction can be potentially lifesaving when faced with a severe danger. However, this response can also occur in the context of anxiety, when faced with a situation that causes stress but does not actually require a fight or flight response. In these situations, neurotransmitters and hormones are still released, but the energy created in the body is not used, causing an unneeded state of arousal ^[5].

This is what creates the common physical symptoms of anxiety, such as increased heart rate, sweating, shaking, and muscle tension, while also contributing to dysregulation in the gastrointestinal mechanisms that are affected by these chemical changes, potentially causing nausea, vomiting, stomach pain, and diarrhea ^[2][7].

For people with persistent anxiety, the body remains in this aroused state for much longer than normal, which can cause ongoing stomach issues, such as irritable bowel syndrome (IBS) and peptic ulcers ^[6]. These issues can then potentially worsen anxiety, as they can cause further negative impacts, such as worrying about access to toilets while out and concerns around physical wellbeing ^[3].

Types of anxiety disorder that can cause nausea

Nausea and stomach issues can occur in the context of any anxiety disorders, as well as in specific anxiety disorders and other mental health conditions, including ^[1][2][8]:

• Generalized anxiety disorder
• Social anxiety disorder
• Phobias
• Panic disorder
• Obsessive-compulsive disorder (OCD)
• Posttraumatic stress disorder (PTSD)
• Depression

How to manage anxiety nausea

When you feel nauseous, it can help to ^[3][9]:

• Eat plain and dry foods, such as toast or crackers
• Sip water regularly in small amounts
• Remain seated or lying down
• Drink peppermint or ginger beverages
• Avoid caffeine and spicy or greasy foods

If you often experience anxiety nausea, you may find it useful to seek professional help in managing your anxiety. There are several ways to reduce anxiety symptoms, including ^[1][3]:

• Medications: There are several types of medications that can be prescribed to help reduce symptoms of anxiety, such as antidepressants, antihistamines, benzodiazepines, and beta-blockers. Your doctor will advise which medication is appropriate for you, and it is important to take the medication exactly as prescribed, to prevent adverse effects.
• Therapy: Therapy, particularly cognitive behavioral therapy (CBT), has been found to be effective at reducing symptoms of various anxiety disorders, by teaching coping strategies and how to change unhelpful thoughts and behaviors.
• Self-help techniques: Breathing exercises, relaxation, yoga, mindfulness, and exercise can all help to reduce symptoms of various anxiety disorders. Maintaining a healthy diet can help to improve physical and mental wellbeing and may help to reduce abdominal pain and discomfort that can occur with anxiety.