Physical signs of mental health conditions

Have you ever experienced a racing heart when you were anxious? Or your stomach started hurting due to stress? These are all signs of how mental health can show up in our physical bodies. The physical symptoms of mental health conditions can be just as challenging as the emotional ones.

It might be easy to assume that your physical symptoms aren’t as important as your emotional ones. Or you might wonder if you’re making them up. But know they’re real — physical symptoms are a documented and proven aspect of mental health conditions. With the right care, you can find relief. If you’re experiencing physical signs of mental health concerns, working with a mental health provider can help. 

How mental health problems can show up physically

Because mental and physical health are so closely linked, many people find that they experience physical symptoms as a result of mental health concerns. This doesn’t mean that these physical symptoms aren’t “real” or “just in your head.” They’re absolutely real and valid.

Mental health conditions can be so powerful that they cause uncomfortable and even painful symptoms in your body. In fact, many mental health conditions list physical symptoms in their official diagnostic criteria, including:  

• Depression: Symptoms of depression include changes in appetite and sleep patterns. This can sometimes lead to significant weight gain or loss. Fatigue and loss of energy are also officially recognized symptoms of depression.

• Panic disorder: Panic disorder is characterized by many physical symptoms, including heart palpitations, sweating, and chest pain.

• Generalized anxiety disorder (GAD): Muscle tension and tiredness are recognized as common symptoms of generalized anxiety disorder.

• Social anxiety disorder (SAD): Social anxiety disorder often comes along with physical symptoms like sweating or trembling. You might enter a cycle that’s hard to break out of, because you become more anxious that people will notice these physical symptoms.

• Somatic symptom disorder: This mental health condition is characterized by an excessive focus on physical discomfort and pain. You can experience nerve pain, fatigue, and more with this condition.

• Bipolar disorder: During the manic (or hypomanic) mood states of bipolar disorder, you might go for days without sleeping and not feel tired.

On top of these official physical symptoms, you might notice additional ways mental health difficulties present physically. You might experience: 

• Stomach problems, including nausea or diarrhea

• Headaches

• Physical pain or tension in your muscles and joints

• Dizziness or lightheadedness

• Shortness of breath or chest tightness

• Changes in your immune system, like getting sick more often

To be clear, these symptoms aren’t always due to mental health conditions. It’s possible these symptoms may be due to physical ailments. A medical professional can help you determine underlying cause(s) and next steps to help you feel better.

Why mental health issues can have physical effects

Mental health and physical health have a deeply interwoven, two-way relationship. What happens in one area affects the other. 

To understand how your brain and body work together, just think about the last time you felt butterflies in your stomach because you were excited about something. Or even the fact that your eyes well up with tears when you’re feeling sad. Most people experience physical signs related to emotions, even if they don’t live with a mental health condition. 

This deep connection is sometimes called the mind-body connection. One way the mind-body connection shows up is through different chemicals and hormones. Neurotransmitters — the brain’s chemical messengers — can affect everything from mood to digestion. 

When you’re anxious, stress hormones like cortisol and adrenaline increase. These chemicals prepare your body for danger, which is why you might notice a faster heartbeat, tense muscles, or stomach problems during stressful times.

Other factors can cause physical signs of mental health conditions as well. For example, when you live with depression, you may be less likely to exercise. You might also spend less time in the sun. This can directly cause physical symptoms like fatigue or lack of appetite. It might even directly affect things like your immune system, which could make you feel under the weather.

Next steps to understanding your symptoms

If you’re experiencing unexplained physical symptoms — especially ones commonly linked with stress and mental health — it’s important to address them. 

Consider these steps you can take to understand and address physical symptoms related to mental health: 

1. Monitor your symptoms. Make note of when and how often physical symptoms show up. Did you just feel nauseated or tired for one stressful day? That may not be anything to worry about. But if unexplained symptoms continue and you can’t identify a reason for them, it may be a good idea to see a medical provider.

2. Get an evaluation. If the symptoms linger, your first step is to figure out what’s causing your symptoms. Your primary care physician (PCP) may be able to rule out medical causes for your symptoms. Many physical health conditions co-occur with mental health conditions, so it’s important to untangle what’s going on.

3. Address underlying physical conditions. Just because you’re experiencing mental health challenges doesn’t mean that you can’t also have a physical medical condition. And when you live with both, the physical condition can make your mental health worse (and vice versa). So if your physician diagnoses you with an underlying physical condition, get treatment for it. 

4. Make lifestyle changes. Sometimes, physical symptoms can happen because of how mental health challenges affect your behavior. For example, you might be fatigued during the day because anxiety keeps you from sleeping at night. So, try to prioritize getting restful sleep. Even if it’s not perfect, even small efforts to support your mind and body can make a difference. 

5. Work with a therapist or psychiatrist. If you’ve ruled out physical causes, a therapist can help you process stress, anxiety, or depression that may be showing up in your body. They can also give you practical tools to manage these symptoms. If needed, a psychiatrist can prescribe medication to help regulate mood, reduce anxiety, or improve sleep.

Clinician’s take

A common mistake people make when interpreting physical symptoms of stress or mental health conditions is that sometimes they’re not related. It’s important to discuss all your symptoms, including mental and physical symptoms, with your provider so we can have a full understanding of what might be happening.

Halee Fullerton, PMHNP-BC

Clinical reviewer