Headaches, a queasy stomach, muscle pain—is it time to reach for the aspirin or ibuprofen? Or is it anxiety or depression causing your symptoms?
Anxiety and depression are best known for causing mental distress—making you feel nervous, worried, sad, or numb. But these common mental health conditions—anxiety disorders affect an estimated 40 million Americans and major depressive disorder affects approximately 17 million—are also associated with a host of physical symptoms.
According to Amen Clinics, a global leader in brain health that has treated tens of thousands of people with mental health issues over the past 30-plus years, here are five of the most common physical signs of anxiety and depression.
Research has found that chronic daily headaches are common in people with clinical depression and anxiety, especially in people with generalized anxiety disorder or panic disorder.
Some people experience tension headaches that can cause mild to moderate pain and may involve stiffness in the neck and shoulders. Others suffer from migraine headaches, which are associated with more severe pain and can interfere with daily activities.
A 2018 study in the journal Headache found that people with frequent migraine headaches are more likely to experience anxiety and depression.
Muscle tension is often seen in people with anxiety disorders, such as panic disorder, and chronic pain is frequently seen in depressed people. Research in the Journal of the Neurological Sciences shows that people with depression tend to have a lower tolerance for pain.
At Amen Clinics, brain imaging studies using single photon emission computed tomography (SPECT) scans show that people who experience chronic pain often have too much activity in an area of the brain called the thalamus.
This brain region is part of the deep limbic system, which is the brain’s emotional centers. On brain scans, overactivity in the limbic system is often associated with depression. This suggests that chronic pain and depression may activate the same brain systems.
Everyone knows that anxiety about a big life event can trigger a nervous stomach, but the connection between the digestive tract and mental health goes even deeper. Feeling nauseous, having stomach cramps, or experiencing constipation or diarrhea are all associated with anxiety and depression.
Findings from a study appearing in Advanced Biomedical Research showed that people with irritable bowel syndrome (IBS) have higher anxiety and depression symptoms compared with people who don’t have IBS.
Researchers have also found that people with anxiety or mood disorders are more likely to have constipation compared with the general population.
When you have anxiety, you may worry incessantly, which can be exhausting. Similarly, having depression is strongly linked to fatigue. Being depressed can lead to a physical lethargy, a sense of apathy, and a loss of mental energy.
However, the fatigue you feel may also be related to sleep troubles. Anxious thoughts may make it difficult to fall asleep or may cause you to wake up in the middle of the night when worries start spinning in your mind. According to scientific evidence, over half of all people with anxiety have trouble sleeping.
Depression and poor sleep also go hand in hand. Research in Dialogues in Clinical Neuroscience shows that about 75% of people with depression also have insomnia. Early awakening is also common among depressed people.
A smaller percentage of people with depression sleep more than usual but still feel daytime sleepiness. If you aren’t sleeping well, get an evaluation before taking sleeping pills, which may be hard to stop.
Feeling your heart start to race or experiencing tightness in the chest can be symptoms of panic attacks. After the panic attack subsides, heart rate usually returns to normal levels and any chest pain goes away.
In some people with depression or anxiety, however, chest pain can become chronic. A 2023 study explores the bidirectional relationship between heart disease and depression and anxiety.
According to this study, the prevalence of people with depression who have cardiovascular disease is 20%–40%, far higher than the rate among healthy individuals. At the same time, people with heart disease are more likely to develop depression compared to the general population.
These findings also indicate that people with cardiovascular disease are more likely to have anxiety. In fact, they have a 26% increased risk of anxiety.
Because of this, if you’re experiencing any form of chest pain, it’s critical to see a doctor to determine what’s causing it.
You may not realize that the recurring aches and pains, digestive issues, or fatigue you experience are related to mental health problems. Many people simply head to their primary care physician or another traditional medical professional in an effort to treat the physical issues without considering the possibility of underlying anxiety and depression.
However, this can lead to treatments that don’t solve the underlying issue. For example, taking medication for physical symptoms without treating the anxiety and depression won’t provide the lasting relief you want. Getting to the root cause of your physical symptoms is the key to feeling better.
To help you understand what’s causing your issues, pay attention to when your physical symptoms arise. Is it during times of increased stress, nervousness, or sadness?
Becoming aware of an increase in pain, more frequent headaches, or an uptick in digestive problems or other physical symptoms may be a clue that anxiety or depression may be to blame.
If you aren’t getting relief, it may be time to seek help from a mental health professional who understands the connection between the brain, body, and mind.
Getting a brain SPECT scan allows psychiatrists to identify brain activity patterns associated with anxiety and depression, as well as other brain and mental health issues. With a more accurate diagnosis, you’ll be on your way more quickly to feeling better both mentally and physically.
Wei, Cui-Bai et al. “Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study.” Chinese Medical Journal vol. 129,12 (2016): 1394-9. doi:10.4103/0366-6999.183410
Chu HT, Liang CS, Lee JT, et al. “Associations Between Depression/Anxiety, Headache Frequency In Migraineurs: A Cross-Sectional Study.” Headache. 2018, 58(3):407-415. doi: 10.1111/head.13215.
Zambito Marsala, Sandro et al. “Pain perception in major depressive disorder: a neurophysiological case-control study.” Journal of the neurological sciences vol. 357,1-2 (2015): 19-21. doi:10.1016/j.jns.2015.06.051
Roohafza, Hamidreza et al. “Anxiety, depression and distress among irritable bowel syndrome and their subtypes: An epidemiological population based study.” Advanced biomedical research vol. 5 183. 28 Nov. 2016, doi:10.4103/2277-9175.190938
Hosseinzadeh, Sahar Tahbaz et al. “Psychological disorders in patients with chronic constipation.” Gastroenterology and hepatology from bed to bench vol. 4,3 (2011): 159-63.
Nutt, David et al. “Sleep disorders as core symptoms of depression.” Dialogues in clinical neuroscience vol. 10,3 (2008): 329-36. doi:10.31887/DCNS.2008.10.3/dnutt
Harvard Health Publishing. “Sleep deprivation can affect your mental health,” August 17, 2021, https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health
Li, Xinzhong et al. “Cardiovascular disease and depression: a narrative review.” Frontiers in cardiovascular medicine vol. 10 1274595. 21 Nov. 2023, doi:10.3389/fcvm.2023.1274595
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