Anxiety you feel in your body
For many people, anxiety doesn't start as a thought. It starts in the chest, in the stomach, in the hands. The heart speeds up in a calm meeting; the throat closes in the supermarket; the jaw wakes up clenched.
And then comes the question: what is wrong with me, if nothing is happening?
This page answers from the body. First what you feel, then why.
What does anxiety feel like in the body?
These are the most common forms. Few people have all of them; almost everyone has several.
a fast or pounding heart, sometimes with skipped beats
feeling short of air, or unable to take a full breath
tightness or weight in the chest
a lump in the throat
a closed stomach, nausea, a sudden urge to go to the bathroom
tingling in the hands, the feet or around the mouth
dizziness, a sense of unreality, of watching everything from far away
a clenched jaw, raised shoulders, a stiff neck
trembling, heat, cold sweat
huge tiredness once it passes
All of this is real, and it has a precise physiology: that of a body getting ready for danger.
Why does my body react like this when there's no danger?
Your nervous system is constantly assessing whether what surrounds you is safe, and it does so before you think anything; the researcher Stephen Porges called this process neuroception. By the time the mind finds out, the body has already decided.
If it decides there is a threat, it presses the accelerator: adrenaline, a faster heart, short breaths, muscles ready, digestion on hold, the same response that saves us from a car running a red light.
In a system that spent a long time on alert, that detector gets recalibrated and sees danger in a serious face, in an unanswered message, in your own heartbeat. The alarm really goes off. There is no fire.
Why do my hands tingle, or why does it feel like I can't breathe?
When the body gets ready to run, breathing turns fast and high, up in the chest, and breathing like that without moving lowers the carbon dioxide in your blood.
That drop produces exactly what frightens you: tingling in the hands and lips, dizziness, a sense of unreality, and the feeling of being short of air when in fact there's more than enough. The body reads all this as more danger. It breathes even faster.
Knowing this doesn't stop the cycle by itself, but it helps. What you feel has an explanation, and the explanation isn't that something serious is happening.
Understanding isn't enough
Many people already know where their anxiety comes from, they've been to therapy and can explain it clearly, and the body still keeps reacting the same way.
Understanding is made of words; the nervous system, of sensations, rhythm, breath, muscle tone. That's why sensible advice often doesn't get through in the middle of anxiety (the part of the brain that would take it in has gone offline).
What helps in the moment
None of this makes anxiety vanish at once. It gives the body signals that it can come down.
Look around slowly, moving your eyes and your neck, and name what's there. Feel your feet on the floor and the weight of your body on the chair; let the out-breath last longer than the in-breath, without taking big breaths. Rest a hand on your chest or your belly and notice its warmth.
And if you can, don't stay alone: a calm voice on the other end of the phone regulates more than many techniques do, because nervous systems regulate each other.
What to rule out first
As a doctor, I don't assume every symptom is anxiety. Some things need checking:
chest pain that is new, comes with exertion, or spreads to the arm or jaw: that's an emergency, not anxiety, until proven otherwise
fainting, or palpitations with shortness of breath during exertion
thyroid, anemia, blood sugar
coffee, energy drinks, some medications, and withdrawal from alcohol or tranquilizers
A medical visit and a few simple tests are usually enough to rule out anything serious, and after that, work with the nervous system stands on firm ground.
What I do as a doctor and as a therapist
First I look at the whole picture: your symptoms, your tests, what you already take. If something needs another test or medication, I'll tell you.
With somatic therapy we work in the body's language, and little by little, at a pace you can sustain, the nervous system learns that it can switch on and come back. That's what I call being regulated: having range.
With Gestalt we look at how you organize yourself around anxiety today, what you avoid and what is hard for you to say. If the anxiety has older roots, the page on trauma explains how I think about it.
Sessions last 60 minutes, in Tepoztlán or online.
Who this isn't for, or not yet
If you have chest pain, fainting or palpitations that haven't been checked, the first step is a doctor.
If you're under psychiatric treatment, this doesn't replace it. It can go alongside it, in coordination with whoever manages it. I never suggest stopping or changing a medication.
If the anxiety has kept you from leaving the house, eating, or sleeping much at all for weeks, look for a medical or psychiatric evaluation soon. This work can come afterwards, or alongside.
If you want it gone in three sessions, this probably isn't it. And if you're unsure, write to me before booking, or don't book: that's fine too.
Frequently asked questions
Can anxiety cause real physical symptoms?
Yes. Palpitations, chest tightness, tingling, dizziness, nausea and muscle tension are real effects of nervous system activation. Even so, it's worth having a doctor rule out other causes, especially if the symptoms are new.
Why do I feel anxious when I'm not thinking about anything?
Because the nervous system assesses danger below awareness, before thought: sometimes the body switches on first and the mind looks for a reason afterwards, or doesn't find one.
Does anxiety go away?
I'm not going to promise you it disappears. The goal of the work is for the body to regain range: to be able to switch on and come back, and for the alarm to go off less loudly and for fewer reasons.
Are sessions online or in person?
Both. I see people in person in Tepoztlán, Morelos, and online by video call. Each session lasts 60 minutes, in English or Spanish.
A first step
If any of this sounds familiar, we can talk. The first session is for looking together at what your body does when it switches on, and what makes sense to do next. You don't need to arrive with anything figured out.
Book a first session or message me on WhatsApp.
You may also want to read: why your stomach shuts down under stress.