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If you’ve ever had a serious panic attack, you’ve probably noticed some intense symptoms. Things like sweating and elevated heart rate are obvious to most people, and that ringing in your ears, mixed with the metallic taste of adrenaline in your mouth can make it pretty clear that something is wrong.
But among the symptoms of anxiety attacks, none are quite so obvious to everyone around you as one in particular: nausea.
Vomiting in a sense of panic may sound theatrical, but it’s a fairly common symptom for chronic anxiety sufferers in stressful situations.
People with morning anxiety may experience it when they wake up, and people with generalized anxiety might experience it at any time of the day.
Anxiety definitely can cause nausea. Luckily, it can be managed — just like the anxiety itself. With the right tools, you can manage yours, too.
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In the grand scheme of mental health conditions, what we understand as anxiety is actually a group of disorders — anxiety disorders — which are grouped together because of shared, similarly defined symptoms of intensely negative feelings of anxiety (obviously), and general or acute unease or panic.
Anxiety disorder has several subtypes, and each subtype can have overlapping symptoms — panic disorder, for instance, which is a more intense form of anxiety disorder, may include milder anxiety symptoms.
Conversely, a person with mild anxiety may sometimes experience severe panic as a symptom.
For a diagnosis of generalized anxiety disorder (GAD), several of these symptoms must be felt multiple days a week for a period of at least six months.
We still have many questions about what really causes anxiety, but science has found an important link between this mood disorder and imbalances of brain chemicals like serotonin.
Anxiety shows itself in many ways. Mental anxiety symptoms may be obvious only to you, whereas physical symptoms may be visible to the people close to you, or to everyone.
Restlessness, difficulty sleeping, fatigue, muscle tension, feeling frequently on edge or wound-up, sudden increases in blood pressure, experiencing difficulty concentrating and having patterns of irritability and uncontrollable worry are all symptoms of anxiety.
But there’s one stomach-turning symptom we should address: anxiety nausea.
Nausea due to anxiety is one of the many stress and anxiety symptoms that some people may suffer.
It can happen with any anxiety or panic disorder, but generally, it is seen as a serious symptom of milder anxiety disorders like GAD.
In the big picture, feelings of nausea is a result of your “fight or flight” response kicking in.
Essentially, when you become afraid, panicked or anxious, your body begins a series of unconscious instinctual checks against whatever threat has manifested.
A few millennia ago, this might have saved your life — escaping predators, natural disasters or other threats.
But time and evolution have made escaping a predatory animal less important, and so this vestigial reaction is unfortunately why we avoid our breakfast sometimes before a big presentation.
An upset stomach is, of course, different from severe vomiting, and your stress response and the intensity of your anxiety will determine how bad things get.
You could experience mild to severe stomach cramps for a period of time.
You may only dry heave, while another person can’t hold down food. You may avoid leaving the house when your anxiety spikes, while someone else may simply have an upset stomach throughout the day.
For you, it’s possible that the physical symptoms of anxiety might even come across as motion sickness—even if you’re not moving.
It’s different for every person, just like other anxiety symptoms.
Treating nausea is about controlling both the symptom and the source, which means while your over-the-counter nausea treatment may help, it’s not going to make the problem itself go away.
So, while your mom may hand you a ginger ale to sip on, the big picture is that these symptoms aren’t going away without you taking actions to address the bigger problem: the anxiety itself.
So how do you treat nausea due to anxiety? While carrying around anti-nausea meds for the rest of your life might be a tolerable inconvenience, there are better ways to bring an end to the problem — like treating your anxiety, first.
There are several ways to do this. Prescription medications are the go-to solution these days for safe and effective treatment.
Typically, the medication you will receive for treating anxiety disorders is going to be an antidepressant.
Medications like selective serotonin reuptake inhibitors or SSRIs are often prescribed for anxiety treatment, but it’s possible that a mental health professional might recommend serotonin and norepinephrine reuptake inhibitors (SNRIs) if SSRIs are ineffective.
Another option is therapy, which is frequently used in parallel with medication. You can learn more about therapy with our guide, What Is Psychotherapy & How Does It Work?.
Lastly, treating anxiety may require a talk about your lifestyle. Your quality of life is important, and while we know that there’s a delicate balance between avoiding stress and accomplishing your goals, there’s a simple rule to be observed here: if you’re experiencing gastrointestinal issues due to chronic stress or anxiety, you need to make a change.
Healthcare providers may point to changes that could be made in your diet, recommend regular exercise or they may call out excessive alcohol consumption or substance abuse (which may be exacerbating your anxiety).
Addressing any and all of these issues could alleviate some anxiety symptoms.
The next step on your journey is to talk to a healthcare professional and get a game plan together for treatment. If you’re tired of dealing with mild or severe nausea due to anxiety (or anxiety in general), check out our online therapy offerings to start.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.