Your question: Why does anxiety make me want to throw up?

My reply:

Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy.

Anxiety occurs when your brain detects something or someone that it considers a potential threat, so it triggers a warning signal that generates a physical and emotional discomfort that can sometimes be disconcerting.

I would like to start by reassuring you by saying that the feeling of fatigue and the urge to vomit are normal during episodes of anxiety. While we all experience moments of anxiety to a lesser or greater extent, when it becomes too frequent and intense, we are dealing with a problem that can wear down your body and mind.

Your body and mind are related. So while anxiety begins as a thought that generates intense worry or fear, it eventually transforms into physical symptoms such as tachycardia, sweating, muscle tension and in your case, fatigue, vomiting and in cases of extreme anxiety, vomiting.

Therefore, before introducing you to coping strategies to deal with anxiety and reduce its annoying sensation, it is necessary that you know your body and understand the origin of the feeling of nausea associated with anxiety in order to prevent and reduce it.

What other symptoms does anxiety cause?

Psychology has studied anxiety as a complex phenomenon, which has specific characteristics that affect people in different areas. In addition to the feeling of fatigue and the urge to vomit, anxiety is characterized by the following symptoms: (1).

Cognitive symptoms: fear of losing control; fear of death; fear of “going crazy”; fear of negative evaluation by others; frightening thoughts.

Physiological symptoms: increased heart rate, palpitations; shortness of breath, rapid breathing; chest pain or pressure; dizziness.

Affective symptoms: nervous, tense, wound up; frightened; sadness; irritability.

Why does anxiety make you want to throw up?

The relationship between the digestive system and mental health is not often discussed. Gastrointestinal problems are the most common physical ailments in people with depression and anxiety. There are different biological causes that explain the feeling of fatigue, stomach pain and the urge to vomit that appear during episodes of anxiety.

Did you know that in the intestine there are large amounts of serotonin? This neurotransmitter that is mainly associated with the brain is responsible for regulating our emotions and producing the feeling of happiness and satisfaction in our body. When serotonin is deregulated it produces an imbalance in emotions, giving people the feeling of anxiety and sudden sadness (2).

Serotonin in the gut during episodes of anxiety can make you feel “sick to your stomach” which causes that feeling of fatigue and the urge to vomit. Studies have also shown how nausea is a typical symptom of anxiety and anticipation, generated by the physical imbalance that occurs during anxiety, which affects the digestive system, causing the feeling of fatigue (3).

Although vomiting is a less frequent response than fatigue during anxiety, it is also possible. Some factors that increase the likelihood of vomiting during an episode of anxiety are vitamin deficiencies, previous gastrointestinal problems, and having recently eaten large amounts of food.

What can you do?

To alleviate the feeling of nausea that appears during anxiety, and to reduce the feeling of anxiety in general, there are several strategies to take into account, which should be complemented by seeing a professional such as a psychologist or a doctor if your anxiety symptoms worsen and in particular, if the feeling of fatigue and the urge to vomit persist.

Slow breathing (4-4-4)

When the feeling of nausea caused by anxiety overcomes you, breathing exercises can help you to diminish the sensation. Close your eyes, inhale through your nose for 4 seconds, hold your breath for 4 seconds and exhale through your mouth for another 4 seconds. Keep a slow rhythm while resting your hands on your abdomen. Repeat this exercise for 5 to 20 minutes until you feel that your anxiety and nausea have subsided.

Question your thoughts

Anxiety is inevitably related to your way of thinking, so you need to modify it in order to reduce anxious symptoms. When you have automatic thoughts that overwhelm you, you should question them and modify them for a positive and functional one. For example, if during a class you have an abrupt thought that tells you “you are not good for this career”, you should respond to it internally by saying “I do the best I can to improve in my studies, and although I am not perfect, I learn to be better every day”. In this way every negative and hurtful thought that appears during the day, you must face it and replace it with a more positive and functional one.

Physical exercise

Physical activity is necessary because it allows you to train both your body and your mind. Whether in a gym, playing a sport or from the comfort of your home, physical exercise helps you release hormones and neurotransmitters related to happiness, allows you to feel more focused and helps you drain negative emotions.

5, 4, 3, 2, 1

This technique consists of using your senses to dissuade emotional discomfort at a given moment. It is useful when you experience a lot of physical agitation or when you feel you have a lot of unpleasant thoughts, and you find it difficult to control your emotions. Wherever you are, you will focus on identifying 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste. This will allow you to focus your attention on specific things during the period of anxiety, and slowly, the feeling of intense worry will diminish.

In my experience…

Feeling the urge to vomit is an extremely common sensation during anxiety. My recommendation would be to pay particular attention to the feeling of nausea, observing if it is sustained and intensifies over time, as you may need to see a doctor to rule out other problems. Coping with anxiety and its symptoms is hard work, but not impossible. By developing coping strategies, reinforcing your confidence, seeking professional support and understanding that anxiety does not have to determine your life, you will be able to confront your anxiety and improve your quality of life.

I believe you have the ability to improve and heal these feelings of discomfort you are experiencing now. The fact that you are seeking professional help through this medium proves it to me, and I applaud you for making that decision and being on track to improve your mental health and overall, your physical health.

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