How To Tell If Nausea Is From Stress Or Anxiety

Medically reviewed by Julie Dodson, MA, LCSW and Corey Pitts, MA, LCMHC, LCAS, CCS
Updated October 11, 2024by BetterHelp Editorial Team

When people think of anxiety, they often think of the mental component: worry, fear, a sense of dread. However, it’s common for anxiety to cause physical symptoms, too. Headaches, muscle aches, shortness of breath, sweating, lightheadedness, and nausea are just a few possibilities. 

Here, we’ll explain why anxiety in day-to-day life can sometimes cause physical symptoms—nausea and digestive issues in particular—and how to tell whether your symptoms are from anxiety or not.

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Anxiety isn’t always just in your head

What exactly causes anxiety-related dizziness?

Everyone may experience anxiety differently, whether it’s routine nervousness or a clinical anxiety disorder. In general, however, physical symptoms are often a part of this experience. 

This is because mental stress and worry automatically trigger the fight-or-flight-or-freeze response in humans. This response causes the body to release the stress hormone, cortisol, as well as adrenaline to prepare you to respond to immediate, impending danger. 

How do hormones work in the heart and rest of the body?

Hormones that are associated with symptoms of stress and anxiety, such as cortisol, work to:

  • Tense muscles

  • Increase heart rate and blood pressure

  • Sharpen senses

  • Expand airways

  • Send more oxygen to the brain

The fight-flight-freeze response

Fight, flight, or freeze is thought to be a mechanism that helped our early ancestors survive, since it increases our chances of escaping from or neutralizing a threat. When you’re feeling anxiety about a conflict with a friend or the health of a family member, fighting or running away is not usually what will help—but the body triggers this response anyway because of your fear, worry, or anxious thoughts.

This response can trigger dizziness, trouble breathing, and increased heart rate

That’s why people often experience physical symptoms as a result of stress and anxiety, because the fight-flight-freeze response gets triggered. 

When it comes to nausea, stomach cramps, gastrointestinal issues, and other symptoms that are related to digestion, the direct reason is typically that the cortisol and adrenaline released as part of the body’s automatic stress response enter the digestive tract, which can cause stomach upset.

With chronic stress or anxiety, this may happen repeatedly and cause irritation in the lining of the stomach—which may contribute to complications like irritable bowel syndrome in more severe cases.

How to tell if nausea is from anxiety or stress

There’s generally no way for you to tell for certain if your nausea is related to anxiety, something else, or a combination of factors. That said, checking in with how you’re feeling and what’s going on in your life right now might help you identify which source is more likely. 

Consider whether you’ve been more anxious or stressed lately

For instance, you may be able to identify certain worries or stressful situations that have been on your mind lately. You may also be able to look for other symptoms of anxiety that you may be experiencing, such as irritability or trouble concentrating. 

Identifying your current vulnerabilities could also help you recognize if anxiety is a likely culprit. For example, say you have an important exam or work project due at the end of the week. This could be causing anxiety and related symptoms like nausea—but what if you don’t normally feel that anxious in this type of situation? Consider if there may be other factors at play that could be exacerbating your anxiety and leading to additional physical symptoms like nausea.

Other factors that trigger anxiety and lead to nausea

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

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How to tell if nausea is from anxiety: When to seek medical attention

If some of these apply to you today, it could be that you’re feeling especially anxious and may be experiencing symptoms like nausea as a result.

That said, if you’re experiencing persistent nausea without a clear cause, it’s generally recommended that you seek medical attention to identify any possible underlying causes—whether physical, such as irritable bowel syndrome, or mental, such as bipolar disorder, depression, or anxiety. 

Occasional anxiety vs. anxiety disorders

Virtually everyone will experience feelings of anxiety at some time or another. Occasional anxiety is normal. However, it may qualify as one of the mental health conditions under the umbrella of anxiety disorders when these feelings are persistent, difficult to control, and interfere with daily life. 

According to the Anxiety and Depression Association of America, there are various types of anxiety disorders, any of which could potentially contribute to feelings of nausea. 

For example, someone with generalized anxiety disorder may experience this anxiety symptom as a result of frequent worry about possible future events. A person with panic disorder could feel nauseated due to the fear they feel at the prospect of having another panic attack. A person with social anxiety disorder might experience nausea the night before a social event. 

What do you need to do when you have these symptoms?

If you’re routinely experiencing nausea along with other anxiety symptoms, it’s generally recommended that you meet with a mental health professional like a therapist or psychiatric provider for evaluation and treatment advice. Treatment options for anxiety disorder usually include therapy and anti-anxiety medication. 

Occasional, nonclinical anxiety could also cause nausea from time to time, but since an untreated anxiety disorder could result in more serious, potentially long-term health consequences, it’s typically worth promptly investigating whether one may be at play.

Tips for managing physical symptoms like nausea, stomach upset, and breathing difficulty

In addition to meeting with a healthcare provider to address any underlying causes and a mental health professional to get evaluated for an anxiety disorder, there are some measures you can take to manage anxiety-related nausea yourself.  

Ways to calm yourself and prevent panic attacks

First, taking measures to relax and soothe your mental state in the moment can be helpful since this may help quell the fight-flight-freeze response and its physical manifestations.  You can also:

  • Engage in breathing exercises or mindfulness practices

  • Do a grounding exercise

  • Practice progressive muscle relaxation

  • Listen to music you enjoy

  • Take a bath

  • Participate in light exercise

Soothe your stomach

It can also help to engage in activities to soothe your stomach specifically. Drinking mint or ginger tea is one example, as these both can be beneficial for the digestive system, and hot water may help relax the muscles of the stomach and digestive tract. The simple ritual of enjoying a warm cup of tea could also produce anxiety-reducing benefits. 

Pay attention to your diet and avoid stress

Finally, paying closer attention to your eating habits might also decrease anxiety-related nausea. Eating foods that are gentle on the stomach—not overly spicy, greasy, or salty—might decrease stomach upset. Getting enough sleep, making sure you stay hydrated, and limiting or avoiding alcohol may also be advisable, particularly if you’re vomiting and not just feeling ill.

Persistent, frequent vomiting can be an emergency

If you've been vomiting consistently for 24 hours or experiencing anxiety and nausea regularly enough that it's disrupting your life, seeking immediate medical attention is generally recommended. Persistent vomiting can lead to severe dehydration and other dangerous conditions.

While it is common with anxiety, it’s possible that your nausea isn’t caused by anxiety. Being evaluated for other underlying conditions is therefore especially important.

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Anxiety isn’t always just in your head

How therapy can help with anxiety and panic attacks

If anxiety or related symptoms are causing you distress or disrupting your life, it may be time to seek professional support. Whether you suspect you may have an anxiety disorder or are interested in learning coping tools for occasional worry, a therapist may be able to help. They can support you in identifying the root causes of your anxiety, learning to identify and shift distorted thoughts that may be contributing to anxious feelings, and developing techniques and strategies for managing symptoms.

Online routes may be better for you

If the thought of calling therapy offices to find availability and make an appointment and then traveling to in-person sessions triggers additional anxiety, you might explore online therapy instead. You can use a platform like BetterHelp to get matched with a licensed therapist and then meet with them from anywhere via phone, video call, and/or in-app messaging. 

Research suggests that online therapy can produce “sustained, clinically meaningful improvements” in symptoms of anxiety, similar to in-person therapy. If you’re interested in online therapy, see below for some reviews of mental health professionals at BetterHelp.

"Molly has been my counsellor for numerous years. She’s helped me become the most confident and happy version of myself. She’s helped me learn how to work with my emotions, anxiety and stress to stay healthy and learn from leading opportunities as they arise in my life. I’m so grateful that she is my counsellor!"
— BetterHelp member’s review of their therapist

Takeaway

Can anxiety cause nausea? The answer is yes, in some cases. The question of whether nausea is from anxiety can be more difficult since it’s not always easy to isolate a single cause. 

Anxiety-induced nausea often feels distressing and can be a potential symptom of a diagnosable anxiety disorder. It could also be caused by an underlying health condition(s), so meeting with your doctor if you’re experiencing persistent anxiety and nausea is recommended. 

If it is caused by anxiety, engaging in relaxation techniques and eating foods that are gentle on the stomach could help. You might also meet with a therapist for support in coping with anxious feelings and symptoms.

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