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Anxiety and Physical Symptoms: Does the Body Actually Keep the Score?
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Hello friends! This episode continues the anxiety series — featuring Cassandra and Garth digging into the physical symptoms of anxiety: what they are, why anxiety is a body experience first, what to do when doctors say nothing is wrong, what somatic anxiety is, and why EMDR works where cognitive approaches alone often can't. Cassandra is a licensed therapist and EMDR Consultant at Seen Therapy Services in Springfield, Missouri, offering EMDR therapy, EMDR intensives, and couples counseling in person and via telehealth throughout Missouri. Visit seentherapy.org or call 417-708-7909 to get started. Get a taste for the episode below. If you enjoy your listen, give us a follow, share, or five star review. Have a good one!
"Anxiety is body first, thoughts second. And for some people, it never really gets to the cognitive level at all. They have the body response and that's where it stays."
Hello, hello, hello friends. Welcome to the podcast where we simplify everything about mental health. Just kidding. But here's what we are gonna do. We're gonna sit down together a licensed mental health professional, that's me, and a regular old Joe, as my husband Garth would describe himself. We're gonna talk about the nitty-gritty of the MBR, some nervous system mapping, how couples can help each other heal, what's healthy parenting actually looks like, maybe a little bit of good old banter mixed in. All with the goal of making mental health a little bit simpler for you. Which note, because my lawyer says that I have to. I'm a therapist, but not your therapist, unless I am. Even if I am, this is still just a podcast, okay? Now have a good listen. Hello, friends. We are moving along in our anxiety series today. We are talking anxiety and physical symptoms. Does the body actually keep the score? Bum bum bum. Garth, there's a big controversy. Controversy starting the body keeps the score book. We're not gonna really talk about that today, but I just want to throw that out there.
SPEAKER_00What is it?
SPEAKER_01I I don't even know. I mean I do, but it's I don't know how to explain it really quickly.
SPEAKER_00Gotcha.
SPEAKER_01But we are gonna be talking about physical symptoms of anxiety today. And before we really roll into it, bant us away, sir.
SPEAKER_00Man, okay. So favorite musician or music group of all time.
SPEAKER_01Genuinely have no idea.
SPEAKER_00Yeah, I figured I figured you wouldn't. You know the lyrics to everything you've ever heard, but could not tell a soul who sung it or what band or what the name of the song is. It's impressive. You can sing along to things. I'm like, there's no way you've ever heard this song before, and you're just singing along, and I'm like, okay.
SPEAKER_01I legitimately don't have to hear it more than once for it to just be like locked in. Whatever is happening in my brain that makes that happen. Like, I had a client just today, actually, that I had not seen for over a year. They were a returning client, and they were like, Well, let me remind you of I don't know, yeah, I I don't need reminded Remind me. It is like it locked in there somehow. But yeah, couldn't couldn't tell you who singing the song, who the band is. Don't know. Don't know. So anyway, yeah, I'm sorry. I think this might be the first band that I don't have an answer to. I mean, I could throw somebody out there. Inequatry.
SPEAKER_00Yeah. We'll throw it out there so we get a sense of the style you're into.
SPEAKER_01My favorite concert was probably Ed Sheeran, just because I thought his looping was really yeah impressive.
SPEAKER_00It was very performative and impressive, and it's not just a pretty face.
SPEAKER_01If I'm honest though, Ed Sheeran was probably my second favorite concert, but I know that my first favorite concert, you're I know. Anyway, Garth really loves the Foo Fighters, loved the Foo Fighters, but was very let down by Dave Grohl's recent events. Recent events.
SPEAKER_00Let's just leave it at that. Yeah.
SPEAKER_01Not a great dad move or a great partner move. I say not a great dad move.
SPEAKER_00I mean to who?
SPEAKER_01Right, right. The worst dad, worst dad move would have just been to completely ignore it, I guess. But anyway, here we are. So how about you?
SPEAKER_00Yeah, it's it's gotta be my boys over at Koheed and Cambria.
SPEAKER_01Knew it. Okay.
SPEAKER_00Gotta be.
SPEAKER_01I don't necessarily guess your bant answers correctly as often as I would like to, but I had that one in my head. Yeah. Had it locked with.
SPEAKER_00Yeah. Okay. I've got their tour tour dates pulled up. Next time they're in Kansas City or St. Louis, we're gonna have to we're gonna have to go. Sorry. We're just gonna go.
SPEAKER_01Hop on over there.
SPEAKER_00Yeah.
SPEAKER_01Okay. Sounds good. All right, sir. We're doing the same format that we've done for the last two. You've got the questions. Hopefully, I have some answers. So if you want to take us away with questions, I will start trying to answer them.
SPEAKER_00Reminder today's topic is anxiety and physical symptoms. Pretty much what I'm summarizing. So, question number one. I think a lot of people don't connect their physical symptoms to anxiety. What are we talking about?
SPEAKER_01Okay, you have physical symptoms of anxiety, you have headaches, you have stomach issues, digestive issues, you have chronic muscle tension. I want to loop back to that one. You have difficulty falling asleep, staying asleep, fatigue that does not relieve even when you do sleep well. So people will tell me like my sleep score for my aura ring is really high, but I'm still feeling exhausted. You experience an elevated heart rate for no reason, shortness of breath for no reason, start to have skin responses like rashes for seemingly no reason. The body can really start to have some, I'm moving away from the microphone, some pretty significant reactions as a result of anxiety. I wanted to loop back to muscle tension because for folks with an anxiety disorder, we'll say their body over time has become so tense that the body itself is starting to indicate to the body that it should be having an anxiety response because of the level of tension that it's in. So this is where you know, chiropractic care, massage therapy. If you're in Springfield, Missouri, shout out Dr. Abigail Emery. She is wonderful. She is my chiropractor, and she is hiring a massage therapist the week of this recording, which is the beginning of August. So going and relieving that muscle tension really is an efficacious, which essentially just means like research-backed way to help you to manage anxiety. You will see faster symptom reduction if you do some physical things for that muscle tension alongside therapy.
SPEAKER_00Yeah.
SPEAKER_01So fun fact.
SPEAKER_00Okay. That makes sense to me. That brings us to question number two.
SPEAKER_01Sorry, you're just like, I am rolling us along. I am not taking the bait on your long-winded answers today.
SPEAKER_00Not today.
SPEAKER_01Not today.
SPEAKER_00Question number two.
unknownOkay.
SPEAKER_00Why does anxiety show up in the body at all? What's the mechanism? You talked about it just now.
SPEAKER_01Mm-hmm. Why does anxiety show up in the body at all? That's hard to answer because it's like anxiety is the body.
SPEAKER_02Sure, yeah.
SPEAKER_01It's the body first. I think when we think of anxiety, we think of anxious thoughts. But the body is or I'm sorry, anxiety is body first, thought second. That makes sense. Like, why does it even show up in the body? It it is the body.
SPEAKER_00Like it's where it is. It's there. Yeah.
SPEAKER_01Right, right. Like it is the fight or flight response. Like there's yeah.
SPEAKER_00I think maybe on a more like literal level, it shows up in the body because it's designed to protect you in situations where you may need to fight or flight, right? Fight or flee.
SPEAKER_01Yeah, we talked about this in a previous episode. Like anxiety is not a bad thing. And I think too, because we for for whatever reason, and I don't I'm not sure if this is something that's come about as a result of like cognitive behavioral therapy. I don't know, but when we think of anxiety, we do think of anxious thoughts. And some people are confused because they come to me and they're describing anxiety symptoms, but they're not really having anxious thoughts. Some people don't get all the way there. They have the body response without the like really cognitive response. Does that make sense?
SPEAKER_00Yeah, for sure.
SPEAKER_01They're they're like, they're not having that ruminating thinking that we that we think of when we think of anxiety, but they are having that initial body response.
SPEAKER_00Yep. Okay, question number two.
SPEAKER_01I should I feel like I need some sort of like sound bite whenever I'm not like when you're done, you need a little ding.
unknownYeah.
SPEAKER_01Okay, question three.
SPEAKER_00You could just do that.
SPEAKER_01Oh now I'm just a little obsessed with it.
SPEAKER_00Three. A lot of people have been told by doctors that nothing is wrong. What happens to them?
SPEAKER_01Can you tell me more what you mean about what happens to them?
SPEAKER_00So a lot of people are having this anxiety, it's showing up in their body, and doctors are like, You're fine, nothing's broken, everything's working like it should. What do they do then? The doctor said you're fine.
SPEAKER_01So like I'm having this intense stomach pain, but everything seems like it's checking out why why is this happening? Yeah.
SPEAKER_00So and and then what what happens to them? Like what what's the next step?
SPEAKER_01Yeah, well, hopefully they come to therapy. Like I I have a brochure that I hand out to doctors' offices, and it the whole brochure is like when to know to refer your patient, and it's to EMDR specifically, when to know how to know when to refer your patient to EMDR. But one of the things that it talks about is having physical symptoms that are going unexplained. Right. And so unfortunately, oftentimes if somebody is dismissed, their symptoms do exacerbate quite a bit before they're addressed in therapy. But if you were having physical symptoms that you have done a thorough, you've done your due diligence to have that addressed with like your primary care and everything's coming up seemingly fine, consider therapy because I'm referencing back to what I said earlier. It is confusing for folks when they aren't having anxious thoughts, but they are having body responses to, or they're having anxiety responses. That does happen. So if you're one of those people who's having those significant unexplained symptoms, but you're not having like the ruminating thoughts, go to therapy, come see us, come go see somebody that can start to kind of walk through that with you. Does that make sense? Does that answer the question?
SPEAKER_00I think it does. And unfortunately, uh and maybe this is my perception, maybe you can help me here. Doctors aren't always eager to refer out to mental health. Sometimes it's oh, you have a stomach issue, I didn't find anything. You need to go see the specialist doctor, and it's not a referral to maybe mental health, maybe that's just a cons misconception that I have. Not a doctor, not a therapist. But I don't know.
SPEAKER_01I do think because of how we generally pursue litigation in this country, that like a primary care, for instance, would be more likely to refer to, you know, a cardiologist when you're having chest tightness. Not in the present moment, but like when you describe having had it, you know, every two weeks fairly consistently. And also like, yeah, go to the car, but I I want you to go to the cardiologist.
SPEAKER_02Sure.
SPEAKER_01Right. And when the cardiologist clears you, I want them to refer you to me. I guess I've never totally thought through that before, but yeah, I go see a lot of primary cares. I don't see a lot of specialists, but really, if I'm a primary care, I'm sending somebody to the cardiologist. So anyway, uh yeah, it makes sense to me. I I don't think that primary cares or that physicians in general are resistant to mental health care referrals. And I do think they should do their due diligence beforehand. I don't think that primary cares are often very connected to private practice clinicians like myself that niche that specialize in something, but that's not necessarily on them. Like I think we as clinicians need to be working to make that connection. Anyway, really got off there. So ding. What I'm here for. Yeah. Drive you off topic. Yeah, summon myself out.
SPEAKER_00All right. Okay. What's our next question number four? Is there a name for this? The anxiety that shows up as physical symptoms.
unknownMm-hmm.
SPEAKER_01Again, this would so our last episode was on high-functioning anxiety. That is not a clinical term. This is not a clinical term, so it's not like a diagnosis in the DSM5, but we would call it somatic anxiety or body-based anxiety. Again, folks, that everybody has a physical experience with anxiety, but some people really only have a physical experience and don't have much of a cognitive experience. And no matter how much you notice the physical experience, the physical experience does come before the cognitive experience. Yeah. And it's also on a spectrum like is that physical experience bleeding, or is it really worn on your body? And even when you're not in an immediate anxiety stress response, you're still experiencing some significant symptoms like extreme muscle tension. Right. So everybody has that anxiety response. And then some people also notice a significant cognitive response. And then if that happens long enough, you're also going to experience more chronic symptoms like um intense muscle tension. Did you follow there? Did I get off track? Okay.
SPEAKER_00No, I think that answers it. It was a pretty straightforward question. So I think you answered it fully. Ding. Question number five. What does treatment look like when anxiety is mostly physical? Are there different things that you do?
SPEAKER_01Yeah, this is why EMDR can be so helpful in addressing anxiety, right? Is because again, not everybody gets to the cognitive part in a really significant way. So EMDR and other like somatic work focuses on the body, the nervous system. There is some thought work in EMDR as well, but we have to utili something that can work at the place where the anxiety originated, where it lives. I use the imagery often, like I want to pull up the weed. I don't want to just cut it off at the top. Right. And so I think addressing just cognitions trims the weed. Addressing where the anxiety lives, which is in the body, pulls the weed up. Yeah, you cannot separate anxiety from the body. We have known it as more of a cognitive-based experience, but it is it does not start there. And for some people, it never gets there.
SPEAKER_00Yeah. Ding.
SPEAKER_01I need an actual physical bell.
SPEAKER_00You do. I'll work on that.
SPEAKER_01Okay.
SPEAKER_00Last question.
SPEAKER_01Okay.
SPEAKER_00If you answer it quickly, we may be under 20 minutes for the first time in our lives podcasting. Whoa. What would you say to someone who is convinced it's physical and not psychological? That there's something physically wrong with them and it's not anxiety causing these physiological symptoms.
SPEAKER_01Well, someone is really intent that something physical is going on. I am always going to encourage them to pursue talking to their primary care, talking to, you know, getting a referral for a specialist. Like follow that intuition. And at the same time, we cannot separate body and mind. Like it is a full system. If we have pursued things with our primary care and even specialists, can we consider for a moment what the nervous system might be carrying? Like is that possible? Right. To just sit with that. So again, I am always encouraging people, let's do our due diligence with primary cares with specialists, but we cannot separate the body and the mind. And if you have been chronically anxious, your nervous system has had a heavy load to carry. I beat 20 minutes, but now you've got to summarize for us. Go.
SPEAKER_00Number one, I think a lot of people don't connect their physical symptoms to anxiety. What are we talking about? Number two, why does anxiety show up in the body at all? What's the mechanism? Number three, a lot of people have been told by doctors that nothing is wrong. What happens to them? Number four, is there a name for this anxiety that primarily shows up as physical symptoms? And number five, what does treatment look like when anxiety is mostly physical? And number six, what would you say to someone who's convinced is is physical, not psychological?
SPEAKER_01Ooh. Still didn't make it. We're at 2030. But it was close. It was dang close. Folks, thanks so much for stopping in and having a listen with us. I really appreciate it. I know Garth does as well. We are genuinely just I mean, we enjoy putting this podcast out and love that people sit down and listen to us every week. So tell your friends, come back for another listen, and we'll talk to you soon. Bye. Well, that's all, folks. Please see our show notes for ways to connect with us or go give us a follow on Instagram. You can find us at Simply Mintal. If this episode resonated with you, send it over to a friend. Give us a five star rating, subscribe, download all the things that cool kids are doing these days. Thanks for having me listen.