Have you ever experienced physical symptoms to do with your heart or your breathing, and Googled them to find out what they are? For example, you might have asked:

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• “Why is my heart racing for no reason?”
• “Why do I have a tight chest?”
• “Why am I breathing so fast?”
• “Why do I feel breathless?”
• “Why am I shaky?”
• “Why do I feel light-headed or dizzy?”

Symptoms like these can sometimes have a physical cause – but they could also be related to a mental health difficulty such as anxiety, stress or panic disorder.

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When people talk about physical symptoms during CBT treatment, our therapists will ask a series of questions to help establish whether this is the case. You can do the same, to get an idea of whether there might be a psychological reason behind what you’re feeling. It’s worth saying at this point that panic attacks can occur out of the blue, with no tangible origin.

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• Have you been under stress, or are you feeling anxious?
• Have you experienced a difficult situation recently?
• Have you been working long hours?
• Have things been getting on top of you – maybe lots of small triggers that on their own may not cause problems, but could have built up over time?

If the answer is “no” and you’re worried that your symptoms may have a physical cause, please seek advice from your GP.

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So why do things that happen unseen in our minds manifest themselves in physical ways?

‍Understanding why your body may be reacting in a particular way can often be very helpful on its own.

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Physical symptoms such as a racing or thumping heart, or shaking legs, are part of the involuntary stress response that ensures we can perform as we need to in a challenging or dangerous situation. The brain floods your body with stress hormones, including adrenaline, to prepare you for action, and tells the heart to pump more blood to the muscles. A rise in heart rate can make you breathe faster, as your body tries to take in more oxygen.

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This response was essential once upon a time, ensuring our ancestors had a chance of survival if they were being chased by a sabre-toothed tiger…and it can be useful today if we’re faced with a threat, or even if we’re in a high-pressure situation such as taking an exam. It’s a lot less helpful if the reaction is completely of proportion to the gravity of the event we’re facing, or it continues for a long time, or seems to happen for absolutely no reason.

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What can we do about it?

‍There are two components involved in a stress response:

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• the sympathetic nervous system, which triggers the fight-or-flight response, and
• the parasympathetic nervous system, which pulls on the reins and calms the body down after the threat has passed.

Our bodies do gradually stop reacting to highly stressful situations, and calm down on their own. Sometimes the most powerful thing you can do if you’re afraid that your heart won’t stop racing, for example, is to do nothing – and see for yourself how it resolves naturally as the parasympathetic nervous system does its job.

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There are also positive actions we can take to help ‘quieten down’ the stress response – including breathing exercises, practicing yoga, regular exercise, taking a brisk walk when we’re experiencing symptoms, building a good support network with friends and family, and learning relaxation and mindfulness techniques.

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If the symptoms are interfering with your life – for example, making you want to avoid doing things, or leading to a lot of worry – CBT could help you feel better. A talking therapy, CBT will help you understand what’s behind your symptoms, and learn practical skills and techniques for managing them.