Anxiety and Underlying Medical Conditions: A Two-Way Street
Updated: Aug 21
Changes in mental health can result in physical illness. And the reverse is also true. A wide range of medical conditions can trigger anxiety and depression. Changes in brain chemistry, hormones, and body functions cause these changes. It can become a vicious cycle unless you interrupt the pattern. Some of these issues can be minimized with early attention: If you can calm or treat one part of the cycle, you often help the other as well. Anxiety and underlying medical conditions are a two-way street.
The following is an overview of some common mind-body relationships and possible approaches to breaking the cycle.
Mental Health Problems Commonly Contribute to Physical Illnesses
Of course, many illnesses are caused by factors other than emotional issues, like environmental issues and disease transmission. But when the brain becomes distressed and stays in distress mode, the body pays the price.
How Does This Happen?
When you’re anxious or overwhelmed, your body activates the fight‑or‑flight system. The brain signals for cortisol to rise in the body; it enters the brain and, over time, areas in the brain can be “overworked” (hippocampus and prefrontal cortex) and become less functional. At the same time, mental health problems dysregulate serotonin, dopamine, and norepinephrine. An increase in cortisol release is normal in illness; it protects a person. But when it stays active for weeks and months, it can cause trouble in the body. The following is a basic discussion of how the release of hormones and neurotransmitters in the brain affects the rest of the body.
PHYSICAL EFFECTS OF PROLONGED CORTISOL RELEASE
Your heart rate and blood pressure stay higher than they should
Muscles stay tense
Digestion slows, causing stomach issues
Sleep becomes shallow or disrupted
Healing and the immune response become impaired. It becomes more difficult for the body to fight infection, and autoimmune conditions can flare more easily.
Constant cortisol exposure leads to inflammation and overexertion, which damage multiple organs and systems, causing chronic problems like
Heart disease
Diabetes
Chronic pain
GI disorders
Autoimmune flare-ups
DYSREGULATION OF SEROTONIN WHEN YOU ARE ILL
During periods of stress, anxiety, and depression, serotonin levels in the brain and body are dysregulated (it goes up in some places and goes down in others). When this happens, a person can develop some of the following physical symptoms:
Pain sensitivity increases, leading to headaches, migraines, and fibromyalgia-like pain
Digestion becomes erratic, causing IBS, nausea, constipation, diarrhea, changes such as overeating or loss of appetite
Sleep becomes disrupted, resulting in insomnia, non-restorative sleep, brain fog, and decreased memory and alertness)
CHANGES IN NOREPINEPHRINE WHEN YOU ARE ILL
When norepinephrine is too high (anxiety, chronic stress):
Heart races
Blood pressure rises
Muscles tense
Breathing becomes shallow
You feel “wired but tired.”
When norepinephrine is too low (depression, burnout):
Fatigue
Brain fog
Low motivation
Slow reaction time
CHANGE IN DOPAMINE WHEN YOU ARE ILL?
Dopamine reduction is common in depression and chronic stress/anxiety
Motivation drops
Movements feel heavy
Pain feels more intense
Concentration becomes difficult
Low dopamine is why depression can feel like “moving through mud.”
Short-term anxiety, stress, and Depression Can Cause Short-Term Medical Problems. Some examples include the following
Cardiovascular System
Increased heart rate
Dizziness
Musculoskeletal Symptoms
Muscle tension
Gastrointestinal Symptoms
Upset stomach
Dermatologic / Skin/Rashes
Respiratory System
Shortness of breath
Sleep & Energy Regulation
Insomnia
Neurological / Pain
Headaches
Immune System
An increase in colds and other short‑term illnesses
Long-term Anxiety, Stress, and Depression Can Also Cause Long-Term Illness.
Gastrointestinal System
Ulcers
Irritable bowel syndrome (IBS)
Unexplained stomach pain or discomfort
Cardiovascular System
Cardiovascular disease
High blood pressure
Heart attack
Stroke
Neurological / Cognitive Function
Brain fog
Memory problems
Difficulty concentrating
Headaches
Sleep & Energy Regulation
Poor sleep quality/insomnia
Excessive fatigue
Immune & Inflammatory System
Increased inflammation
Musculoskeletal / Pain Disorders
Increase in preexisting pain
Metabolic / Endocrine
Weight gain
Increases cholesterol (increasing LDL, the bad cholesterol, and decreasing HDL, the good cholesterol)(1)
Medical Problems That Commonly Contribute to Anxiety and Depression
Heart and Circulatory Problems
Heart disease
Irregular heart rhythms
High blood pressure
Breathing and Lung Conditions
Asthma
COPD
Any condition that makes breathing difficult (which naturally increases fear and anxiety)
Hormone and Metabolic Imbalances
Thyroid disorders (especially hyperthyroidism)
Adrenal dysfunction
Diabetes
Sex‑hormone changes (PMS, perimenopause, menopause)
Gastrointestinal Conditions
Irritable bowel syndrome (IBS)
Chronic digestive discomfort
Acid reflux (can mimic chest‑related anxiety symptoms)
Chronic Pain Conditions
Arthritis
Fibromyalgia
Back or nerve pain
Neurological Conditions
Stroke
Multiple sclerosis
Traumatic brain injury
Epilepsy
Dementia
Sleep Disturbances
Insomnia
Sleep apnea
Fragmented or poor‑quality sleep
Other Common Triggers
Electrolyte imbalances
Caffeine sensitivity or overuse
Certain medications or withdrawal states
How Does This Happen: How Do Anxiety and Underlying Medical Conditions Create A Two-Way Street?
Physical illness triggers a disruption of hormones and neurotransmitters that regulate stress, anxiety, and depression. When the body is sick or under strain, serotonin and dopamine levels tend to decrease, while norepinephrine levels increase. These shifts create a very recognizable mood pattern:
Low serotonin contributes to low mood, worry, irritability, sleep problems, appetite changes, and a general “down” feeling.
Elevated norepinephrine produces the physical sensations of anxiety — feelings of restlessness, jumpiness, tension, as the body shifts into a fight‑or‑flight state.
Low dopamine leads to low motivation, reduced pleasure, and fatigue, which are also hallmarks that accompany a physical illness.
Together, this combination can make someone feel anxious, irritable, overwhelmed, down or depressed, and drained — a mix of emotions that are common during illness.
Cortisol, a hormone, also increases when a person is ill. Initially, it starts high to protect a person from illness, strengthen the immune system, reduce inflammation, and help mobilize energy to fight it off. But, after a while, when an illness becomes chronic, cortisol kicks into overdrive, decreasing inflammation, mobilizing energy, keeping blood pressure stable, and more. While short-term increases help the body respond, long-term or repeated elevations in cortisol can weaken the immune system, making recovery harder. Cortisol can strongly affect our moods: high levels increase anxiety and irritability, while long-term cortisol disruption can lead to low mood, fatigue, and emotional exhaustion - essentially symptoms of depression.
To stop the vicious cycle, it is important to address both the physical symptoms AND the emotional problems. See the following pages for some approaches to calming stress, anxiety, and depression.
Your mind and body are always in communication. Clearly, stress can trigger physical symptoms, anxiety can amplify them, and depression can change how your whole system functions. Mental health issues can change patterns of the nervous system into negative patterns that don't go away easily because neuroplasticity strengthens whatever pathways you use most — whether they’re calming or stressful.
So yes, the mind‑body relationship can become “wired” into chronic patterns involving:
Cortisol
Neurotransmitters
Emotional responses
Physical symptoms
But the hopeful part is equally true:
The same neuroplasticity that created the chronic body-mind pattern can also un‑create it. Therapy, mindfulness, new habits, medication, and repeated corrective experiences can build new pathways that override the old ones.
Take care of the medical issues as well as you can, and you may notice your anxiety or depression easing. Support your mental health at the same time, and you may find yourself relating to your body in a calmer, more hopeful way. Treating both sides of the mind‑body connection often opens the door to a healthier, more sustainable way of living.
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