Anxiety symptoms in women: body, mind and at night

Anxiety is a feeling of worry, unease or fear. Most people feel anxious sometimes, before an exam, an interview or a hard conversation, and that is normal. It becomes a problem when the worry is hard to control and starts to affect daily life.

Signs some women notice in the mind include:

• worry that is hard to switch off, about the past, the future or the people you love
• expecting something bad to happen, or a sense of dread
• feeling tense, restless or on edge
• feeling irritable or snapping at people
• finding it hard to concentrate or make decisions

The World Health Organization notes that girls and women are more likely than boys and men to experience an anxiety disorder.

Anxiety is not only in your head. It runs through the whole body, which is why it can be so confusing and frightening.

Signs some women notice in the body include:

• a heartbeat that feels fast, strong or irregular
• feeling short of breath
• sweating, trembling or shaking
• feeling dizzy or light-headed
• nausea, stomach aches or other stomach problems
• headaches, muscle tension or aches
• a dry mouth, or pins and needles
• tiredness, even when you have not done much
• trouble falling or staying asleep

Many of these signs can also come from other things, such as the thyroid, the heart or low iron. Only a doctor can tell what's going on.

At night there are fewer distractions, so worries that you pushed aside during the day come back louder. Lying still in a quiet room, you also notice your heartbeat and breathing more. The NHS describes how the mind can fill with worrying thoughts at bedtime, and stress and anxiety are among the most common reasons for trouble sleeping.

Signs some women notice at night include lying awake with a racing mind, a pounding heart as soon as the lights go off, or waking in the early hours with a sense of dread. Poor sleep then makes the next day harder, and the worry grows. If this sounds familiar, our guide to overthinking at night has a simple wind-down to try.

Anxiety can change with your hormones, and some hormone conditions cause symptoms that feel just like anxiety. That is why it is worth mentioning both to a doctor.

Your cycle. The NHS lists feeling upset, anxious or emotional among premenstrual symptoms, in the weeks before a period. If your worry rises at the same point each month, read about anxiety before your period.

The thyroid. An overactive thyroid can cause nervousness, anxiety and irritability, mood swings, trouble sleeping, a fast or irregular heartbeat and trembling. These overlap closely with anxiety, so a doctor may ask for a blood test to check your thyroid.

PCOS, now called PMOS. The NHS lists depression and anxiety among the main symptoms of PMOS, the new name for PCOS. An international guideline asks health professionals to check for anxiety in all adults with the condition.

The years before menopause. The NHS lists anxiety among the symptoms of perimenopause, often alongside hot flushes and poor sleep.

Anxiety and low mood often come together too. The NHS lists low mood among the symptoms of generalised anxiety. If you notice both, read about anxiety and low mood together.

"Anxiety attack" is not a medical term. People use it to describe a wave of intense worry or fear. A panic attack is a sudden rush of intense fear with strong physical symptoms.

During a panic attack, the NHS says you may feel a racing heartbeat, feel faint, have chest pain or shortness of breath, and feel dread or a fear of dying. The NHS says most panic attacks last between 5 and 20 minutes. They are frightening, but they are not dangerous.

Chest pain can also come from the heart. If you have chest pain and you are not sure it is anxiety, call 112 now. It is always better to check.

If panic attacks keep coming back, or you start avoiding places in case one happens, talk to a doctor.

These ideas come from the NHS and the World Health Organization. They will not make worry vanish overnight, but many people find they take the edge off.

• Breathe slowly. Calm, slow breathing can help your body settle when anxiety rises.
• Set a daily "worry time". Give your worries a short slot each day, so they don't take over the whole day.
• Move your body. Regular exercise helps, even if it is only a short walk.
• Try mindfulness or yoga. Focusing on the present moment helps some people feel calmer.
• Protect your sleep. Keep regular bed and wake times, and have tea or coffee earlier in the day.
• Cut down on alcohol. The WHO notes that alcohol and drugs can make anxiety worse.
• Keep a diary. Note what you were doing and how you felt. Patterns, like your cycle or a certain day of the week, become easier to see.

When self-help is not enough, talking-based help works for many people. The WHO names cognitive behavioural therapy (CBT) as the approach with the most evidence for anxiety disorders. A doctor can tell you whether other help, including medicine, makes sense for you.

• What the anxiety feels like: in your mind, in your body, or both.
• When it is worst: mornings, nights, before your period, at work.
• How long it has been going on, and whether it is getting worse.
• Any panic attacks: what happened, how long they lasted.
• Sleep, appetite and energy.
• Any thyroid test, any change to your periods, and any medicines or supplements you take.
• How much tea, coffee or alcohol you have in a day.

Talk to someone if worry is hard to control and affects your daily life, if anxiety keeps you from sleeping, or if self-help is not helping. Talk to a doctor if you are not sure whether a body symptom, like breathlessness or a racing heart, is anxiety or something else.

A Nari health counsellor can listen, help you describe what is happening, and book you with a Nari doctor. The doctor can check for physical causes, such as the thyroid, and decide on any tests. Counsellors never give medical advice; medical decisions come from a Nari doctor.

Nari 1 is not an emergency service. If you are thinking of harming yourself, or you are in danger, call 112 now. For free mental health support at any hour, call Tele-MANAS on 14416 or 1-800-891-4416, a Government of India helpline.