"Mom, my stomach hurts."

Do you remember saying this as a kid? ...More than just a few times?

While you may have indeed been sick once or twice, it's more likely that you were experiencing anxiety-induced nausea.

"Ok, but this also happens as an adult — at night, before work, randomly... Is that still anxiety?"

I don't know you personally - and I'm not your doctor - but chances are, your frequent nausea might be linked to anxiety.

While nausea usually occurs from problems like food poisoning or a virus, people with anxiety disorders can experience gastrointestinal discomfort when they encounter specific triggers. For example, they may feel physically unwell in the hours leading up to a highly-anticipated social interaction.

Fortunately, science has explored the close relationship between the nervous and digestive systems. And fortunately, we're here to break it down for you.

Too long; didn't read

• Anxiety and nausea can both cause psychological and physical discomfort.
• When the nervous and digestive systems are in distress, the brain and stomach signal each other, explaining the association between anxiety and nausea.
• Anxiety-induced nausea is related to the fight or flight response.
• You can manage anxiety and nausea by trying anti-anxiety medications or even using oils, among other strategies.
• Anxiety is one of the most common comorbid conditions among people with ADHD.
  

⚠️ Disclaimer: This article is not meant to replace professional medical advice. If you're not currently receiving anxiety treatment but believe you're exhibiting symptoms, please consult your healthcare physician for a formal diagnosis and treatment plan. 

What is anxiety-induced nausea?

When someone with an anxiety disorder experiences psychological stress, an alarm sounds in the brain. Oftentimes, this leads to physical symptoms, including nausea. ¹ Anxiety and nausea may last a few hours, sometimes up to a full day.

What are the most common physical symptoms of anxiety?

Gastrointestinal (GI) symptoms:

• Nausea
• Acid reflux
• Heartburn
• Stomach cramps
• Diarrhea
  

Other physical symptoms:

• Insomnia
• Headaches
• Shivering
• Sweating 
• Tinnitus (ringing in the ears)
• Dry mouth
• Light-headedness
  

How is anxiety related to nausea?

The gut-brain connection

The brain plays a significant role in the digestive system and vice versa.

For example, suppose you have a stomachache after a big meal. In that case, the stomach signals to your brain that it's unwell, making you feel upset, worried, or tired... not to mention - anxious.

It works the other way, too, with anxiety as a trigger for nausea. In fact, any strong emotion can provoke stomach issues; even anger and happiness have the potential to cause you to feel sick!

For your reference: science definitions

The following sections review biological processes that may be unfamiliar to some readers. In addition to the definitions provided below, we've also bolded each term every time it's used for the remainder of the article.

ACTH: adrenocorticotropic hormone; triggers adrenal glands to release cortisol
Adrenal glands: produces and releases hormones; one gland is located on each kidney
Amygdala: small midbrain structure; involved with the processing of emotions and fear
Cortisol: stress hormone
‍CRH: corticotropin-releasing hormone; regulates stress response²
Epinephrine: adrenaline; hormone
Hypothalamus: brain region; acts as "command center" for the nervous system; communicates with rest of the body³
Pituitary gland: "master gland"; regulates many brain functions

What's the science behind anxiety and nausea?

When you experience stress, your brain triggers the release of specific hormones, such as cortisol, to prepare you for action.

Stress hormones

First, the hypothalamus expresses corticotropin-releasing hormone (CRH).

Next, CRH makes its way to the pituitary gland, causing the release of adrenocorticotropic hormone (ACTH).

At this point, the "fight, flight, freeze, or fawn" response is triggered, also known as the "fight or flight" response.

The "fight, flight, freeze, or fawn" response

The body automatically enters protection mode when exposed to danger. However, each brain's perception of "danger" is subjective depending on its experience with anxiety or trauma.

The 4F's: What's going on in the brain?

When danger is detected, a few things happen in the body to activate a stress response:

1. The amygdala sends a distress signal to the hypothalamus.
2. The hypothalamus relays the distress to the adrenal glands.
3. The adrenal glands flood the bloodstream with hormones, specifically adrenaline (epinephrine).
4. Epinephrine prompts physical symptoms that prepare you to react with one of the four F's: fighting, fleeing, fawning, or freezing.
   

The above steps apply to the "normal" response to danger: pupil dilation, increased heart rate, alertness, etc. But these responses can also trigger something else:

Anxiety.

And for someone with an anxiety disorder — or even PTSD — this "fight or flight" stress response can go into overdrive, allowing some of the hormones to interact with the digestive tract. This leads to stomach pain and other GI symptoms.

Treating your anxiety

There are several treatment options and coping strategies for anxiety, most of which can also reduce nausea as a symptom. Treatment for anxiety and nausea may take trial and error to find the best plan. If you continue facing challenges with anxiety, request a referral to a psychiatrist or counselor the next time you see your primary care doctor.

Anti-anxiety medication

Certain medications can help to decrease the anxious hypervigilance that causes nausea.⁴

Examples include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and noradrenaline reuptake inhibitors (SNRIs)
• Benzodiazepines
• Pregabalin
  

Psychological therapy

If you're in the market for a therapist — or if you already have one — we recommend addressing your concerns about anxiety-induced nausea during your next session.

Specifically, therapists trained in cognitive-behavioral practices can help you pinpoint triggers you may not have noticed.

DIY mindfulness strategies

While waiting for your next therapy session or doctor's appointment, try a few of the following strategies at home.

• The 5-4-3-2-1 grounding technique
• Yoga
• Apps with guided meditations (such as Headspace; for our readers with ADHD, Inflow has anxiety and meditation modules)
• Box-breathing
• The reorientation grounding technique

Natural remedies

Many people swear by the healing properties of certain natural remedies for nausea:

• Applying peppermint oil to wrists or using peppermint aromatherapy
• Sipping ginger tea or chewing ginger gum
• Sucking on ice cubes
• Adding lemon to your water