The Fight or Flight Response: Understanding the Body’s Physical Response to Stress and Emotion

Have you or your child ever sought a doctor’s support in treating odd physical symptoms that seem to appear out of nowhere such as stomach aches, dizziness, or randomly pounding heart rate, only to do test after test with no indication of any actual physical health issue? Often, you will hear doctors and other professionals recommending “deep breathing” rather than prescribing medication or further testing. Although the recommendation for deep breathing may be an excellent place to start, this can leave people feeling frustrated, especially when they may not have a thorough understanding of the reasons why a doctor would recommend such a thing.

Interestingly, our emotions, especially ones that lead to anxiety, can sometimes cause us to experience these physical ailments, which may be referred to as “somatic anxiety”. Somatic anxiety refers to the physiologic response, including increased levels of cortisol, elevated heart rate, and muscle tension (Daley & Reardon, 2024), among other bodily symptoms. Related, is “cognitive anxiety” which consists of two components: worry about the situation and potential outcomes, and disruptions in focus or concentration (as cited in Daley, 2024). Among anxious youth, 50% to 95% report somatic complaints including headaches, abdominal pain, shortness of breath, sweating, racing heart, fatigue, and other symptoms (Crawley et al., 2014; Ginsburg, Riddle, & Davies, 2006; Hofflich, Hughes, & Kendall, 2006 as cited in Hale et al., 2018).

Experiencing typical anxiety on its own is hard enough, but when physical ailments such as stomach aches are added in, this can lead to increased anxiety and concern about what is happening to us. Awareness of common symptoms that can occur when someone experiences intense emotions or anxiety, could be key to helping address it. Research has shown reductions in somatic symptoms have been associated with decreases in overall anxiety (Crawley et al., 2014; Ginsburg et al., 2006 as cited in Hale et al., 2018). These physical symptoms can present very differently from one person to the next, with one person experiencing several at once and others only having one or two or in some cases not noticing any at all.

When anxiety presents physically, some common bodily symptoms that may appear are:

• muscle ache, tension, or pain

• trembling, twitching, or shaking

• sweating even in cold temperatures

• changes in body temperature

• stomach ache and indigestion

• nausea

• diarrhea

• intense startle responses

• rapid heart rate

• shortness of breath

• dizziness

• headaches

• insomnia

• dry mouth

The Fight or Flight Response

The above physical symptoms can be caused by our internal reaction to an outside stimulus, which is best known as the fight or flight response, which was first conceptualized by a physiologist, Walter Cannon, while observing the stress response of animals (Cannon, 1963, as Cited in Boyle, 2012). This response also includes the “freeze” response. Since then, other experts on the topic have created other interesting reactions such as the “fawn” and “flop” reactions. We experience these various states of functioning when our brain alerts us to perceived danger. It is a historical and universal response to perceived threat and is often described as the instant reactions that a caveman would have if they were head-to-head with a lion. For example, in order to fight off a lion, bodily process would change, such as digestion for example, as our body diverts our energy towards addressing the danger in front of us (fighting the lion, choosing to run away, or choosing to freeze in hopes the lion won’t keep bothering us and will move on to something better!). This is when a stomachache may kick in. This response is moderated by different areas in our brain, and depending on if our initial reaction is fight or flight our body will respond accordingly, often by increasing or decreasing certain hormones and neurotransmitters in our bodies which will either speed up a bodily process or slow it down, (amongst many other reactions). Interestingly, research regarding anxiety has theorized that both the adult and youth population may have biological vulnerability to acute stress reactions (e.g., Barlow, Allen, & Choate, 2004; Biederman et al., 1993), such that anxious individuals demonstrate overactivity in brain regions that typically work to suppress fight-or-flight and fear responses (e.g., Mathew, Coplan, & Gorman, 2001 as cited in Weersing et al., 2012).

What to do about it?

One of the key factors here may be deciphering between what is a threat and what is not. As our brains are programmed to react quickly, we sometimes mistake things as threats when they may not actually be (or not as much of a threat as it feels like in the moment!). A good place to start in assessing the threat is to identify what the “trigger” is. When discussing mental health, a “trigger” is a specific stimulus or event that causes a negative emotional or psychological reaction in an individual. If we are able to identify the trigger, we can move on to the next step: assessing the level of risk of the trigger to our wellbeing. With that being said, sometimes it can be hard to identify a trigger. With more understanding of how the body reacts and learning how to connect it to certain situations and experiences, the hope is that eventually we can recognize the trigger, assess the risk, slow down our mental and physical reaction to it (unless deemed it is a real and immediate danger of course!), and implement some skills that can prevent these triggers from causing us to spiral further.

Helpful Tools to Identify Your Triggers and Physical and Mental Responses

Find a way to make it fun when assisting your child. Increasing the means for communication in a way that makes the child remember to take note of how they are feeling and also to share it with you is a good place to start. One idea is to create a “worry monster”, a quick craft where kids can write down or whisper their worries to the worry monster. This can be a fun way to open up conversation about how kids are feeling.

Other tools that can be useful for older children or teens are:

• Journaling – Helps you to reflect on the situation and how you felt in the moment

• Trackers/Logs - these can be used for tracking emotions, thoughts, physical symptoms, behavioural reactions, time of day that you experience symptoms, rating scales to monitor the intensity of your feelings. A quick search on Google or Pinterest such as “anxiety symptom tracker” or “thought record” will yield many results for a chart or log to print off and start using right away.

• Online programs: There are many different apps nowadays that can support with positive

  wellbeing and mental health. Anxiety Canada has created an online program “My

  Anxiety Program (MAP)” geared towards children and youth, see more information here:

  • https://maps.anxietycanada.com/courses/anxiety-plan-children-teens/

See my next post about common positive coping skills that can help to bring the body and mind back to its happy normal resting state, aka “homeostasis”.

References

Boyle, M. M. (2012). The dynamic of stress. Journal of the Australian-Traditional Medicine Society, 18(2), 81–83.

Daley, M. M., & Reardon, C. L. (2024). Mental Health in the Youth Athlete. Clinics in Sports Medicine, 43(1), 107–126. https://doi.org/10.1016/j.csm.2023.06.003

Hale, A. E., Ginsburg, G. S., Chan, G., Kendall, P. C., McCracken, J. T., Sakolsky, D., Birmaher, B., Compton, S. N., Albano, A. M., & Walkup, J. T. (2018). Mediators of Treatment Outcomes for Anxious Children and Adolescents: The Role of Somatic Symptoms. Journal of Clinical Child and Adolescent Psychology, 47(1), 94–104. https://doi.org/10.1080/15374416.2017.1280804

Weersing, V. R., Rozenman, M. S., Maher-Bridge, M., & Campo, J. V. (2012). Anxiety, Depression, and Somatic Distress: Developing a Transdiagnostic Internalizing Toolbox for Pediatric Practice. Cognitive and Behavioral Practice, 19(1), 68–82. https://doi.org/10.1016/j.cbpra.2011.06.002