After dealing with something that spikes your anxiety — a tense work meeting, a fight with a significant other, saving your cat from diving out your third-floor window — you may feel like your breakfast is coming back up to say hello. Nausea is a pretty common side effect of anxiety, but why would dealing with stress make you want to hurl?

“The reason stress, anxiety, or even fear can cause digestive issues is because our gut and our brain actually communicate with each other through a direct pathway called the gut-brain axis,” Dr. Jaclyn Tolentino M.D., a physician at medical provider Parsley Health, tells Bustle. This allows the brain to send signals to the gut and vice versa. “These signals can influence a variety of things, from a heightened appetite and mouth-watering response when our brain first registers the sight of a delicious meal, to stomach cramps when we're facing a tense situation or tight deadline at work,” Dr. Tolentino says.

Those cramps are one culprit behind the waves of nausea you might feel when you’re anxious. “High levels of anxiety can shift our body into fight-or-flight mode, the body's response to intensely stressful situations,” Dr. Tolentino says. Fight-or-flight mode does many things, including raising your breathing rate and sending blood to your muscles to help you run away, but it also releases the stress hormone cortisol into your bloodstream. That can end up making the muscles around your stomach cramp, creating the feeling that the contents are about to reappear in Technicolor.

Your abdominal muscles may also tense when you’re anxious, which can be uncomfortable for your stomach; it’s the same mechanism that makes you feel a little sick when you do a bunch of intense crunches in a row.

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A lot of anxiety over a long period of time can make you more susceptible to gut issues in general, including nausea. “Chronic exposure to stress, and the hormones associated with the stress response, can also disrupt the gut microbiota — which can be another contributing factor in gastrointestinal discomfort,” Dr. Tolentino says. The Anxiety & Depression Association of America (ADAA) notes that when you’re anxious, cortisol enters your digestive tract, when it can interfere with your gut flora and decrease antibody production. A study published in 2018 in PNAS found that chronic anxiety can make you more likely to develop gastrointestinal conditions, and can also irritate the lining of your stomach, making it vulnerable to small disturbances like cortisol spikes.

Dealing with anxiety-induced nausea can mean jogging on the spot, drinking water, or taking stomach-settling medication like Pepto-Bismol, but as it’s a symptom of anxiety issues, those also need attention. It may be a good idea to see your doctor or a mental health professional to figure out ways to reduce your anxiety responses, through deep breathing, meditation exercises, and therapy.


Dr. Jaclyn Tolentino M.D.

Studies cited:

Appleton, J. (2018). The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health. Integrative medicine (Encinitas, Calif.), 17(4), 28–32.

Foster, J. A., Rinaman, L., & Cryan, J. F. (2017). Stress & the gut-brain axis: Regulation by the microbiome. Neurobiology of stress, 7, 124–136.

Gao, X., Cao, Q., Cheng, Y., Zhao, D., Wang, Z., Yang, H., Wu, Q., You, L., Wang, Y., Lin, Y., Li, X., Wang, Y., Bian, J. S., Sun, D., Kong, L., Birnbaumer, L., & Yang, Y. (2018). Chronic stress promotes colitis by disturbing the gut microbiota and triggering immune system response. Proceedings of the National Academy of Sciences of the United States of America, 115(13), E2960–E2969.

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