ALPIMS • Anxiety & Autonomic
What feels closest right now?
Worried, physically unsettled, overloaded—or unsure?
Choose one description below. You can begin with a small support while you work out what else you may need.
You do not need to explain everything first.
In Australia, call 000 for severe or worsening chest pain, severe breathing difficulty, or a racing heart with chest pain, breathlessness, dizziness or fainting. Elsewhere, use your local emergency number. Do not assume these symptoms are anxiety.
Read healthdirect’s urgent adviceA small check-in
Open whichever feels most relevant. More than one can fit.
My mind is worried or expecting something bad “What if…?” • uncertainty • fear • repeated checking
Name the concern in one sentence: “I am worried about ______.”
Ask: “Is there one useful action for now, or do I need support with the feeling?”
A little more support
If there is a practical problem, choose one manageable step. You do not need to solve every possibility.
If no action is needed now, write the concern down and choose a later time to consider it. A trusted person may help you work out the next step.
Persistent anxiety that affects daily life deserves care. Talking therapies and other treatments can be discussed with a health professional.
My body feels shaky, racing or unsettled Palpitations • sweating • nausea • internal trembling
Pause what you are doing and find a safe, supported position.
If this is a familiar, assessed pattern, follow your agreed care plan.
What might be relevant?
Anxiety can cause bodily symptoms. Similar sensations can also have medical causes. The feeling alone cannot tell you which explanation fits.
New, changing or recurring symptoms need medical advice. Tell your clinician when they happen, how long they last and what else occurs with them.
You can receive support for fear while your physical symptoms are assessed.
I feel worse when standing or sitting upright Light-headed • faint • racing heart • better lying down
If you feel faint, stop and sit or lie down safely. Ask for help if needed.
Avoid pushing through or standing up repeatedly to test yourself.
Why the pattern matters
Symptoms repeatedly triggered by being upright can occur with orthostatic intolerance, including POTS or a fall in blood pressure. This check-in cannot identify the cause.
Tell your GP whether symptoms improve when you lie down. They may assess your heart rate, blood pressure and other possible causes.
If you already have a diagnosis, use your individual plan. Changes to salt, fluids, compression or medication should fit your medical circumstances.
There is too much input or too much happening Noise • bright light • demands • conversation • change
Reduce one demand: pause a conversation, lower the noise or move somewhere quieter if possible.
You can say: “I need a little less input before I can think about this.”
Choose what feels comfortable
Quiet, softer light, fewer questions or familiar surroundings may feel more manageable.
Grounding does not have to involve naming lots of things or scanning your body. You might simply look at one familiar object or listen to a calm voice.
Skip breathing exercises or body-focused techniques if they make you feel more distressed or dizzy. Reducing demands is also a valid starting point.
Something feels threatening or reminds me of the past Alarm • feeling trapped • memories • a difficult interaction
Check your surroundings: “Am I safe here, and do I need space or help?”
If you are safe, you might gently name where you are and who you can contact.
Support without forcing an explanation
You do not need to explore painful memories while overwhelmed. A pause, distance from a difficult interaction or a trusted person may be more useful now.
If you are currently unsafe, practical safety and help come first.
Recurring trauma-related distress deserves support from a qualified professional. Physical symptoms can also need assessment alongside that care.
I am not sure—or several things fit You can begin without choosing a cause
A comfortable position, less noise, a pause in demands or someone to sit with you.
If symptoms are new or concerning, seek medical advice rather than relying on this page.
A few gentle questions
- Is this familiar, or different from usual?
- Did it begin after standing, a demand or a stressful event?
- What would make the next few minutes more manageable?
You do not need to answer all three. Avoid repeated checking if it makes you feel worse.
How does this fit the Anxiety / Autonomic domain? A short explanation—only if you want it
This ALPIMS domain brings together experiences involving worry, fear, arousal and autonomic symptoms. Grouping them together does not mean they share one cause.
The autonomic nervous system helps manage functions such as heart rate and blood pressure. Anxiety and autonomic conditions can produce some similar sensations.
Feeling anxious does not settle the cause of a bodily symptom. Having a physical condition does not remove the need for emotional support.
Pain, poor sleep, sensory demands and other health concerns may also be relevant. Support should fit the person, their symptoms and their available capacity.
Read about bodily symptoms, anxiety and trauma overlap →What is one next step?
Keep the helpful adjustment, ask for support, or arrange assessment if the pattern needs investigating.
You do not need to feel completely calm before asking for what you need.
Sources & further reading
The check-in choices are practical prompts, not a validated screening or diagnostic tool.
ALPIMS is an organising framework, not a medical diagnosis. This page provides general information and optional support ideas. It cannot determine the cause of symptoms or replace individual medical or mental health advice. Follow your agreed care plan and seek assessment for new, persistent or changing symptoms.