Notice how anxiety may be showing up,
understand what may be contributing,
and find a response that fits what you need right now.
Anxiety can involve thoughts, feelings,
physical sensations and behaviour.
It can also overlap with sensory overload,
pain, illness, autonomic symptoms,
neurodivergence and reduced capacity.
Choose the area that feels closest.
You do not need to work through the guide in order,
and more than one area may be relevant.
Anxiety may not be the whole explanation.
You can feel anxious and also be exhausted,
in pain, sensory overloaded,
autonomically activated,
unwell or dealing with too much demand.
ALPIMS encourages a
both / and
approach rather than assuming every symptom
has one cause.
WHY ANXIETY CAN BUILD
Anxiety can create a feedback loop
The exact pattern varies,
but physical sensations,
thoughts and behaviour
can influence each other.
1
Something happens
A situation,
body sensation,
memory,
uncertainty
or thought appears.
2
It feels threatening
Your brain may predict danger,
loss, failure,
illness or something going wrong.
3
Activation rises
Heart rate,
breathing,
muscle tension
and vigilance may increase.
4
The symptoms become evidence
The stronger sensations
can then make the danger
feel even more convincing.
But this is not the only possible cycle.
Physical illness,
pain,
sensory overload,
autonomic dysfunction
and low capacity can also trigger body sensations
that then become frightening.
What might help right now?
Different anxiety states need different responses.
Sometimes regulation helps.
Sometimes the most useful thing
is changing the environment,
reducing demand
or dealing with a practical problem.
Regulate
Help your system move toward
a more manageable state.
Anxiety may be important,
but it often sits alongside
other physical,
sensory
and psychological factors.
Anxiety & Autonomic
Anxiety can activate the autonomic nervous system,
while autonomic symptoms can also feel anxiety-like.
Laxity & Connective Tissue
Pain,
fatigue
and autonomic concerns
may overlap with connective-tissue conditions.
Pain & Bodily Sensitivity
Pain,
migraine
and uncomfortable sensations
can increase vigilance and distress.
Immune & Inflammatory
Illness,
post-viral symptoms
and inflammatory load
can reduce overall capacity.
Mood & Mental Health
Worry,
trauma,
stress
and low mood
can interact with anxiety.
Sensory & Neurodevelopmental
Sensory overload,
uncertainty,
executive demand
and communication load
can increase activation.
IMPORTANT OVERLAP
Anxiety and autonomic dysfunction can look similar
The autonomic nervous system helps regulate
automatic body functions including heart rate,
blood pressure,
sweating,
digestion
and temperature regulation.
Anxiety can activate this system,
but autonomic dysfunction can also create
similar physical symptoms.
Can occur with anxiety
Racing heart
Shakiness
Sweating
Breathlessness
Digestive changes
Dizziness
Feeling highly activated
May also occur with autonomic dysfunction
Fast heart rate or palpitations
Light-headedness when upright
Standing intolerance
Exercise intolerance
Brain fog
Fatigue
Temperature-regulation changes
Similar symptoms do not necessarily mean the same cause.
Anxiety may be present,
autonomic dysfunction may be present,
both may occur together,
or another health issue may be involved.
Persistent,
new
or unexplained symptoms
deserve appropriate assessment.
ALPIMS • ANXIETY GUIDE
What feels relevant?
Open anything that sounds close.
Each section gives you
a little more information
and one place to start.
Useful supports to consider
Related ALPIMS domains
Suggested tools & articles
You do not have to challenge every anxious thought.
Sometimes the most useful response
is reducing sensory input,
getting more information,
meeting a physical need,
asking someone for help,
resting,
or making the situation itself easier.
A strategy that works in one situation
may not fit another.
The aim is to match the response
to what is actually happening.
A USEFUL ALPIMS QUESTION
“What is anxiety asking me to do —
and what does my body or situation actually need?”
Important
This page provides general educational information
and self-help ideas.
Anxiety can cause strong physical symptoms,
but physical symptoms can also have other causes.
New,
severe,
persistent
or significantly changing symptoms
should not automatically be assumed to be anxiety.
Seek appropriate medical,
psychological
or allied-health support where needed.
Understand what may be happening,
notice patterns and find practical ways to respond.
You do not need to work through this guide from beginning to end.
Tap a section for a quick explanation, practical tips,
neurodivergent adaptations, related ALPIMS domains
and suggested tools or articles.
Current full section: Symptoms of anxiety
SECTION 2 OF 21
You do not have to complete the guide in order.
Start with the part that seems most useful today.
TAP A BOX FOR INFORMATION + TIPS
Anxiety Navigate
Each coloured section opens a quick guide.
Use as much or as little as you need.
8–10Sections to addTitles not supplied yet
About this adapted guide:
Section 2 is based on the symptom material supplied for this page.
The additional tips, neurodivergent adaptations,
ALPIMS domain links and suggested tools are ALPIMS additions.
Sections whose original source text was not supplied are presented
as short ALPIMS-style summaries rather than reproductions
of the original guide.
SECTION 2 OF 21
Symptoms of anxiety
Anxiety can show up through feelings,
physical sensations, thoughts and behaviour.
You may notice some of these rather than all of them.
QUICK CHECK-IN
Do I have symptoms of anxiety?
Do you spend large periods of the day worrying?
Do you feel nervous, apprehensive or on edge?
Do you often experience unpleasant physical sensations
such as butterflies in your stomach,
tense muscles, dizziness or breathlessness?
Do you find it hard to relax and switch off?
If you answered yes to any of these,
you may be experiencing symptoms of anxiety
and may find parts of this guide helpful.
TAP A BOX
How is it showing up?
Choose the part that seems most relevant.
Each opens symptoms, practical ideas,
and neurodivergent adaptations.
FEELINGS
How anxiety might feel
On edge
Nervous
Panic
Stressed
Scared
Overwhelmed
Irritable or lacking patience
Uptight
What may help?
Open only the idea that seems useful.
Name what you are feeling
Sometimes moving from
“everything is wrong”
to something more specific
can reduce confusion.
Scared?
Overwhelmed?
Angry?
Uncertain?
Frustrated?
Exhausted?
Neurodivergent adaptation
If naming emotions is difficult,
you do not need to identify the perfect feeling.
Try broader categories such as:
good / bad / too much / low / activated / shut down / unsure.
Reduce what is adding load
Strong emotions can become harder to manage
when the system is already overloaded.
Reduce noise or conversation.
Pause a non-urgent demand.
Move somewhere quieter.
Reduce decisions.
Ask someone else to handle one task.
Neurodivergent adaptation
What looks like anxiety may sometimes be
sensory overload, demand overload,
uncertainty or loss of processing capacity.
Reducing the load may be more useful
than asking yourself to “calm down”.
Regulate before problem-solving
When emotion is intense,
the immediate goal may be to make
the moment more manageable.
Grounding
Orienting
Rhythm or movement
Sensory regulation
Co-regulation
Neurodivergent adaptation
Regulation does not have to mean
sitting still, breathing deeply
or maintaining eye contact.
Movement, stimming, quiet,
familiar sensory input or fewer words
may work better.
Ask for support
Another person may help by:
staying nearby
using fewer words
helping with one practical task
reducing uncertainty
giving clear choices
Neurodivergent adaptation
Support does not need to involve
talking through feelings.
Practical help,
predictable information
and calm presence may be more useful.
Before assuming a sensation is only anxiety,
check whether something physical needs attention.
Food or fluids?
Too hot or too cold?
Pain?
Fatigue?
Need to sit or lie down?
Illness or another symptom?
Neurodivergent adaptation
Interoception can vary.
Some people notice body signals
very strongly, while others may not notice
hunger, thirst, pain or fatigue
until they are intense.
A checklist may be easier
than relying on “feeling what your body needs”.
Reduce nervous-system activation
Depending on what suits your body,
you might try:
reducing stimulation
orienting to the room
comfortable slower breathing
gentle rhythm or movement
resting in a supported position
Neurodivergent adaptation
Breath-focused exercises are not comfortable
for everyone.
If breath awareness increases panic,
body monitoring or dizziness,
try external orienting,
movement or sensory regulation instead.
Consider autonomic overlap
Symptoms such as:
racing heart
dizziness
sweating
fatigue
brain fog
temperature difficulties
can overlap with autonomic dysfunction.
Anxiety and autonomic symptoms
can also occur together.
When to get more help
New, severe, persistent
or unexplained physical symptoms
should not automatically be assumed
to be anxiety.
Appropriate medical assessment
may be needed.
Try describing it as a thought
rather than immediately treating it as a fact.
For example:
“I am having the thought
that something bad is going to happen.”
Neurodivergent adaptation
If abstract thought work is difficult,
write the thought down exactly as it appears.
You do not need to analyse it immediately.
Fact, possibility or prediction?
Ask:
What do I know for certain?
What am I predicting?
Is there another possible explanation?
Am I treating uncertainty as danger?
Neurodivergent adaptation
Open-ended questions can be hard.
Try three boxes instead:
KNOW / MAYBE / DON’T KNOW YET
Solve what can actually be solved
If there is a practical problem,
identify one next step.
If the question cannot be answered now,
repeated thinking may not create
more certainty.
Neurodivergent adaptation
Executive-function difficulties can make
an unfinished problem feel especially urgent.
Externalise it:
write it down,
make one next-step box,
or ask another person to help structure it.
Check the body and environment too
Strong physical symptoms,
exhaustion or sensory overload
can make anxious thoughts feel
more convincing.
Sometimes reducing body
or environmental load
makes thinking clearer.
Thought Challenge Tool — Coming soon
Worry or Problem? — Coming soon
WHAT I DO
Things anxiety may lead you to do
Avoid doing things that make you anxious
Find it hard to relax
Snap at people easily
Avoid people or things you would normally enjoy
Talk very quickly
What may help?
Ask what the behaviour is doing for you
Behaviour often makes more sense
when you understand its function.
Am I trying to escape fear?
Am I reducing sensory overload?
Am I exhausted?
Am I trying to create certainty?
Neurodivergent adaptation
What looks like “avoidance”
may sometimes be a response to:
sensory overload,
social processing demand,
executive dysfunction,
unclear expectations
or depleted capacity.
Work out the function before deciding
the behaviour needs to change.
Avoidance or protection?
Not all avoidance is the same.
Fear-driven avoidance
can sometimes make life smaller.
But reducing genuine sensory overload,
pacing around illness
or avoiding unsafe situations
can be appropriate.
Neurodivergent adaptation
Do not automatically treat
sensory protection,
need for routine,
communication breaks
or reduced social exposure
as anxiety behaviours.
Try a smaller step
If something is safe
but anxiety is stopping you,
make the challenge smaller.
Shorter duration
More support
More predictability
A quieter environment
Recovery afterwards
Neurodivergent adaptation
Adapt the environment
before increasing the challenge.
Success does not require doing the task
in the same way as everyone else.
If you are snapping or talking very quickly
These can be signs that your system
is highly activated or overloaded.
Reduce words,
pause the conversation,
reduce demands
and return to the issue later.
Neurodivergent adaptation
Processing may decrease during overload.
Written communication,
extra response time,
fewer questions
or temporary silence
may help.
Anxiety does not always sit neatly in one box.
Thoughts and emotions matter,
but so can the nervous system,
physical symptoms,
sensory load,
illness,
pain,
capacity and the environment.
Anxiety & Autonomic
Anxiety can activate the autonomic nervous system,
while autonomic dysfunction can independently
produce overlapping physical symptoms.
Sensory & Neurodevelopmental
Noise, light, uncertainty,
social processing, executive load
and sensory overwhelm may increase distress.
Pain & Bodily Sensitivity
Pain, migraine and uncomfortable body sensations
can increase vigilance,
worry and nervous-system load.
Immune & Inflammatory
Illness, post-viral symptoms
and inflammatory load can affect energy,
sleep, cognition and resilience.
Laxity & Connective Tissue
Hypermobility-related symptoms can overlap
with pain, fatigue and autonomic concerns.
Mood & Mental Health
Worry, fear, trauma,
low mood, stress and learned patterns
may influence anxiety.
Anxiety and neurodivergence
Anxiety can look different in autistic,
ADHD and other neurodivergent people.
What appears to be anxiety may sometimes involve
sensory overload, uncertainty,
executive-function demand,
communication load,
interoceptive differences
or accumulated exhaustion.
Reduce sensory and cognitive load
before assuming another coping skill is needed.
Use clear, concrete language
rather than vague reassurance.
Allow extra processing time.
Adapt grounding and mindfulness
if body-focused attention is uncomfortable.
Do not automatically treat stimming,
need for routine,
reduced eye contact,
withdrawal or sensory protection
as anxiety behaviours.
Ask whether the environment
can be adapted before expecting
the person to tolerate more.
IMPORTANT OVERLAP
Anxiety and autonomic dysfunction can look similar
The autonomic nervous system helps regulate
automatic body functions such as heart rate,
blood pressure, sweating,
digestion and temperature regulation.
Anxiety can activate this system.
Autonomic dysfunction can also produce
physical symptoms independently of anxiety.
Symptoms that can occur with anxiety
Racing or pounding heart
Shakiness
Sweating
Breathlessness
Digestive changes
Dizziness
Feeling highly activated
Symptoms that may also occur with autonomic dysfunction
Fast heart rate or palpitations
Light-headedness when upright
Standing or exercise intolerance
Brain fog
Fatigue
Sweating or temperature changes
Digestive symptoms
The important distinction
Similar symptoms do not necessarily mean
the same underlying cause.
Anxiety may be present,
autonomic dysfunction may be present,
both may occur together,
or another explanation may be involved.
Persistent or unexplained symptoms
deserve appropriate assessment rather than
being automatically attributed to anxiety.
AN ALPIMS QUESTION
Instead of only asking “Is this anxiety?”
it may help to ask:
What am I feeling emotionally?
What is happening in my body?
Is my nervous system highly activated?
Is sensory load contributing?
Has demand exceeded my current capacity?
Is uncertainty or executive load making this harder?
Is there a physical symptom
that needs separate attention?
Anxiety & Autonomic Dysfunction
A guide to overlapping physical symptoms.
Coming soon
Is This Anxiety, Overload or Both?
A quick ALPIMS comparison tool.
Coming soon
Anxiety & Neurodivergence
Adapt anxiety support for autistic,
ADHD and other neurodivergent people.
Coming soon
My High-Activation Plan
What to check,
what helps,
and when to get more support.
Coming soon
Important:
This guide provides general educational information
and self-help ideas.
Anxiety can cause physical symptoms,
but physical symptoms can also have other causes.
New, severe, persistent or concerning symptoms
should not automatically be assumed to be anxiety.
Seek appropriate medical,
psychological or allied-health support where needed.