Anxiety symptoms in women: Causes, coping strategies, and more

by Kaiser Permanente |
Young woman looking out a window and contemplating

If you’re a woman struggling with anxiety, you’re not alone. Anxiety disorders are the most common mental health conditions. Nearly half of U.S. adults have symptoms of anxiety. And anxiety disorders are more than twice as common in women as in men. But despite being so common, anxiety in women is often misunderstood or overlooked.

Here’s what you should know about anxiety symptoms in women — including what makes anxiety in women unique, treatment options, and self-care strategies.

What is anxiety?

Everyone experiences anxiety from time to time. It’s a feeling of worry, unease, or nervousness. You can also feel physical changes in your body, like a racing heart.

But for people with anxiety disorders, it’s more than occasional worry. Their anxiety becomes overwhelming and doesn’t go away.

4 major types of anxiety disorders

Generalized anxiety disorder (GAD) is when people worry too much about everyday issues — even when there’s no reason to worry.

Panic disorder is when people have frequent panic attacks. These are sudden feelings of terror when there’s no danger. Physical symptoms like chest pain are common. This can make panic attacks feel like heart attacks.

Social anxiety disorder is when people get very nervous in ordinary social situations. They often fear being watched and judged by others.

Specific phobia is an intense fear of things that pose little to no actual threat. For example, some people fear closed-in spaces, water, or heights.

What are the signs of anxiety in women?

Anxiety shows up differently in different people. Many women experience a range of symptoms. These may include:

  • Persistent worry
  • Feeling irritable or nervous
  • Increased heart rate
  • Breathing rapidly
  • Sweating and/or trembling
  • Muscle tension
  • Headaches
  • Feeling weak or tired
  • Difficulty concentrating 
  • Trouble sleeping
  • Gastrointestinal (GI) problems

It’s important to note that while anxiety and panic attacks share similar symptoms, they can have different causes. Anxiety usually has specific triggers, like a stressful event. Panic attacks don’t always have a specific trigger. They can happen unexpectedly and suddenly. They can also be more intense. 

What triggers anxiety in women?

Anxiety is caused by a combination of factors in both women and men. Family history plays a role. So do everyday concerns like work, finances, and trying to manage stress. Traumatic events can also trigger anxiety. But certain causes of anxiety are unique to women.

Hormonal changes

Hormones fluctuate during the menstrual cycle, pregnancy or postpartum, perimenopause, and menopause. These hormonal shifts impact your brain chemistry and can cause changes in your mood. This can have a tremendous impact on anxiety levels.

“Pregnancy can bring both joy and worry, sometimes heightening anxiety, while the postpartum period can be a vulnerable time for new or stronger anxious feelings,” says Dr. Karen R. Stewart, a psychiatrist at Kaiser Permanente. “During perimenopause and menopause, shifting hormones can trigger mood swings and anxiety.”

Societal and cultural expectations

Women have historically been more likely to be caregivers. They may be expected to take on the bulk of both raising children and caring for older family members. Women may feel they can’t spend time prioritizing their own well-being.

On the other hand, women who don’t have kids or marry may feel judged for those choices. It’s a double-edged sword. Both situations can cause or worsen anxiety.

“One of the biggest stressors for women is pressure to be partnered and have children,” says Dr. Stewart. “If a woman hasn’t done that — or doesn’t want to — they often worry about managing other people’s expectations. This can lead to anxiety.”

Social pressures and perfectionism

Women are also conditioned to prioritize the needs of others. They’re encouraged to “keep it together” at all times. And many women fear being seen as unstable if they don’t. They often feel responsible for managing relationships and household tasks. The push to “do it all” can lead to perfectionism — and to internalizing stress. It’s a recipe for anxiety.

These competing pressures create a vicious cycle. As Dr. Stewart explains, “Many women deal with anxiety by trying to manage all the possibilities. They work hard to stay ahead of anything that could go wrong. They overthink. They overprepare. But because you can never prepare for all scenarios, it may make anxiety worse.”

It can also feel like struggling with anxiety is part of everyday life. But if your symptoms are making it difficult to function or if they feel overwhelming, you can get the help you need.

Is it anxiety, or something else?

One of the most frustrating things for women living with anxiety is misdiagnosis. Sometimes a problem is physical. Sometimes it’s mental. And sometimes it’s both.

Anxiety is often misdiagnosed as a physical condition

Anxiety causes physical symptoms. These might closely mimic common conditions like irritable bowel syndrome, migraines, and heart conditions. So looking for physical health problems makes sense. But many symptoms overlap. Anxiety should never be overlooked as a cause or contributing factor.

Physical conditions are often misdiagnosed as anxiety

On the flip side, sometimes women’s physical health problems are mislabeled as anxiety. While a physical health issue like a migraine may lead to anxiety, it’s not necessarily caused by anxiety.

Nobody wants to hear that the symptoms they feel in their body are in their head. So trust your instincts. Ask questions. And get a second opinion if you need one.

The right care team makes all the difference

“When a woman comes in with physical symptoms that may indicate anxiety, of course we want to rule out underlying medical issues. But we really need to consider all possible causes,” explains Dr. Stewart. “That’s why having mental health embedded in primary care is so important. We can treat the whole person.”

When primary care doctors and mental health clinicians work together, they can do more to help you.

What to do if you’re experiencing anxiety

If anxiety is interfering with your daily life, talk to your doctor. You don’t have to wait to be at your breaking point. Seeking help is a sign of strength. Here are some things you can do to make the conversation easier:

  • Keep track of symptoms. Record what you’re experiencing and when. This can help your doctor spot patterns and create a treatment plan.
  • Think about your triggers. Like with your symptoms, take note of specific events, places, or thoughts that trigger or make your anxiety worse.     
  • Ask specific questions. Sometimes it’s as simple as asking if symptoms might be related to anxiety. It’s OK to ask. That’s why your care team is there.

You should always feel safe talking to your doctor about your concerns.

What’s the best treatment for anxiety?

Anxiety can be managed with the right support. But everyone experiences anxiety differently. There’s no one-size-fits-all treatment. And that’s a good thing. Your treatment should be tailored to your needs.

Your doctor may recommend lifestyle changes, therapy, or medication — or a combination. These things can help you manage your symptoms and find some relief.

Clinical support from your doctor

  • Therapy: Many women with anxiety benefit from therapy. Individual and group therapy can both be helpful. As Dr. Stewart explains, “Things like cognitive behavioral therapy can help women understand their thoughts, moods, and behaviors. It can help build coping skills and foster resilience. And that can go a long way in managing anxiety.”
  • Medication management: Some women with moderate to severe anxiety may need medication. Your doctor can explain your options if they think medication might help you.

Lifestyle changes you can make on your own

  • Physical activity can help reduce anxiety symptoms. Even just 5 or 10 minutes of exercise can help.  
  • Sleep is disrupted by anxiety. And poor sleep makes anxiety worse. Prioritizing sleep is essential. Start with a calming bedtime routine. And aim for a consistent sleep schedule.
  • Nutrition impacts all aspects of health. Eating a balanced diet is always a good idea. Limiting caffeine and alcohol is also smart. While they may provide temporary relief, they can worsen anxiety symptoms over time.
  • Self-care activities like deep breathing can help quiet your mind. Or you can try digital apps that offer mindfulness exercises, meditations, and more.*
  • Asking for help is essential. Dr. Stewart highly recommends unloading stress instead of just managing it. “There’s no badge of honor for being Superwoman,” she urges. “I encourage my patients to let go of the idea that they need to ‘do it all.’ It only leads to burnout. Accepting help is an important form of self-care.” Remember that the people in your life are there for a reason. Give them permission to help where they can.

Anxiety in women is a response to stress, biology, and lived experiences. It’s common and treatable. It’s also complicated. But the more you know about it, the more you can do to manage it. Remember that mental health support is available, and it works. If you’re struggling with anxiety, you’re not alone. And you deserve compassionate care and support.

*The apps and services described above are not covered under your health plan benefits, are not a Medicare-covered benefit, and are not subject to the terms set forth in your Evidence of Coverage or other plan documents. The apps and services may be discontinued at any time.

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