Anxiety Sensitivity: When Anxiety About Anxiety Keeps You Stuck
The start of a panic attack often begins with noticing a physical sensation.
"The fluorescent lights in the grocery store are making me feel like I'm not real. Am I losing my mind?"
"I notice my heart starting to beat faster. What if something is seriously wrong with me?"
For many people, it isn't the physical sensation itself that causes panic—it's the meaning they attach to that sensation.
What Is Anxiety Sensitivity?
Anxiety sensitivity is the tendency to interpret the physical symptoms of anxiety as signs of danger. These symptoms can include sweating, shaking, dissociation, gastrointestinal symptoms, heart palpitations, dizziness, and rapid breathing.
People with anxiety sensitivity often misinterpret these sensations as evidence that they are about to lose control, become incapacitated, or experience a serious medical or psychological emergency. They may believe that anxiety itself can cause social, physical, or psychological harm.
Common Examples of Anxiety Sensitivity
Social Harm
"If my boss notices me stuttering because I'm anxious, they'll think I'm incompetent."
"If I get sweaty on this date, the other person will think I'm an anxious mess."
Physical Harm
"I'm breathing really hard right now. What if I hyperventilate, pass out, hit my head, and I'm never the same again?"
"If my heart rate goes above a certain number, I'll have a heart attack or a medical emergency."
Psychological Harm
"I feel dissociated while driving. What if I lose control of my mind and crash the car?"
"My thoughts are racing so fast. Am I going crazy? Should I go to the hospital for a psychiatric emergency?"
Anxiety Sensitivity and Anxiety Disorders
Many people with anxiety disorders—including panic disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD)—experience anxiety sensitivity.
Research suggests that addressing anxiety sensitivity in therapy can improve treatment outcomes and may help support lasting recovery. Studies have found that anxiety sensitivity predicted treatment outcomes in individuals receiving treatment for OCD (Anxiety sensitivity as a predictor of outcome in the treatment of obsessive-compulsive disorder; Blakey, Abramowitz, Reuman, Leonard, & Riemann, 2019).
How Do You Reduce Anxiety Sensitivity?
The good news is that there are several evidence-based approaches that can help.
1. Educate Yourself Through Trusted Sources
In OCD treatment, we often encourage people to tolerate uncertainty and resist reassurance-seeking. However, if you don't have accurate information in the first place, seeking education is not reassurance-seeking—it's information-seeking.
For example, imagine you are afraid of choking on a prescription medication and dying. It may be reasonable to learn about the anatomy of the airway and why pill aspiration is extremely uncommon.
If you have the fear of choking on a pill it would help to know that the adult trachea is approximately 1.5–2 cm in diameter and is supported by cartilaginous rings that help keep the airway open. Understanding how the airway functions can provide important context when evaluating fears about swallowing medication.
It is reasonable to educate yourself about sensations that distress you so that you have the information needed to evaluate your fears accurately. We are often exposed to misinformation about health, anxiety, and the human body. Talking with a trusted medical professional or reviewing reliable sources can help you better understand what is happening.
Knowledge can be empowering. When you understand how your body works, you can ground yourself in science rather than fear.
Instead of:
"What if I choke on this pill?"
You may be able to shift toward:
"I understand why this feels uncomfortable, but I also know that pill aspiration is very unlikely. This sensation is unpleasant, but it is not dangerous."
2. Practice Interoceptive Exposure
Once you understand that a sensation is safe and unlikely to result in a dangerous outcome, you can begin practicing interoceptive exposures.
Interoceptive exposure is a type of exposure therapy that targets the fear of physical sensations associated with anxiety.
For example:
If you fear a rapid heartbeat, you might do jumping jacks, run in place, climb stairs, or do burpees.
If respiratory sensations trigger anxiety, you might practice breathing through a straw, intentionally breathing faster than usual, or briefly holding your breath.
If dizziness is a trigger, you might spin in a chair or shake your head side to side.
A therapist trained in exposure therapy can help identify the sensations that trigger your anxiety and create exercises that safely recreate those sensations.
The goal is not to get rid of the sensations. The goal is to learn through experience that they are uncomfortable but not dangerous.
After an exposure exercise, it can be helpful to debrief:
What happened physically?
Did your feared outcome occur?
Did your anxiety continue rising indefinitely, or did it eventually decrease?
What did you learn about your body's ability to recover?
Discussing these observations can help challenge beliefs that may be maintaining anxiety and build confidence in your ability to tolerate uncomfortable sensations.
3. Engage in Aerobic Exercise
Another strategy that has been shown to reduce anxiety sensitivity is aerobic exercise.
Research suggests that even relatively modest amounts of aerobic exercise can decrease anxiety sensitivity. Some studies have found benefits from as little as 20–30 minutes of jogging several times per week. Other research suggests that higher-intensity exercise may produce even greater reductions in anxiety sensitivity.
This makes sense when viewed through the lens of interoceptive exposure.
Exercise naturally creates many of the same sensations people fear during panic:
Increased heart rate
Heavier breathing
Sweating
Muscle fatigue
Lightheadedness
The more experience you have with these sensations in a safe context, the more opportunities you have to learn that they are normal, healthy, and temporary.
Research supporting the role of exercise in reducing anxiety sensitivity includes:
Broman-Fulks et al. (2004), Effects of Aerobic Exercise on Anxiety Sensitivity
LeBouthillier & Asmundson (2015), A Single Bout of Aerobic Exercise Reduces Anxiety Sensitivity
Broman-Fulks et al. (2018), Anxiety Sensitivity Mediates the Relationship Between Exercise Frequency and Anxiety and Depression Symptomology
Final Thoughts
If you panic when you notice bodily sensations and worry about embarrassment, losing control, or having a medical emergency, you are not alone. Anxiety sensitivity is a common experience across many anxiety disorders and OCD.
The encouraging news is that anxiety sensitivity is highly treatable. Through education, interoceptive exposure, and regular aerobic exercise, many people learn to relate differently to their physical sensations and regain confidence in their ability to tolerate discomfort.
If anxiety sensitivity is keeping you stuck, consider working with a therapist who is knowledgeable about exposure therapy and interoceptive exposures. With the right support, it is possible to feel more empowered and confident in both your mind and your body.
