Physical vs. Mental Anxiety: Why Understanding the Root Cause Matters

Paula Gallagher on 01/26/2026

Anxiety is often discussed as a single condition — but clinically, it’s much more nuanced.

At Village Green Apothecary, we frequently see individuals who are “doing all the right things” for anxiety — meditation, breathwork, therapy, and supplements — yet still feel wired, panicky, or constantly on edge. In many of these cases, the issue isn’t a lack of psychological resilience. It’s rooted in physiology.

Understanding the difference between mental anxiety and physical (biochemical) anxiety is often a crucial turning point in recovery.

What Is the Difference Between Mental and Physical Anxiety?

Mental (Situational) Anxiety

Mental anxiety is a normal, adaptive response. It’s the nervous energy you feel before a presentation, a big test, or a difficult conversation. This type of anxiety:

Is short-lived
Matches the situation
Resolves once the stressor passes

This response is part of our evolutionary survival system and still plays a useful role today.

Physical (Biochemical) Anxiety

Physical anxiety is different. Symptoms often include:

Chest tightness or shortness of breath
Heart palpitations
Dizziness, shaking, or sweating
Panic attacks that feel disproportionate or “out of nowhere”

This form of anxiety often persists for weeks or months and doesn’t respond well to mindset tools alone — because the root cause is biological, not purely emotional.

Anxiety as a Symptom — Not a Standalone Diagnosis

In functional and integrative care, anxiety is viewed as a symptom of an underlying imbalance — not a diagnosis in itself.

Common physiological root causes include:

Blood sugar instability
Chronic stress and cortisol dysregulation
Nutrient deficiencies
Gut-brain axis dysfunction
Low-grade inflammation

If the biological root causes aren’t addressed, treatment becomes guesswork.

Blood Sugar Imbalances as a Hidden Driver of Anxiety

Hypoglycemia and Panic Episodes

When blood sugar spikes and crashes too quickly, the brain perceives it as an emergency. This triggers the adrenal glands to release cortisol and adrenaline, leading to:

Shakiness
Rapid heartbeat
Irritability or fear
Sudden panic

This is why anxiety often shows up mid-morning, late afternoon, or in the middle of the night.

Insulin Resistance and Neurotransmitter Disruption

Chronically elevated blood sugar can cause insulin resistance, which impairs brain signaling and alters neurotransmitters like dopamine — crucial for mood regulation.

Physical symptoms may include:

Fatigue
Brain fog
Weight gain
Poor motivation or mood instability

Nutrient Deficiencies That Can Mimic Anxiety

The nervous system requires specific nutrients for proper function. A lack of key vitamins and minerals can create or worsen anxiety, even if stress levels are low.

Common nutrient contributors to anxiety include:

Magnesium – Supports GABA and calms the nervous system
Zinc – Critical for neurotransmitter signaling
Vitamin D – Impacts serotonin and dopamine regulation
Iron – Essential for oxygen transport and serotonin synthesis
Omega-3s – Required for brain structure and neurotransmission

At Village Green Apothecary, we offer:

Functional nutrient testing
Expert interpretation by clinicians
Custom-compounded supplements to match your exact needs

The Gut–Brain Axis: How Digestive Health Influences Anxiety

Roughly 70% of serotonin is produced in the gut. An imbalanced microbiome can interfere with:

Neurotransmitter production
Immune signaling
Inflammatory responses

Symptoms of gut-driven anxiety may include:

Mood swings
Panic attacks
Food sensitivities
Digestive discomfort

Our practitioners evaluate digestive health through:

Stool testing and microbiome analysis
Food sensitivity assessments
Inflammation and immune marker testing

Personalized support may include:

Targeted probiotics and botanicals
Gut-healing nutrients
Customized meal planning without harsh elimination diets

Chronic Stress and Brain Chemistry Changes

Prolonged stress doesn’t just feel bad — it physically alters how your brain functions.

Research shows chronic stress can:

Disrupt myelin (nerve insulation)
Impair neurotransmitter production
Alter communication between brain regions

These biochemical changes make anxiety feel “sticky” and hard to shift without physiological support.

Gluten Sensitivity and Inflammatory Anxiety

Even without celiac disease, some individuals experience neuroinflammation triggered by gluten. In sensitive people, gluten can:

Increase intestinal permeability
Trigger immune responses
Promote systemic inflammation

Village Green supports guided elimination and reintroduction — not permanent restriction — using lab results and symptom tracking to assess true gluten sensitivity.

Why Personalized Functional Testing May Be The Key for Anxiety Relief

Anxiety isn’t a single-pathway issue. Generic solutions rarely work.

Our approach includes:

Comprehensive lab testing
Customized supplement formulations
Collaborative care from pharmacists, nutritionists, and integrative practitioners

If your anxiety feels persistent, physical, or unrelated to your life circumstances — it may not be “all in your head.”

It might be:

Metabolic
Nutritional
Gut-driven
Inflammatory
Related to cortisol and stress chemistry

And that means it’s addressable — with the right testing and guidance.

Get to the Root of Your Anxiety — Not Just the Symptoms

→ Book a free 15-minute consultation with a Village Green practitioner to explore whether functional testing, nutrient support, or integrative strategies are right for you.

Frequently Asked Questions About Physical and Mental Anxiety

How can I tell if my anxiety is physical or mental?

Physical anxiety often feels persistent and unrelated to external stressors. It may come with symptoms like rapid heart rate, panic attacks, or insomnia, even during calm moments. Mental anxiety tends to be short-lived and situation-specific.

Can nutrient deficiencies really cause anxiety?

Yes. Deficiencies in magnesium, vitamin D, iron, and other nutrients can impair neurotransmitter function and mimic anxiety symptoms, even when mental stress is low.

How does gut health affect anxiety?

The gut produces around 70% of the body’s serotonin. An imbalanced microbiome can affect mood, immune function, and inflammation — all of which can contribute to anxiety.

What kind of testing is available to uncover root causes?

Village Green offers lab testing for nutrient levels, blood sugar balance, cortisol patterns, microbiome health, inflammation, and more to identify root causes of anxiety.

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Bethesda, Maryland, 20814
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