 Why You Feel That Sinking Feeling and What You Can Do Have you ever had an important meeting, a first date, or an upcoming test that made your stomach feel like it was twisting? That fluttering, uneasy sensation is often called “butterflies in the stomach.” It’s a real physical reaction that happens when you feel anxious or nervous, and you’re definitely not imagining it. What causes this feeling? Why does your stomach respond to your emotions? Most importantly, what can help when the anxiety feels like too much? As psychiatrists, we see this connection all the time. Let’s break it down. The Brain–Gut Connection: Why Your Emotions Show Up in Your Stomach Your brain and your gut are constantly talking to each other through a powerful communication system called the gut-brain axis. This connection helps explain why emotions can cause real, physical symptoms in your digestive system. At the center of this communication is the vagus nerve which is the longest cranial nerve in the body. It acts like a highway between your brain and major organs like your stomach When you feel anxious:
In some people, this signal is stronger or more sensitive. That’s why some feel just a little jittery, while others feel actual stomach pain, nausea, or even diarrhea when they’re nervous. Why Anxiety Feels So Uncomfortable Anxiety is a normal human emotion, but when it becomes too intense or too frequent, it can affect how your mind and body function. Common stomach-related symptoms of anxiety include:
These symptoms can make anxiety worse by creating a cycle: you feel nervous, your stomach reacts, you worry more because of the stomach pain, and the anxiety increases. Over time it can lead to chronic stomach issues, like irritable bowel syndrome (IBS), frequent nausea, or loss of appetite. What Can Help? If you're dealing with frequent anxiety and stomach discomfort, know that you're not alone and there are ways to feel better. 1. Relaxation Techniques Practices like deep breathing, mindfulness, and meditation can help calm the nervous system. These techniques activate the parasympathetic system (the opposite of fight-or-flight) which helps your stomach relax. 2. Physical Activity Exercise, even light movement like walking, reduces stress hormones and promotes digestive health. It can also help release pent-up energy from anxiety. 3. Therapy Cognitive Behavioral Therapy (CBT) is one of the most effective tools for anxiety related stomach issues. It helps you understand how your thoughts affect your body and teaches you how to interrupt the anxiety cycle. 4. Diet and Gut Health Some foods can irritate an already sensitive stomach. Avoiding caffeine, highly processed foods, and carbonated drinks during high-stress times can help. Probiotics may also support gut balance though results vary from person to person. Additional natural strategies to treat a nervous stomach can be found here. Are Medications Helpful? Yes, medication can be a helpful tool, especially when symptoms are interfering with daily life. A psychiatrist may prescribe:
Not everyone needs medication, but for some people, it can make a big difference. Your stomach symptoms are not all in your head. Anxiety has very real physical effects, and psychiatrists are trained to help you treat the problem at its root, not just mask the symptoms. When Should You See a Psychiatrist? If you’re experiencing any of the following, it may be time to talk with a professional:
You don’t have to live with constant stomach pain or that sinking feeling in your gut. Many patients are surprised how quickly symptoms improve once they get the right diagnosis and support. At Your Family Psychiatrist, we specialize in helping people understand these symptoms, get the right treatment, and feel like themselves again. Whether your anxiety shows up in your mind or your stomach, we’re here to help. Request your appointment online today. 
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 You’re about to give a speech. Your heart races, your hands feel clammy, and suddenly your stomach metaphorically flips upside down. You feel quite nauseous. Do you need to run to the restroom? Maybe you just want to crawl into a quiet place and hide? What is that twisting uncomfortable feeling in your gut? It's a nervous stomach. You’re not alone. Why do nervous stomachs happen, how are your mind and body connected, and what can you do to feel better? The Brain-Gut Connection Let’s start with a surprising truth. Your stomach has a "brain" of its own. It’s called the enteric nervous system, and it’s made up of over 100 million nerve cells lining your gastrointestinal tract. This “second brain” doesn’t do much thinking on its own. It does communicate constantly with your actual brain through a pathway known as the gut-brain axis. When your brain feels stress, your gut does too. Think of your brain as sending an alarm signal to your stomach like “Get ready! We’re in danger!” Whether the danger is real (like a car accident) or emotional (like public speaking), your body responds the same way. Blood rushes to your heart and muscles, and your digestive system slows down. This is all part of the body’s fight-or-flight response. The fight-or-flight response is a survival mechanism humans evolved to escape danger. In modern life, “danger” might come in the form of deadlines, exams, financial stress, relationship tension, or social anxiety. Instead of running from a lion, you might find yourself sitting at your desk with a churning stomach. What Does a Nervous Stomach Feel Like? Everyone experiences nervous stomach symptoms a bit differently. Some people describe it as having “butterflies.” Other people say it feels like nausea, bloating, or even cramping. Here's a list of common symptoms:
These symptoms can appear during high-stress events or linger throughout the day. Some mistake it for a stomach virus. It's important to note that a nervous stomach is not the same as conditions like Irritable Bowel Syndrome (IBS), Crohn’s disease, or ulcers. If you have persistent or severe symptoms, you should consider going to the ER or meeting with a gastroenterologist to rule out urgent issues. Why Your Stomach Reacts to Stress Let’s return to that gut-brain axis. When you feel anxious, your brain releases chemicals like cortisol and adrenaline. These stress hormones are powerful. They increase your heart rate, speed up your breathing, and shift blood flow away from digestion. Why? If you’re in danger, your body wants to fight or flee instead of utilizing energy to digest food. Our body has a limited amount of blood and energy. Some of our body's energy utilization can be shifted to better manage certain situations. When food is present, we want blood flow to effectively manage and digest the food properly. If stress goes on for days or weeks, it wears on the digestive system. Food isn't processed efficiently, and it can lead you to feel uncomfortable. That’s when people start noticing more intense or more frequent stomach symptoms. Over time, your gut becomes more sensitive. The relationship goes both ways. Just as stress can make your stomach worse, stomach discomfort can increase your anxiety. It’s a cycle that can spiral unless you learn how to stop it. Common Causes for a Nervous Stomach Everyone has different stress triggers, but here are some of the most common ones:
Understanding your triggers is the first step to managing a nervous stomach. Once you name the source, you can begin to take control. Effective Strategies to Calm a Nervous Stomach How do we calm the stomach when it’s reacting to stress? At Your Family Psychiatrist, we recommend a combination of practical, therapeutic, and when appropriate, medical approaches. Here are some strategies that may help: 1. Slow, Deep Breathing One of the quickest ways to calm your nervous system is through your breath. Slow, deep breathing slows down the fight or flight system in our body. Try inhaling slowly through your nose for four seconds, holding it for four seconds, and then exhaling through your mouth for four seconds. Wait four seconds before repeating this a few times. This breathing with 4 equal steps is called box breathing. 2. Progressive Muscle Relaxation This technique involves tensing and relaxing each muscle group in your body. Start with your feet and move up to your face. This helps shift your focus from anxiety to feeling physically calm. Our muscles also feel more relaxed when stretched gently. 3. Mindfulness and Meditation Practicing mindfulness (being present without judgment) can help break the cycle of anxiety and stomach distress. Phone apps like Calm, Headspace, or even guided videos on YouTube can help you get started with just 10 minutes a day. While some think this sounds silly at first, it is quite effective. The downside is that it is a much harder skill than you think. Meditation involves clearing all thoughts from your brain for multiple minutes at a time. I'm not sure about you, but my brain is good at staying constantly active or attentive to something. 4. Therapy Cognitive Behavioral Therapy (CBT) is one of the most effective treatments for anxiety-related physical symptoms including nervous stomachs. Working with a therapist can help you challenge negative thoughts, identify stress triggers, and learn calming techniques tailored to you. Expect to spend 6+ weeks in therapy to notice a significant difference. 5. Medication In some cases, medication can be helpful. Antidepressants or anti-anxiety medications may reduce overall stress, while antispasmodics or anti-nausea medications can ease stomach symptoms. Always talk to a psychiatrist or primary care doctor before starting medication. Some medications can make stomachs feel worse, especially when taken on an empty stomach. Lifestyle Tips to Support Gut Health if the Pit in Your Stomach Won't Go Away Calming your nervous stomach isn’t just about reacting to symptoms It is also about building a lifestyle that protects your gut and mind. Consider these supportive habits: 1. Eat Gut-Friendly Foods Focus on meals rich in fiber, healthy fats, and fermented foods like yogurt, kimchi, or kefir. Avoid triggers like caffeine, greasy foods, fried foods, artificial sweeteners, and excess sugar which can worsen stomach sensitivity. 2. Stay Hydrated Water helps your digestion stay on track and can reduce the impact of stress on your gut. Aim for six to eight cups per day unless otherwise directed by your doctor. 3. Exercise Regularly Physical activity helps reduce stress hormones, improve digestion, and release natural endorphins. Even a brisk 20-minute walk can make a noticeable difference in your stress levels. Aim for a total of 300+ minutes of exercise each week. 4. Take Breaks Give yourself permission to pause. Short breaks during the day can help prevent nervous system overload. These breaks would be a great time to practice progressive muscle relaxation, meditation, or box breathing. 5. Create a Soothing Routine Winding down at the end of the day is just as important as starting your day strong. A nighttime routine that includes soft lighting, gentle music, reading, or journaling can prepare your body and stomach for rest. Natural Remedies for Treating a Nervous Stomach Many patients ask about natural ways to calm their stomach. While these don’t work for everyone, they’re generally safe to try:
When to Seek Professional Help While a nervous stomach is often linked to stress, you should consult a doctor or psychiatrist if:
There is no shame in seeking help. Nervous stomach symptoms are relatively common. Being open and honest with your physician can lead to productive discussions. Your mental and physical health are deeply connected, and both may need care. One of the most powerful things I can tell you as a psychiatrist is that what you’re experiencing is real. You are not “overreacting.” You’re a human being with a nervous system that’s trying to protect you even if it is over-reacting. A nervous stomach isn’t something you have to suffer through forever. With awareness, self-care, and support, you can learn to calm your body and ease your mind.  |
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