Last Updated on October 27, 2026 by Laura Abbatangelo
It’s 3am. The house is quiet, and your mind is wide awake, running through tomorrow. The meeting. The email you haven’t answered. The thing someone said last week that you’re still turning over.
Nothing is actually happening. You’re lying in bed. And yet your heart is a little faster, your shoulders are up near your ears, and your stomach has that tight, unsettled feeling.
That’s worry. And it’s one of the most common ways stress keeps a hold on the body.
Table of Contents
What is worry, exactly?
Fear, worry and anxiety are close relatives; they all use the same alarm system. The difference is timing.
- Fear is the alarm for something happening now.
- Worry is the mind rehearsing something that might happen.
- Anxiety is the body staying on alarm, before or after the moment has passed.
Worry is mostly thinking: “what if this goes wrong?”, on repeat. It can feel useful, like preparing. Sometimes it is. But when it loops, it stops solving anything and starts wearing you out.
Can worrying cause physical symptoms?
Yes. This is the part many people find surprising.
The body’s stress response was built for short, real threats: something happens, the alarm goes off, you deal with it, the alarm switches off. The trouble with worry is that the threat lives in your head, so it never quite finishes.
Researchers call this perseverative cognition: repeated worry and rumination. In 2006, Professor Jos Brosschot and colleagues put forward the idea that it isn’t only stressful events that affect our health, but how long we keep thinking about them. Worry stretches a short stress response into a long one. A large review in 2016 (Ottaviani and colleagues, pulling together many studies) found that worry and rumination are linked to measurable changes in the body, such as a higher heart rate and blood pressure.
So when your body reacts to a worry, it isn’t overreacting. It’s doing exactly what it’s designed to do. It just can’t tell the difference between a real threat and a rehearsed one.
Why does worry go to the stomach?
The gut and the brain are wired together. When the stress response switches on, digestion is one of the first things to change: the gut can speed up or slow down, and it becomes more sensitive to normal sensations. Professor Emeran Mayer, a gastroenterologist who has spent decades researching the gut-brain connection, describes stress changing both how the gut moves and how sensitive it is.
That’s why so many people notice their stomach symptoms flare up in worrying weeks: before a deadline, during a family difficulty, in the days before travelling. It’s also why the muscles around the stomach can feel tight and braced, as if you’re waiting for something.
If you’d like to read more on this, I’ve written about anxiety and stomach pain, and how they’re linked.
Why do I worry more at night?
During the day, your attention is busy. Work, people, noise and tasks all compete for it. At night, there’s nothing left to compete with, and the worries get the whole stage.
Sleep researchers such as Professor Allison Harvey have described how this becomes a loop: worrying in bed switches the stress response on, being more alert makes sleep harder, and then you start worrying about not sleeping. The bed itself can start to feel like the place where worrying happens.
What helps calm a worrying mind?
You can’t simply decide to stop worrying. Telling yourself “don’t worry” rarely works; the mind has to think about the worry to push it away. What helps is giving the body and the mind a different instruction.
1. Give worry an appointment. This one comes from research by Professor Thomas Borkovec in the 1980s. Choose 15 minutes earlier in the evening as “worry time”. Write the worries down then. When a worry turns up at 3am, tell it: “not now; tomorrow at 6pm”. It sounds too simple, but it teaches the mind that the worry will be dealt with, just not in bed.
2. Use the longer out-breath. Breathe in through your nose for 4, and out through your mouth for 6. Repeat for a minute. A longer out-breath is one of the ways the body gets the message that it’s safe to stand down. (If it makes you dizzy, stop and breathe normally.)
3. Retrain the pattern. Worry is a habit of the automatic part of you, the part that learnt to stay on alert. Habits can be retrained. This is a big part of the work I do with hypnotherapy: helping the automatic part of the mind learn that it can switch off.
When to get help
Worry is part of being human. But if it’s taking over your days or nights, or your body is reacting in ways that worry you, please speak to your GP first, so that anything that needs checking is checked. If you ever feel overwhelmed or unsafe, you can call Samaritans free, day or night, on 116 123.
A free audio to help you switch off
I’ve recorded a free Rest & Sleep audio for exactly those nights when your mind won’t stop. You can listen in bed, as many times as you like.
Laura Abbatangelo, Stress Specialist. NCH-registered hypnotherapist, practising since 2012. More about working with me.
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Sources
- Brosschot JF, Gerin W, Thayer JF. The perseverative cognition hypothesis: a review of worry, prolonged stress-related physiological activation, and health. J Psychosom Res 2006;60(2):113-24. PubMed
- Ottaviani C, Thayer JF, Verkuil B, et al. Physiological concomitants of perseverative cognition: a systematic review and meta-analysis. Psychol Bull 2016;142(3):231-59. PubMed
- Mayer EA. The neurobiology of stress and gastrointestinal disease. Gut 2000;47(6):861-9. PubMed
- Harvey AG. A cognitive model of insomnia. Behav Res Ther 2002;40(8):869-93. PubMed
- Borkovec TD, Wilkinson L, Folensbee R, Lerman C. Stimulus control applications to the treatment of worry. Behav Res Ther 1983;21(3):247-51. PubMed
- Zaccaro A, et al. How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci 2018;12:353. PubMed