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How we feel physically is influenced by our mental state and vice-versa. People who suffer from generalised anxiety disorders for example, may also have physical symptoms associated with their anxiety. Senior Physiotherapist Davide Lanfranco explains this reasoning.

About Davide Lanfranco

Davide creates bespoke treatment sessions using different approaches including mindfulness, Acceptance and Commitment Therapy and Hypnotherapy, as well as therapeutic exercise therapy. When combining his extensive skills from years of study and experience, these allow him to support people in a most comprehensive and effective way both in person and via remote consultations.
View Davide Lanfranco’s full profile

What mental health issues can affect the body?

Chest tightness, abdominal pain, nausea, and dizziness are only a few of the features typical of this issue. As the anxiety increases there is also a spike in their bodily sensations. 

Explaining 'top-down' and 'bottom-up'

This mechanism is called ‘top-down’. However similar body symptoms, even those not anxiety related, may trigger a 'fight or flight' response because they can be misinterpreted by the brain and therefore judged as dangerous and threatening. 

This could lead to anxiety and even to panic attacks. This mechanism is called 'bottom-up'. There is a constant exchange of information between our nervous system and its periphery.

Female office worker at a desk

How different factors influence pain

The same thing happens with other problems like joint pain. There is an overwhelming amount of evidence suggesting how there are many factors that contribute to modulate pain. 

We call these psycho-social factors, which relate to:

  • our mental health
  • our beliefs
  • our lifestyle
  • our social relationships.

This picture suggests how different aspects modulate pain:

Mental and physical health cycle


There is a strong association between physical and mental health. The two aspects are strictly interconnected and it is not possible to separate them.  In light of this we should not label physical sufferance, or physical pain, and an emotional one as separate entities.

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