It can happen when you’re in a stressful situation. Maybe you’re giving a presentation, getting your blood drawn or standing in a crowded room. All of a sudden, you feel dizzy and your field of vision narrows. Before you know it, you’re waking up on the floor.
Anxiety-related fainting, also called vasovagal syncope, affects millions of people.
“This condition is also known as the ‘common faint.’ It is the most frequent cause of fainting, causing about 35% to 70% of cases,” said Angelia Lomu, a family medicine nurse practitioner with Banner Health.
Fainting can be confusing and scary but most of the time, it’s harmless. When you understand what’s happening, you can learn to spot the warning signs and use simple strategies to feel more in control and less afraid when anxiety hits.
The science behind anxiety fainting episodes
Feeling anxious or stressed can trigger your body’s fight-or-flight response, which releases adrenaline. Adrenaline makes your heart race and your blood pressure rise to prepare for action.
But sometimes, that system overreacts. Instead of staying in “alert mode,” your body overcorrects and your heart rate and blood pressure suddenly drop. Blood pools in your legs and when your brain doesn’t get enough blood flow for a few seconds, you faint.
It’s called vasovagal syncope because it happens when the vagus nerve, which helps manage your heart rate and blood pressure, gets overstimulated by strong emotions, pain or fear. It’s a response that’s trying to protect your body when you get overwhelmed.
The cause is emotional but the response is real. It’s not “all in your head.” It’s your body’s way of reacting to overwhelming stress.
Common anxiety-related triggers
“Triggers for anxiety vary greatly from person to person,” Lomu said. Trauma is one of the most common causes of stress fainting. Other triggers include:
- Medical procedures like blood draws or shots
- Public speaking or performance anxiety
- Panic attacks
- Intense fear
- Being in a crowded space or feeling trapped
- Emotional distress or shock
- Standing too long in one place
- Increased stress at work or home
- Lack of sleep
- Nutritional deficiencies
- Substance use
- Stressful life events such as a death in the family
- Certain medications
The cycle of anxiety and fainting can repeat. That’s because, once you faint from anxiety, worrying that it might happen again can make your body more sensitive to stress and make it more likely you’ll have another episode.
Recognizing the warning signs
Before you faint, you’ll probably notice a few clues. If you learn to spot the early symptoms, you can take steps to stop your body’s reaction before you lose consciousness.
Early warning signs:
- Lightheadedness or dizziness
- Nausea or upset stomach
- Sweating or feeling clammy
- A rapid heartbeat
- Tunnel vision, blurry eyesight, flashing, or darkening or white-out of vision
- A loss of hearing or hearing a “whooshing” sound
- Pale or grayish skin
- Feeling unusually warm or cold
Just before fainting:
- Weakness in your legs
- Ringing in your ears
- A sense of “floating” or feeling detached or disconnected
What to do:
- Sit or lie down right away
- Raise your legs or place your head between your knees
- Loosen any tight clothing
- Take slow, steady breaths until the feeling passes
Don’t try to “push through” dizziness. Fighting it can make it worse. Listening to your body early can keep you from fainting.
Immediate coping strategies
“When you recognize the first signs of anxiety, you can use coping skills to reduce or stop symptoms,” Lomu said. These techniques can help:
Physical counterpressure
Briefly raising your blood pressure can help keep blood flowing to your brain:
- Cross your legs and tense your thigh and abdominal muscles.
- Clench your fists or grip a soft object firmly.
Breathing and grounding exercises
Grounding helps calm your body and mind:
- Try deep, controlled breathing. Inhale slowly through your nose for four counts, then exhale for six. Repeat until the feeling that you might faint passes.
- Use the 5-4-3-2-1 method to focus your senses: Find five things you can see, four you can touch, three you can hear, two you can smell and one you can taste.
Stay ahead of triggers
You can also take these steps to make it less likely that you will faint:
- Stay hydrated, since you’re more likely to faint when you’re dehydrated.
- Eat regular, healthy meals to help keep your blood sugar stable.
- Try not to stand still for long periods.
- If settings like hospitals or crowds trigger you, let staff or friends know so they can offer support.
- Find a place to sit down or take a short break if you’re dealing with a stressful situation.
Long-term anxiety management
You can manage anxiety and fainting by tackling the physical and emotional sides of the problem. “Long-term solutions include addressing underlying causes of anxiety,” Lomu said.
Work on anxiety triggers:
- Cognitive behavioral therapy (CBT) can help you spot anxious thoughts so you can challenge them.
- Exposure therapy can lower your fear of fainting or your fear of certain triggers.
- Mindfulness, relaxation and breathing techniques reduce your overall stress response.
Healthy habits to support your body:
- Stay hydrated and eat balanced meals.
- Aim to get plenty of restorative sleep every night.
- Exercise regularly, since movement helps manage your nervous system.
- Limit caffeine and alcohol, which can make both anxiety and dehydration worse.
When to get medical help
Anxiety-related fainting is usually not dangerous but it’s important to get evaluated, especially if it’s your first episode.
“Sometimes, the symptoms of anxiety are related to a medical condition as opposed to mental health symptoms. It is important to reach out and discuss your symptoms and possible causes,” Lomu said.
Even if your fainting feels anxiety-related, you want to make sure it’s not caused by low blood pressure, heart rhythm problems, hyperthyroidism, substance use or anemia.
Schedule a doctor’s visit if you:
- Faint for no clear reason
- Have a lot of fainting episodes, or episodes that are getting worse
- Notice chest pain, heart palpitations or confusion afterward
- Hurt yourself during a fall when you faint
Get emergency care if you:
- Faint when you’re exercising
- Lose consciousness for more than a few minutes
- Have severe chest pain or shortness of breath
Never assume it’s “just anxiety” without checking in with a medical professional. With the right diagnosis, you can get the care you need.
Care at Banner Health
If you’re experiencing fainting or dizziness that may be linked to anxiety or stress, our experts can help. Our behavioral health specialists, cardiologists and neurologists can find out what’s causing your fainting episodes and build a plan to care for your physical and emotional health.
If you think you might have anxiety-related fainting, schedule an appointment with a Banner Health provider to learn how to manage your symptoms.
