There’s a phrase I’ve been hearing from patients more and more: “I don’t even know why I’m anxious, but I am.”

There are certainly seasons of life that understandably bring anxiety. A serious illness. The loss of a loved one. Financial hardship. The end of a relationship. A major life transition. But what’s striking is that many of these women aren’t going through anything that sets off the anxiety red flags. They’re showing up to work. Caring for their families. Checking things off the to-do list. Making it to Pilates or yoga class. On paper, life looks relatively stable. And yet they tell me they feel constantly on edge.

“On paper, life looks relatively stable. And yet they tell me they feel constantly on edge.”

They’re exhausted but can’t relax. Their minds race the moment they slow down. They wake up in the middle of the night thinking about everything they forgot to do, everything that could go wrong, and everything they’re trying to hold together. Some describe a racing heart, a knot in their stomach, tight shoulders that never seem to soften, or a body that simply can’t seem to exhale.

The more I’ve listened, the less I’ve become convinced that something is “wrong” with them. Instead, I’ve found myself wondering whether their bodies are responding exactly as they were designed to.

As a functional medicine physician, one of the things I love most is helping people understand why they feel the way they do. Because when we understand the “why,” we stop blaming ourselves for symptoms that often make perfect biological sense.

“When we understand the ‘why,’ we stop blaming ourselves for symptoms that often make perfect biological sense.”

Anxiety is incredibly complex. Genetics, hormones, lived experiences, trauma, sleep, nutrition, relationships, lifestyle, and mental health all play important roles. But I also think it’s worth acknowledging something else: We’ve never asked our nervous systems to process this much.

Perhaps the question we should be asking isn’t only “Why am I so anxious?” Perhaps it’s also “What kind of world is my nervous system trying to adapt to?”

Our nervous systems weren’t designed for constant vigilance

The human nervous system is remarkably intelligent. It’s the body’s communication network that’s constantly gathering information from both the world around us and what’s happening inside our bodies, then deciding how we should respond.

Its primary job isn’t to make us happy (though that would be a nice adaptation!). Its job is to keep us alive.

For thousands of years, that meant helping us respond to immediate threats. If danger appeared, our bodies released stress hormones like cortisol and adrenaline, our heart rate increased, our attention sharpened, and we became prepared to fight, flee, freeze, or survive.

The challenge is that while some people are navigating very real threats, many of us are dealing with threats that rarely come in the form of a predator but rather a ping from our ever-exploding inboxes.

“Many of us are dealing with threats that rarely come in the form of a predator but rather a ping from our ever-exploding inboxes.”

Instead, our “predators” arrive as unread emails, financial uncertainty, constant notifications, endless news cycles, social media, comparison, work deadlines, family responsibilities, and the quiet pressure to somehow do it all while looking like we’re doing it effortlessly.

Each threat may seem small on its own. But together, they create something our nervous systems were never designed to experience: a state of constant vigilance.

When the brain repeatedly perceives uncertainty or potential threat, it doesn’t simply switch off because the workday ends. It continues scanning for what could go wrong next.

No wonder so many of us feel unsafe and exhausted.

Feeling safe isn’t the same thing as being safe

One of the biggest lessons I’ve learned through both medicine and my own life is that safety isn’t only about our circumstances. It’s also about our experience.

You can have a home. A family who loves you. Food on the table. A stable career. And still feel deeply unsettled. Because while your logical brain may know you’re safe, your nervous system may still be receiving very different signals.

“While your logical brain may know you’re safe, your nervous system may still be receiving very different signals.”

Chronic stress. Poor sleep. Constant stimulation. Conflict. Shame. Grief. Fear. Even carrying unrealistic expectations of ourselves can keep the body in a state of protection long after the original stressor has passed.

I’ve also come to appreciate how much our environment shapes the way we feel. It’s something I hear about every day as I sit with patients one-on-one and listen to their stories.

We spend hours consuming headlines designed to capture our attention. We scroll through carefully curated versions of other people’s lives. We absorb conversations rooted in fear, scarcity, and urgency.

Far less often do we intentionally immerse ourselves in the things that remind our nervous systems we’re safe: meaningful conversations, laughter around the dinner table, time in nature, quiet moments of prayer or reflection, unhurried time with people we love, or simply allowing ourselves to be fully present without reaching for a screen.

We’re often rushing through the moments that nourish us just to hurry off to carry stress that isn’t even ours. And the truth of it is that we’re becoming remarkably efficient at consuming stress, yet far less intentional about creating moments of safety.

Anxiety doesn’t only live in the mind

One of the reasons I love functional medicine is that it encourages us to zoom out. Rather than asking, “How do we get rid of this symptom?” we ask, “What might be contributing to it?”

When someone comes to me struggling with anxiety, I’m certainly thinking about their emotional health. But I’m also thinking about their physiology. The body and mind are in constant conversation with one another, and anxiety often reflects both.

“The body and mind are in constant conversation with one another, and anxiety often reflects both.”

For example, poor sleep doesn’t just leave us tired — it also makes the brain more emotionally reactive while reducing our ability to regulate stress. Blood sugar swings can trigger the release of stress hormones like cortisol and adrenaline, creating sensations that feel remarkably similar to anxiety. Fluctuations in estrogen and progesterone can influence neurotransmitters involved in mood regulation, which is one reason many women notice changes in anxiety around their menstrual cycle, postpartum, or during perimenopause.

When I’m working with my patients, I’m also thinking about thyroid function, hormone signaling. nutrient deficiencies, excess caffeine or alcohol, chronic inflammation, medications, trauma history, patterns, and whether someone is giving their body the foundational building blocks it needs to feel resilient.

I’m also thinking about gut health. The gut and brain are in constant communication through pathways like the vagus nerve, and emerging research continues to deepen our understanding of how the gut microbiome may influence mood, stress resilience, and mental well-being.

None of these automatically explain anxiety. But they can all influence how sensitive the nervous system becomes.

That’s why I rarely think of anxiety as existing only in the mind. It’s often the result of multiple systems interacting with one another. The more we understand those connections, the more opportunities we have to support the body as a whole.

What actually helps

People often ask me for the one thing that will help them feel less anxious. The truth is, I’ve found it’s rarely one thing.

Healing the nervous system is less about finding the perfect supplement, wellness hack, or breathing technique and more about consistently sending the body signals that it’s safe. That’s an important distinction.

“Healing the nervous system is less about finding the perfect supplement, wellness hack, or breathing technique and more about consistently sending the body signals that it’s safe.”

While anxiety can feel overwhelming in the moment, the nervous system is, thankfully, remarkably adaptable. It responds to the messages we send every single day through our routines, relationships, environment, and the way we care for ourselves. So don’t lose hope or feel like you’re fighting an endless battle. Time is on your side with this one.

I’ve also learned that many of the most effective interventions aren’t necessarily the most expensive or the trendiest. They’re often the foundational practices we overlook because they seem too simple.

Here are a few of the places I often encourage patients to begin.

Start With Your Breath

The average person takes somewhere around 20,000 breaths every day, yet most of us rarely think about them. When we’re anxious, our breathing often becomes faster and shallower, staying high in the chest as the body prepares to respond to a perceived threat.

One of the simplest ways to interrupt that cycle is to intentionally slow your breathing — especially your exhale. Longer exhales help activate the parasympathetic nervous system, the branch responsible for rest, recovery, and regulation.

“One of the simplest ways to interrupt that cycle is to intentionally slow your breathing — especially your exhale.”

I often remind patients that the breath is one of the few things we can consciously control that directly influences how our nervous system responds. Sometimes, the simple act of slowing down your breathing is enough to gently remind your body, You’re safe enough to exhale.

Remember Your Circadian Rhythm

One of the first things I often recommend is getting outside within the first hour of waking.

Morning sunlight helps anchor your circadian rhythm — the body’s internal clock — which influences everything from cortisol production to melatonin release later that evening. When this rhythm becomes disrupted, it can affect sleep quality, mood, energy, and the body’s ability to regulate stress.

“I think of morning light as one of the simplest ways to remind the brain, A new day has begun.“

I think of morning light as one of the simplest ways to remind the brain, A new day has begun. You’re safe to be awake. And you’ll be sleeping well tonight.

It’s free, it takes only a few minutes, and it has a profound impact over time.

Create more stable blood sugar

One of the most underrated ways to support the nervous system is simply eating enough — especially enough protein and fiber — and avoiding long stretches of time without nourishing your body.

“One of the most underrated ways to support the nervous system is simply eating enough.”

When blood sugar rises and crashes throughout the day, the body releases stress hormones like cortisol and adrenaline to bring glucose back into balance. Those same hormones can create sensations that feel remarkably similar to anxiety: a racing heart, shakiness, irritability, sweating, and feeling on edge.

Give your nervous system opportunities to exhale

Our nervous systems were designed to move in and out of stress. They weren’t designed to stay in survival mode all day long.

That’s why I encourage patients to intentionally build moments of regulation into their day. That might look like breathwork, walking, movement, prayer, stretching, time in nature, journalling or simply sitting quietly for a few minutes without reaching for your phone. There’s a reason analog activities are trending again — they help us reconnect with reality and a pace that’s more natural.

“There’s a reason analog activities are trending again — they help us reconnect with reality and a pace that’s more natural.”

These practices don’t erase anxiety and uncertainty. They simply remind the body that it doesn’t have to stay on high alert every moment of the day.

Be intentional about what you consume

We often think carefully about what we put into our bodies. I think we should become just as thoughtful about what we put into our minds.

“Our nervous systems are constantly gathering information and asking one simple question: Am I safe?“

The news we watch. The social media we scroll. The conversations we repeatedly have. The stories we tell ourselves. Our nervous systems are constantly gathering information and asking one simple question: Am I safe?

The more intentionally we curate what we consume, the more opportunities we create for the body to experience calm instead of constant vigilance.

Remember that connection is medicine

Meaningful relationships. Shared meals. Laughter. Time in nature. Physical affection. Faith. Community. Feeling seen by another person. Feeling connected to something bigger than yourself. These moments may not feel like medicine in the traditional sense, but they communicate something incredibly important and powerful to the brain: You don’t have to do this alone.

“Meaningful relationships. Shared meals. Laughter. Time in nature.”

And often that’s exactly the message our nervous systems have been waiting to hear.

Bringing up anxiety with your doctor

If anxiety has become a persistent part of your life, don’t be afraid to bring it up with your healthcare team. There are many practitioners who understand anxiety through a whole-person lens and recognize that emotional health doesn’t exist separately from sleep, hormones, nutrition, movement, relationships, or the way we experience stress.

When I sit down with a patient experiencing anxiety, I’m not searching for a one-size-fits-all solution. I’m listening carefully to their story, looking for patterns, reviewing their medical history, and considering whether laboratory work or specialty testing may help us better understand what’s contributing. Depending on the person, that might mean exploring hormones, thyroid function, gut health, nutrient deficiencies, inflammation, or other factors that could be influencing how resilient their nervous system feels.

“When I sit down with a patient experiencing anxiety, I’m not searching for a one-size-fits-all solution.”

I also want to be very clear about something: I’m not here to vilify medication.

Medication can be an incredibly valuable and, sometimes, a life-changing tool. For some people, it’s exactly what’s needed. For others, herbs, targeted nutrients, supplements, therapy, lifestyle changes, or nervous system regulation practices may play an important role. More often than not, the best approach isn’t choosing one over the other (or everything at once), but rather thoughtfully combining the right tools for the individual sitting in front of you.

That’s one of the reasons I love practicing integrative medicine. I frequently collaborate with therapists, psychiatrists, nutritionists, functional medicine practitioners, Eastern medicine providers, and other healthcare professionals because each brings a unique perspective and set of skills. Anxiety is complex, and caring for the whole person often means working together.

Most importantly, know that you don’t have to simply live with anxiety. You also don’t have to have all the answers before asking for help. There are practitioners who are willing and able to help.

“You don’t have to simply live with anxiety. You also don’t have to have all the answers before asking for help.”

The most important step is simply being willing to say, “Something doesn’t feel quite right, and I’d like to understand why.” From there, you and your care team can begin exploring the resources, tools, and support that make the most sense for you.

The lesson I’m learning, too

As I’ve been building my own private practice this year, I’ve realized how quickly uncertainty can become fertile ground for anxiety. I like having a plan. I like knowing what’s next. Yet this season has reminded me that waiting, changing, and evolving are all part of being human. And that’s incredibly beautiful too.

“This season has reminded me that waiting, changing, and evolving are all part of being human. And that’s incredibly beautiful too.”

I practice the very same things I encourage my patients to practice: extending myself grace, setting boundaries, staying connected to people I love, spending time outside, prayer, and reminding myself that uncertainty isn’t the same thing as danger.

Peace hasn’t come from eliminating the unknown or choosing not to take big leaps of faith. It’s come from learning to feel grounded even while life continues to unfold.

Dr. Jaclyn Tolentino is a board-certified family medicine physician specializing in functional medicine, women’s health, hormone optimization, metabolic health, and longevity. She has been featured in Vogue, The Wall Street Journal, and Women’s Health. As both a physician and a breast cancer survivor, she is passionate about delivering thoughtful, personalized care that empowers patients to better understand their health. Follow her on Instagram for updates and insights.