Anxiety and Looking Pale, Blanched
Blanched, looking pale, pasty, pallor, or white as a ghost are common anxiety symptoms, especially anxiety and panic attack symptoms.
Some people say you look “white” as if you’ve seen a ghost because of your anxiety. While others might comment and say you look "sickly pale" and ask if you are feeling unwell.
This article explains the relationship between anxiety and looking pale.
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Looking Pale Common Anxiety Symptom Descriptions
- Your face looks blanched (white), pale, pasty (colorless), or like you’ve lost the color in your face or skin.
- Some people say you look “white” or as if you’ve seen a ghost. Others may ask if you are feeling okay because you look “sick” or “sickly pale.”
This symptom is not restricted to the face, as it can affect the skin in any area of the body.
This symptom can persistently affect one area only, shift and affect another area or areas, and migrate all over and affect many areas of the skin repeatedly. However, most people experience this symptom primarily on the head, neck, and face.
This symptom can:
- Occur occasionally, frequently, or persistently.
- Precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.
- Precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" for no reason.
- Range in intensity from slight, to moderate, to severe.
- Come in waves where it’s strong one moment and eases off the next.
- Occur for a while, subside, and then return for no reason.
- Change from day to day, moment to moment, or remain as a constant background during your struggle with anxiety disorder.
All the above combinations and variations are common.
NOTE: This symptom can occur even though you don’t feel physically, psychologically, or emotionally different. This symptom is often just an outward indication of apprehensive behavior or hyperstimulation.
To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.
The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.
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Causes: Why Anxiety Can Cause Blanching
Medical Advisory
Talk to your doctor about all new, changing, persistent, and returning symptoms as some medical conditions and medications can cause anxiety-like symptoms.
There are many reasons why this symptom can occur. Related to anxiety, the most common are:
1. Anxiety-Activated Stress Response
Anxious behavior, such as worry, activates the stress response, which secretes stress hormones into the bloodstream, where they travel to specific locations to immediately prepare the body for emergency action – to fight or flee. This instinctual survival reaction is often referred to as the fight or flight response.[1][2]
Visit the “Stress Response” article for more information about the many stress response changes.
Some stress response changes can cause the skin to lose its color, and appearing pale. For instance, the stress response:
Shunts blood to parts of the body vital to survival. The body contains a finite amount of blood (3 to 6 quarts, or 2.8 to 5.7 liters—the amount is dependent upon the body’s height and weight). To equip the body for emergency action, the body shunts blood away from parts of the body that aren’t vital for survival to those that are.
For example, blood is moved from the skin, hands, and feet, and sent to the brain (so the brain has more fuel to think), heart (so the heart can pump suitable quantities of blood to the vital areas), and muscles (to make the body stronger and quicker), to name a few.
The body shunts blood around by dilating some blood vessels (vasodilation) and constricting others (vasoconstriction).
When blood flow is shunted away from the skin, the skin loses some of its “reddish” hue because red blood cells give blood its red color. The movement of blood away from the skin on the face leaves the face looking “white,” blanched, and pale.
Causes muscles to tighten to make the body more resilient to injury. Tightened muscles can also restrict blood flow to the skin, making the skin look pale.
2. Hyperstimulation
Frequent activation of the stress response can cause the body to remain in a state of semi-stress-response-readiness, which we call “stress response hyperstimulation” since stress hormones are powerful stimulants.
Hyperstimulation is also often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation.”[3][4]
Visit the “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body and how we feel.
Hyperstimulation can cause the changes of an active stress response even though a stress response wasn’t activated. While acute blanching is a common symptom of an active stress response, chronic blanching is a common symptom of hyperstimulation.
3. Body temperature regulation
The body also shunts blood around to manage its internal temperature. For example, when the body is too cold, it constricts blood vessels in the skin so that less blood is exposed to the cooler external elements, which reduces heat loss.
However, when the body is too warm, it dilates blood vessels in the skin to allow more blood to be exposed to the cooler elements so that the cooler environment can cool the circulating blood, which helps to keep the body cool.
Consequently, blanching might also be caused by how the body manages internal temperature.[5]
4. Blood oxygen level
To function properly, the body needs a constant level of oxygen circulating in the blood, which sustains cells and tissues. When this oxygen falls below a certain level, hypoxemia can occur. Hypoxemia is often experienced as shortness of breath and looking pale.[6] Low oxygen levels in the blood can occur from breathing too shallowly or holding your breath. Many anxious people hold their breath or breathe shallowly when stressed or anxious.
5. The type of fears at the root of the stress response
The types and degrees of fear can trigger different types and degrees of stress responses. For example, being suddenly frightened or experiencing an emotional shock can cause blanching as the blood is shunted away from the skin, including the skin on the face. Yet, being embarrassed (fear of looking foolish) often causes blood to flow to the face, causing blushing and flushing.
At this time, it’s not known why these differences occur, but that they do. No matter the physiological reasons, blanching and blushing can occur due to the above factors.
Nevertheless, like most anxiety-caused sensations and symptoms, blanching isn’t harmful. It’s merely a consequence of anxious behavior. As you address hyperstimulation and better manage your anxiety, this symptom should disappear and become a nonissue.
6. Other Factors
Other factors can create stress and cause anxiety-like symptoms, as well as aggravate existing anxiety symptoms, including:
- Medication
- Recreational drugs
- Stimulants
- Sleep deprivation
- Fatigue
- Hyper and hypoventilation
- Low blood sugar
- Nutritional deficiencies
- Dehydration
- Hormone changes
- Pain
Select the relevant link for more information.
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Treatment: How To Get Rid Of Looking Pale Due To Anxiety
When this symptom is caused or aggravated by other factors, addressing those factors can reduce and eliminate looking pale.
When this symptom is caused by an anxiety-triggered stress response, calming yourself will end the active stress response and its changes. Your normal color will return as your body recovers from the active stress response.
Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.
When this symptom is caused by hyperstimulation, eliminating hyperstimulation will end this anxiety symptom.
You can reduce and eliminate hyperstimulation by:
- Containing anxious behavior.
- Reducing stress.
- Regular deep relaxation.
- Relaxed diaphragmatic breathing.
- Regular light to moderate exercise.
- Getting regular good sleep.
- Eating a healthy diet of whole and natural foods.
- Avoiding stimulants.
- Passively-accepting your symptoms until they subside.
- Being patient as your body recovers.
Visit our “60 Natural Ways To Reduce Stress” article for more ways to reduce stress.
As the body recovers from hyperstimulation, it stops sending symptoms of hyperstimulation, including blanching (looking pale).
However, eliminating hyperstimulation can take much longer than most people think, causing symptoms to linger longer than expected.
As long as the body is hyperstimulated, even slightly, it can present symptoms of any type, number, intensity, duration, frequency, and at any time, including this one.
Since worrying and becoming upset about anxiety symptoms stress the body, these behaviors can interfere with and stall recovery.
Passively accepting your symptoms – allowing them to persist without reacting to, resisting, worrying about, or fighting them – while doing your recovery work will cause their cessation in time.
Acceptance, practice, and patience are key to recovery.
Remember: Focusing on your sensations and symptoms makes them more pronounced. If you'd like to lessen their impact, learn to focus your attention elsewhere through distraction, enjoying your hobbies, undertaking pleasing and calming activities, regular deep relaxation, and recalling pleasant memories or experiences.
Recovery Support
The Recovery Support area of our website contains thousands of pages of important self-help information to help individuals overcome anxiety disorder, hyperstimulation, and symptoms.
Due to the vast amount of information, including a private Discussion Forum, many of our Recovery Support members consider it their online recovery support group.
Therapy
Unidentified and unaddressed underlying factors cause issues with anxiety. As such, they are the primary reason why anxiety symptoms persist.
Addressing your underlying factors (Level Two recovery) is most important if you want lasting success.
Addressing Level Two recovery can help you:
- Contain anxious behavior.
- Become unafraid of anxiety symptoms and the strong feelings of anxiety.
- End anxiety symptoms.
- Successfully address the underlying factors that so often cause issues with anxiety.
- End what can feel like out-of-control worry.
All our recommended anxiety therapists have had anxiety disorder and overcame it. Their personal experience with anxiety disorder and their Master's Degree and above professional training give them insight other therapists don't have.
If you want to achieve lasting success over anxiety disorder, any one of our recommended therapists would be a good choice.
Working with an experienced anxiety disorder therapist is the most effective way to treat anxiety disorder, especially if you have persistent symptoms and difficulty containing anxious behavior, such as worry.[7][8][9]
In many cases, working with an experienced therapist is the only way to overcome stubborn anxiety.
Common Anxiety Symptoms
Additional Resources
- For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
- Anxiety and panic attacks symptoms can be powerful experiences. Find out what they are and how to stop them.
- How to stop an anxiety attack and panic.
- Free online anxiety tests to screen for anxiety. Two minute tests with instant results. Such as:
- Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.
Return to our anxiety disorders signs and symptoms page.
anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including Looking Pale Face, White As A Ghost, Blanched.
1. Ayada, C, et al. “The Relationship of Stress and Blood Pressure Effectors.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.
2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.
3. Elbers, Jorina, et al. "Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children." Pediatric Neurology, Dec 2018.
4. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.
5. Vinkers, C H, et al. “The Effect of Stress on Core and Peripheral Body Temperature in Humans.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Sept. 2013.
6. “Hypoxia and Hypoxemia.” WebMD, WebMD.
7. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.
8. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.
9. DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.