A groundbreaking international study has found women experiencing moment-to-moment anxiety may have significantly less insight into their own bodily sensations—specifically those related to breathing—than men do. The research, recently published in the European Journal of Neuroscience and highlighted by PsyPost, offers new clues into why anxiety feels and functions differently in men and women, raising important questions for mental health treatment in Thailand and beyond (PsyPost, 2025).
The significance of this finding comes as anxiety rates continue to soar in Thai society, amplified by the ongoing pressures of economic uncertainty, academic competition, and the social changes that come with a rapidly modernizing culture. According to the World Health Organization, women are already nearly twice as likely as men to develop anxiety disorders—an observation mirrored among Thai adolescents and working-age adults (WHO). Yet, this new research reveals that not only does anxiety’s prevalence differ by gender, but women may also uniquely struggle with “interoceptive insight”—the ability to connect their internal sensations, like breathing difficulty or chest tightness, with emotional or mental states.
Interoception, in medical terms, is the process by which people sense internal bodily signals—things like heartbeats, hunger, or shortness of breath (Wikipedia). Accurately interpreting these signals is vital for maintaining physical and emotional health. For example, knowing you’re anxious rather than physically ill when your heart races can guide you toward practices like mindfulness or breathing exercises rather than unnecessary trips to the hospital.
The new study, conducted at four major research centers across Europe and analyzed by lead author Olivia Harrison from New Zealand’s University of Otago, involved 175 healthy adults—half male, half female. Participants completed a series of questionnaires measuring their current (state) anxiety and typical (trait) anxiety levels. They then performed a specialized breathing task, in which subtle resistances were occasionally introduced to their inhalations using a device. After each trial, participants reported whether they noticed the resistance, and how confident they were in their judgment.
While both men and women detected changes in their breathing with similar accuracy, participants with higher state anxiety consistently reported lower confidence in their own judgments—known as “metacognitive bias.” Crucially, when the researchers examined whose confidence best matched their actual performance (“metacognitive insight”), they discovered the negative impact of anxiety was concentrated in women, not men. In simple terms: anxious women tended to doubt their own ability to spot bodily changes, and their feelings of certainty were less likely to match reality (European Journal of Neuroscience).
Dr. Harrison explained to PsyPost: “On average, men and women have the same levels of interoception and related insight towards breathing perceptions. However, the relationship between state anxiety (in-the-moment anxiety) and interoceptive insight is different…greater anxiety is related to worsened insight only in women, while this relationship did not exist for men.” These patterns did not apply to longer-term anxiety (“trait anxiety”) or depression, deepening the case for state anxiety’s particular importance for women (PsyPost, 2025).
This discovery resonates strongly with the lived experiences of many Thai women, who are often expected to maintain composure (หน้าไว้ใจ) and prioritize collective harmony, sometimes at the expense of addressing their own emotional and bodily cues. As Dr. Darunee Rattanavipap, a psychiatrist at Ramathibodi Hospital who was not involved in the research, noted: “In Thai society, girls learn early on to suppress strong feelings, both to honor family and to avoid burdening others. Over time, this can make it even harder for women to distinguish between stress, anxiety, and real physical problems. We see this often with students and young professionals, who might report chronic headaches, palpitations, [or] fatigue, without realizing these are tied to anxiety.”
Previous Thai mental health surveys echo these trends. Studies have shown that women are overrepresented in outpatient clinics for unexplained medical symptoms—sometimes called “somatization”—a pattern which may be explained by reduced interoceptive awareness and insight (Royal College of Psychiatrists of Thailand). Yet, until now, few studies have rigorously explored if anxiety affects how women “read” their bodies differently from men.
The findings also offer an important message for doctors, teachers, and even family members supporting those with anxiety. Since anxious Thai women may doubt the accuracy of their internal sensations, well-meaning reassurance or advice to “just relax” could lengthen the cycle of uncertainty and distress. Instead, Dr. Harrison and colleagues suggest targeted therapies that build confidence in bodily awareness—such as mindfulness, breathwork, or biofeedback—may be especially helpful. These approaches encourage patients to reconnect with their bodies and learn to trust physical signals as valid indicators of emotion.
It’s notable that despite the robust sample size and rigorous design, the international research team did acknowledge some limitations. The cross-sectional study means it’s not clear whether anxiety causes impaired interoceptive insight, or whether the reverse is true. Procedures also varied slightly between study locations, and only breathing-related interoception was studied—leaving open questions about heart, stomach, or other bodily cues (ResearchGate). Future research, possibly including collaborations with Thai universities and hospitals, may clarify whether similar gender-specific effects exist for other sensations or across different cultural settings.
These scientific insights dovetail with a growing body of research on gender, anxiety, and awareness. For example, a 2023 study found that low interoceptive awareness and high body image concern were associated with depression and disordered eating among women, especially those in minority communities (PubMed). The implication, both for Thailand and globally, is that targeting body awareness could be a key strategy for reducing the burden of anxiety in women.
For Thai readers, practical recommendations emerge: If you or someone you know experiences frequent bodily discomfort, unexplained pain, or sudden changes in breathing, consider whether anxiety—especially current stressors—might be a hidden factor. Mindfulness meditation (สติ), yoga, and other body-based practices have been shown in both Thai and international studies to improve interoceptive awareness and reduce overall anxiety (Royal College of Psychiatrists of Thailand; Advance Sage Journals). Healthcare providers should also take extra care to ask female patients about both physical and psychological stress, validating their concerns and avoiding inadvertent dismissal.
As Thailand’s mental health community continues to prioritize personalized care, the message is clear: understanding the mind-body connection, especially for women facing anxiety, will be vital to improving well-being and reducing suffering. อดทนไว้ได้ แต่อย่าฝืนสุขภาพตัวเองจนรู้สึกผิดปกติ—feelings are signals just as real as physical symptoms, and learning to trust them is the first step towards better health and happiness.
For more information on anxiety and interoceptive awareness, consult resources provided by the Ministry of Public Health, contact local mental health centers, or explore evidence-based mindfulness and breathing workshops available in your community.
Sources:
- PsyPost: Anxiety linked to reduced insight into bodily sensations—especially in women (2025)
- European Journal of Neuroscience: Gender Differences in the Association Between Anxiety and Interoceptive Insight (2025)
- Wikipedia: Interoception
- Advance Sage Journals: Gender differences in the association between anxiety and interoceptive insight
- World Health Organization: Mental disorders
- Royal College of Psychiatrists of Thailand: Prevalence of Mental Health Disorders in Thailand