Аннотация: The article is devoted to a comprehensive analysis of the impact of chronic anxiety on a person’s physical health in the framework of psychosomatics. The article considers the historical context of the development of psychosomatics as a science, starting from antiquity and the works of Heinroth, Freud and Alexander. It is emphasized that anxiety, especially in its chronic form, is a powerful link between the psyche and the body, acting as a serious risk factor for the development and aggravation of somatic diseases. WHO (World Health Organization) statistics on the prevalence of anxiety disorders are presented. The main physiological mechanisms of the negative effects of anxiety are described in detail: hormonal disorders (activation of the HPA (Hypothalamic-Pituitary-Adrenal (axis))axis and cortisol), chronic inflammation, autonomic dysregulation (depletion of the ANS (Autonomic Nervous System)), and structural changes in the brain. Special attention is paid to “masks” of anxiety – various somatic symptoms that mimic diseases of the heart (pseudocardialgia, cardiophobia), gastrointestinal tract (IBS (Irritable Bowel Syndrome), functional dyspepsia), respiratory system and musculoskeletal system. The difficulties of diagnosis (the syndrome of multiple negative studies) and the mechanism of somatizationare emphasized. A comprehensive (multimodal) approach to treatment is presented, including pharmacotherapy (antidepressants), psychotherapy (CBT (Cognitive Behavioral Therapy), exposure, psychodynamic, EFT (Emotion-Focused Therapy)) and physical methods (regular exercises, breathing techniques). It is concluded that it is necessary to bridge the gap between mental and somatic health and the importance of cooperation between various specialists for effective patient care.