Particularly when you start hyperventilating....which most of us with anxiety do and we don't realize it. Your body loses too much carbon dioxide and it throws off your blood ph. That causes dizziness, tingling sensations, headaches, and a lot if other panic attack symptoms.

It's possible to hyperventilate to the point of passing out. The only positive about passing out is you'll start breathing normally while unconscious.

So yes, in short, it can become very physical.