I am the same way...I have muscle tension in my legs most of the time and have those little twitches, both of which I can deal with. But then I get that blah sick feeling and hot or cold flashes and I feel awful. Typically my mental anxiety doesn't kick in unless my symptoms make me feel physically sick for awhile. Although I have noticed that I too have little things that should tip me off that I am "unknowingly" anxious...constant shifting in my chair, constantly bouncing my legs under my desk at work. I have been on my first med, Lexapro, for a week and some days, so I am hoping that will clear some of this up for me.