Fluctuating Anxiety Symptoms: When Treatment Isn't Enough

Q: Fluctuating Anxiety Symptoms: When Treatment Isn't Enough

Hello, Xiao Xiang： People with anxiety tend to worry easily, and these worries can trigger physical tension responses, such as rapid breathing and increased heart rate, which can lead to greater discomfort and further intensify the original anxiety and concerns. <br>It is recomme

Anxiety symptoms fluctuate between better and worse?

Hello doctor, I have symptoms of anxiety and am currently undergoing treatment.
Some symptoms have gradually improved, but my chest tightness and heart palpitations have not improved; in fact, they seem to have worsened.
For example, my heart rate does not stabilize immediately after climbing stairs, and even a short walk seems to trigger an episode.
During these episodes, I experience numbness throughout my body, extending to the soles of my feet, along with shoulder and neck pain accompanied by dizziness in the back of my head.
I also feel weakness and soreness in my limbs, particularly a sense of weakness in my calves, and the chest tightness can feel like a slight constriction in my ribcage, making it somewhat difficult to speak.
I find myself reluctant to talk and feeling intense fear about various things, almost as if I am afraid to move.
Even though I am in a good mood to go out, my body feels fearful.
This heightened anxiety seems to manifest after I get out of the car.
I am unsure if my symptoms have not improved and have actually worsened, or if I have triggered other symptoms, such as those related to hyperventilation.

Xiao Xiang, 30~39 year old female. Ask Date: 2016/05/04

Dr. Liang Sunyuan reply Psychiatry

Hello, Xiao Xiang: People with anxiety tend to worry easily, and these worries can trigger physical tension responses, such as rapid breathing and increased heart rate, which can lead to greater discomfort and further intensify the original anxiety and concerns.
It is recommended to start by controlling your breathing; focus on your breath and try to slow it down and make it more even.
Usually, the body will gradually relax.
If you find it difficult to achieve this on your own, consider seeking treatment for biofeedback relaxation training to learn effective relaxation techniques.
You can also discuss other coping strategies with your physician during follow-up visits.
Wishing you all the best.

Reply Date: 2016/05/04

More Info

It sounds like you are experiencing a complex interplay of anxiety symptoms that can be quite distressing. It's important to understand that anxiety can manifest in various physical and emotional ways, and sometimes, despite treatment, symptoms may fluctuate or even worsen. This can be particularly frustrating when you feel that you are making progress in other areas of your mental health.

Firstly, let's address the physical symptoms you are experiencing, such as chest tightness, rapid heartbeat, and feelings of numbness or weakness in your limbs. These symptoms can often be associated with anxiety disorders, particularly panic attacks or generalized anxiety disorder. When you experience anxiety, your body goes into a "fight or flight" response, which can lead to increased heart rate, muscle tension, and other physical sensations. This response is a natural reaction to perceived threats, but in cases of anxiety disorders, it can be triggered by everyday situations or even thoughts, leading to a cycle of fear and physical symptoms.

The fact that you feel physically fine when you are in a good mood but experience these symptoms when you are about to go out or engage in activities suggests that your anxiety may be linked to specific triggers or situations. This is not uncommon; many individuals with anxiety disorders find that certain environments or activities can provoke their symptoms, even if they are looking forward to them. This phenomenon can be related to anticipatory anxiety, where the fear of experiencing anxiety symptoms in a particular situation can create a self-fulfilling prophecy.

Regarding your concern about whether your symptoms are worsening or if you are developing new symptoms, it is crucial to communicate these feelings to your healthcare provider. Sometimes, the medications prescribed for anxiety can have side effects that may contribute to physical symptoms, or they may not be the right fit for your specific needs. Additionally, if you are experiencing symptoms like excessive breathing (hyperventilation), it can lead to feelings of dizziness, tingling, and other physical sensations that can be alarming.

It's also worth considering that anxiety treatment often requires a multifaceted approach. While medication can be effective for many, combining it with therapy—such as cognitive-behavioral therapy (CBT)—can provide you with tools to manage your anxiety more effectively. CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to anxiety, which can help you feel more in control of your symptoms.

In summary, it is essential to maintain open communication with your healthcare provider about your symptoms and any changes you notice. They can help assess whether your current treatment plan is effective or if adjustments are needed. Additionally, exploring therapeutic options alongside medication may provide you with a more comprehensive approach to managing your anxiety. Remember, recovery is often not a linear process, and fluctuations in symptoms are common. With the right support and strategies, you can work towards feeling more stable and in control of your anxiety.

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