Anxiety-Related Physical Symptoms: A Comprehensive Guide

Anxiety-related physical discomfort?

Hello, Doctor: A year ago, due to my living environment, the people around me, and work-related stress, I found myself getting angry easily, almost every day.
Initially, I thought it was not a big deal, but later on, I started experiencing feelings of tightness in my left chest and difficulty breathing when I got angry.
I consulted a cardiologist several times, and all tests, including standard electrocardiograms, chest X-rays, echocardiograms, and 24-hour Holter monitoring, showed no issues.
However, during a stress test, I exhibited mild myocardial ischemia when my heart rate reached 160-170 bpm.
The cardiologist believed that I am still young and that my test results were normal, so he did not consider it a significant problem.
Nevertheless, I began to worry more about my heart and chest discomfort, which made me increasingly anxious.

Later, due to the persistent nature of these symptoms, I went to the emergency room three times for chest tightness, chest pain, difficulty breathing, and hyperventilation.
The emergency room doctors suggested that my symptoms were due to excessive emotional anxiety, and they recommended that I see a psychiatrist.
I followed their advice and was diagnosed with anxiety disorder and panic disorder by the psychiatrist, and I also have obsessive-compulsive tendencies.
The psychiatrist prescribed SSRIs for long-term use and Xanax for emergency situations.
However, after trying several SSRIs and experiencing side effects, I was not comfortable with them, and since I have a strong aversion to medication, the doctor eventually allowed me to stop the SSRIs and use only Xanax as needed.
My question is whether anxiety disorder can frequently cause me to feel unwell, as I often experience chest tightness, difficulty breathing, occasional dizziness, headaches, neck and shoulder tension, nausea, lower back pain, lack of concentration, and a general lack of motivation, wanting only to lie in bed and rest.
These symptoms have been bothering me for a year and severely affect my work.
I have undergone all necessary examinations, including a comprehensive health check and EEG.
I tend to overthink and believe I have health anxiety, often imagining the worst possible outcomes, which makes me very nervous and anxious throughout the day.
This has been my nature since childhood, but I feel it has worsened significantly over the past year.
I feel very tired and scared, wondering if something is really wrong with my body.
Sometimes I feel helpless and frustrated.

Could you please advise me if the physiological and psychological symptoms I described could be manifestations of anxiety disorder? Almost every day, I wake up with a sense of discomfort, and I cannot sleep well.
Could you provide me with some suggestions? Thank you.

Kunrao de ren, 20~29 year old female. Ask Date: 2017/10/30

Dr. Wang Yazhen reply Psychiatry

Hello,
Anxiety-related disorders include anxiety disorders, obsessive-compulsive disorder (OCD), and panic disorder.
In simple terms, these conditions are characterized by significant physical and mental disturbances that affect daily life and functioning for an extended period.
However, clinical practitioners will carefully assess and understand your overall condition before providing a diagnosis and treatment.

While it is common for individuals to experience anxiety, excessive, widespread, and prolonged anxiety can lead to anxiety-related disorders.
High-risk factors for developing anxiety may include perfectionism, excessive worry, and difficulties in coping with long-term or recent stress, which can vary from person to person and over time.

Based on your description, medication may provide some assistance, but given your tendency to overthink, which contributes to your anxiety, it is advisable to discuss with your physician the possibility of engaging in psychotherapy to learn new coping strategies for long-term improvement of your anxiety issues.
Thank you!

Reply Date: 2017/10/30

More Info

Understanding anxiety-related physical symptoms is crucial for both patients and healthcare providers. Anxiety disorders, including generalized anxiety disorder (GAD) and panic disorder, can manifest in various physical symptoms that often lead individuals to seek medical attention, fearing they may have serious underlying health issues. Your experience of physical discomfort, including chest tightness, difficulty breathing, and other somatic symptoms, is not uncommon among those with anxiety disorders.

The Connection Between Anxiety and Physical Symptoms
Anxiety can trigger a range of physiological responses due to the body's fight-or-flight mechanism. When faced with stress or perceived threats, the body releases stress hormones like adrenaline and cortisol. This response can lead to symptoms such as increased heart rate, muscle tension, and hyperventilation, which can mimic or exacerbate physical health issues.
In your case, the symptoms you describe—such as chest pain, shortness of breath, and feelings of dizziness or nausea—are often associated with anxiety and panic attacks. These symptoms can be distressing and may lead to a cycle of increased anxiety about one's health, further exacerbating the physical symptoms.

Diagnosing Anxiety Disorders
From your description, it seems you have already undergone extensive cardiac evaluations, which have ruled out significant heart issues. This is an important step, as it helps to alleviate concerns about serious medical conditions. The fact that your healthcare providers have suggested that your symptoms may be linked to anxiety is a critical insight.
Anxiety disorders can often co-occur with other conditions, such as obsessive-compulsive disorder (OCD), as you mentioned. The presence of multiple anxiety-related symptoms, such as excessive worry, irritability, and physical discomfort, can complicate the diagnosis and treatment process.

Managing Anxiety-Related Symptoms
1. Therapy: Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders. It helps individuals identify and challenge negative thought patterns and develop coping strategies. Exposure therapy can also be beneficial, especially if certain situations trigger your anxiety.

2. Medication: While you have expressed reluctance to continue with SSRIs due to side effects, it’s worth discussing alternative medications with your psychiatrist. There are various classes of medications, including other types of antidepressants or anti-anxiety medications, that may have different side effect profiles.

3. Lifestyle Modifications: Regular physical activity, a balanced diet, and adequate sleep can significantly improve anxiety symptoms. Mindfulness practices, such as meditation or yoga, can also help manage stress and promote relaxation.

4. Support Systems: Engaging with support groups or therapy groups can provide a sense of community and understanding. Sharing experiences with others who face similar challenges can be therapeutic.

5. Self-Care Techniques: Techniques such as deep breathing exercises, progressive muscle relaxation, and journaling can help manage anxiety symptoms on a day-to-day basis.

Conclusion
Your symptoms are indeed consistent with anxiety disorders, and it’s essential to address both the psychological and physical aspects of your experience. It’s understandable to feel overwhelmed, especially when symptoms persist and impact daily life. However, with the right support and treatment plan, many individuals find relief from their symptoms and regain a sense of control over their lives.
I encourage you to maintain open communication with your healthcare providers about your symptoms and treatment preferences. They can help tailor a plan that addresses your unique needs, ensuring that you feel supported throughout your journey toward better health. Remember, you are not alone in this, and there are effective strategies to help you manage your anxiety and improve your quality of life.

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