Which Specialist Should I See for Anxiety and Pulsating Symptoms?

I don't know which specialty to see?

Hello, doctor.
I previously visited a psychiatrist who diagnosed me with mild anxiety disorder.
During the National Day holiday, I suddenly experienced a headache and consulted an otolaryngologist, who prescribed painkillers for me.
The headache lasted for about two days, but it has been occurring intermittently since then.
Recently, I have noticed that when I lie down or sit, I can feel my pulse beating.
I would like to know if this is caused by anxiety or if there could be other reasons.
If I need further examination, should I return to see the psychiatrist or consult another specialist?

JJ, 20~29 year old female. Ask Date: 2020/10/21

Dr. Ye Qianyu reply Family Medicine

Hello! Based on your description, the pulsating sound you hear in your ear is a symptom of tinnitus.
It is recommended that you follow up with an otolaryngologist for further examination.

Reply Date: 2020/10/21

More Info

When dealing with anxiety and physical symptoms such as pulsating sensations, it's essential to approach the situation holistically. Based on your description, it seems you have already been diagnosed with mild anxiety, which can indeed manifest in various physical symptoms, including headaches and unusual sensations like pulsations when lying down or sitting.
Anxiety can lead to heightened awareness of bodily sensations, which may cause you to notice your pulse more acutely, especially in a state of rest. This is often referred to as somatic symptom disorder, where psychological distress manifests as physical symptoms. However, it’s crucial to rule out any underlying medical conditions that could also be contributing to your symptoms.

Given your history of anxiety and the recent onset of pulsating sensations, I recommend the following steps:
1. Consult a Primary Care Physician (PCP): Since you have experienced headaches and now have new symptoms, it would be wise to start with your primary care physician. They can perform a comprehensive evaluation, including a physical examination and possibly some basic tests (like blood tests or imaging) to rule out any medical issues that might be causing your symptoms.

2. Return to Mental Health Specialist: If your primary care physician determines that your physical health is stable, it would be beneficial to return to your mental health specialist (psychiatrist or psychologist). They can help you explore the psychological aspects of your symptoms further. Cognitive Behavioral Therapy (CBT) is a common and effective treatment for anxiety that can help you manage your symptoms better.

3. Consider a Neurologist: If your headaches persist or worsen, or if you experience any new neurological symptoms (like changes in vision, balance issues, or severe headaches), it may be appropriate to see a neurologist. They specialize in conditions affecting the nervous system and can provide further insights into your headaches and any potential neurological causes for your pulsating sensations.

4. Lifestyle Modifications: In addition to seeking medical advice, consider implementing lifestyle changes that can help manage anxiety. Regular physical activity, a balanced diet, adequate sleep, and mindfulness practices (like meditation or yoga) can significantly reduce anxiety levels and improve overall well-being.

5. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing and treating your condition.

In summary, start with your primary care physician to rule out any physical health issues. If everything checks out, returning to your mental health specialist is the next best step. Remember, it’s essential to address both the physical and psychological aspects of your health to achieve the best outcomes. Don’t hesitate to seek help; managing anxiety and its symptoms is a journey, and you don’t have to do it alone.

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