Unexplained Physical Symptoms: When to Seek Help

Physical discomfort?

Hello Doctor, since mid-August, I have been experiencing tingling and numbness in my fingers and limbs upon waking up.
I went to a neurologist for an examination, and I will be undergoing more in-depth tests soon.
Between mid-August and October, I have felt that my body sometimes feels off.
Occasionally, I experience a sensation of increased heart rate, and my sleep has become more fragmented with vivid dreams.
I also occasionally experience mild dizziness and headaches.
Although the tingling and numbness in my limbs are mild, they sometimes occur unexpectedly.
When I feel unwell, I tend to look up potential illnesses.
I make an effort to dedicate an hour each day to jogging and brisk walking to help my body feel more relaxed.
Although I don’t feel particularly anxious, I wonder if my body is being affected by a bit of anxiety, leading to these symptoms, as I did not experience these issues before, and they usually resolve within three days.
Should I see another doctor to check for anxiety symptoms if the neurological tests come back normal? Thank you for your response, as this state has persisted for nearly two months, fluctuating but not particularly severe, sometimes feeling better.
I find that when I feel a slight discomfort, I worry it might be serious, but such thoughts usually pass quickly.

Chen Tongxue, 20~29 year old female. Ask Date: 2021/10/09

Dr. Xiao Yongxun reply Family Medicine

Dear Student Chen,
The characteristics of Generalized Anxiety Disorder (GAD) include chronic and persistent worry that is multifaceted (e.g., concerning finances, family, health, the future, etc.), excessive, difficult to control, and often accompanied by other nonspecific physiological or psychological symptoms.
Essentially, excessive worry is the core feature of this disorder.
Key diagnostic points include:
1.
Excessive anxiety and worry about numerous events or activities (such as work or school performance) occurring more days than not for at least six months.
2.
The individual finds it difficult to control this worry.
3.
This anxiety and worry are accompanied by three or more of the following six symptoms (only one symptom is required for children):
(1) Restlessness or feeling keyed up or on edge
(2) Easily fatigued
(3) Difficulty concentrating or mind going blank
(4) Irritability
(5) Muscle tension
(6) Sleep disturbances
4.
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
5.
The disturbance is not attributable to the physiological effects of a substance (e.g., drug abuse, medication) or another medical condition (e.g., hyperthyroidism).
6.
The disturbance cannot be better explained by another mental disorder.
Therefore, your situation may not qualify as Generalized Anxiety Disorder.
However, differential diagnoses such as Somatic Symptom Disorder, Illness Anxiety Disorder, and Functional Neurological Symptom Disorder should still be considered.
It is advisable for you to discuss your situation with your neurologist to review the examination reports and seek guidance on the next steps.

Reply Date: 2021/10/09

More Info

Understanding unexplained physical symptoms can be quite challenging, especially when they persist over time without a clear medical diagnosis. Your experience of numbness in your fingers, increased heart rate, disrupted sleep patterns, and occasional dizziness can be distressing and may lead to concerns about underlying health issues.
Firstly, it’s important to recognize that unexplained physical symptoms can arise from a variety of factors, including physical health conditions, psychological stress, or a combination of both. In your case, since you have already consulted a neurologist and are awaiting further tests, it’s a good step to rule out any neurological disorders. Conditions such as peripheral neuropathy, carpal tunnel syndrome, or even vitamin deficiencies can cause symptoms like numbness and tingling in the extremities.

The sensations of increased heart rate and sleep disturbances you describe could potentially be linked to anxiety, even if you do not consciously feel anxious. The body can react to stressors in ways that may not always be apparent to us. For instance, the fight-or-flight response can trigger physiological changes, including increased heart rate and heightened alertness, which might manifest as difficulty sleeping or increased dreaming.
Given that your symptoms have persisted for nearly two months and fluctuate in intensity, it may be beneficial to consider the role of anxiety or stress in your physical health. Even if you do not feel overtly anxious, subtle anxiety can still affect your body. It might be worthwhile to consult a mental health professional who can help assess whether anxiety or stress is contributing to your physical symptoms. Cognitive-behavioral therapy (CBT) is one effective approach that can help individuals manage anxiety and its physical manifestations.

In addition to seeking psychological support, maintaining a healthy lifestyle can also be beneficial. You mentioned that you engage in regular exercise, which is excellent for both physical and mental health. Exercise can help reduce anxiety and improve sleep quality. It might also be helpful to incorporate relaxation techniques such as mindfulness meditation, yoga, or deep-breathing exercises into your routine. These practices can help calm the mind and body, potentially alleviating some of the symptoms you are experiencing.

If your neurological tests come back normal, and you still experience these symptoms, it’s essential to keep an open line of communication with your healthcare providers. They can help you explore other potential causes, including stress-related disorders or somatic symptom disorders, where psychological distress manifests as physical symptoms.

In summary, while it’s crucial to rule out any serious medical conditions through appropriate testing, it’s equally important to consider the psychological aspects of your symptoms. Seeking help from a mental health professional can provide you with strategies to manage any underlying anxiety and improve your overall well-being. Remember, you are not alone in this experience, and there are resources available to help you navigate these challenges.

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