Autonomic Nervous System Disorders: Symptoms and Concerns

Q: Autonomic Nervous System Disorders: Symptoms and Concerns

Hello： Symptoms of autonomic nervous system dysfunction are varied and lack typical characteristics. <br>If you experience discomfort in your body without a clear cause, it may be due to autonomic nervous system dysfunction. <br>The autonomic nervous system affects many areas of

Could this be autonomic nervous system dysfunction, or is there a possibility of other cognitive decline?

I am a second-year medical student at a university in Taipei.
Last week, I was under a lot of stress due to various commitments, which led to daily overwhelming pressure (even to the point of crying).
After everything settled down (I was happy during the weekend), I started experiencing shoulder and neck pain, along with numbness in my right limbs (likely due to ulnar nerve involvement, specifically in my ring finger) over the past couple of days (I had already noticed slight hand numbness last week).
Today, the numbness is worse than yesterday (although it usually appears a few hours after waking up).
I've had shoulder and neck pain since high school, but it typically resolves with a day of rest.
However, this time, the numbness is concerning, so I visited the orthopedic department at a major hospital today.
X-rays showed no significant bone issues (although disc herniation cannot be detected via X-ray; a senior colleague mentioned it doesn't seem serious, but my long neck is visible in the X-ray of the seventh cervical vertebra).

Other symptoms include frequent urges to defecate (in small amounts), which I've experienced before (previously alternating between diarrhea for a few weeks and constipation).
I also feel a sensation of tightness in my breathing and a feeling that my esophagus is constricted when swallowing, along with my heart racing at times.
These symptoms have also occurred during periods of high stress.
Additionally, I've noticed that sometimes when I speak, my mind goes blank, and I struggle to find the right words (which is quite apparent).
I occasionally have thoughts like, "Who am I? What am I doing here? Is this body really mine? How cool!"
For background, a month ago, due to insomnia and stress, I visited the psychiatric department at the same hospital and started taking Melatonin (though I still feel like I'm not getting enough rest; it only helps me fall asleep faster).
Two weeks ago, I was diagnosed with unspecified ADHD through a psychological evaluation and began taking Adderall (I also had an IQ test, which showed a normal result of around 120, but my auditory processing was only about 100).
I'm really worried that this could be due to insufficient blood flow to the brain (I also have a deviated septum and take nasal spray).
I have an upcoming exam next week and feel like I won't finish studying, and I still want to become a doctor, but I'm feeling so overwhelmed right now.
Is it possible that this is due to autonomic nervous system dysregulation? I'm afraid that if I go to neurology or neurosurgery, it will just lead to unnecessary tests and waste medical resources.
If it is autonomic nervous system dysregulation, I could just discuss it directly with my doctor during follow-up visits.

On a personal note, since starting university, I've often felt down and find it hard to feel happy, but I haven't had any more extreme behaviors or thoughts.
I have undergone evaluations, so I don't think it's depression.
I also feel like I have many physical issues (and I'm worried that I might be overly sensitive, interpreting minor fluctuations in my health as major problems).
I feel guilty about frequently visiting large hospitals for check-ups and medications, as it seems like I'm wasting healthcare resources as a young person.

Xie, 10~19 year old female. Ask Date: 2023/09/26

Dr. Li Zhengfeng reply Psychiatry

Hello: Symptoms of autonomic nervous system dysfunction are varied and lack typical characteristics.
If you experience discomfort in your body without a clear cause, it may be due to autonomic nervous system dysfunction.
The autonomic nervous system affects many areas of the body, and when it is dysregulated, discomfort can manifest from head to toe, including muscle pain, headaches, dizziness, tinnitus, a sensation of a foreign body in the throat, itchy skin, palpitations, chest tightness, difficulty breathing, poor gastrointestinal function, excessive sweating, frequent urination...
even generalized fatigue, insomnia, and low mood may be related.
If you seek medical attention due to physical discomfort and, after repeated examinations, no clear cause can be identified, it is important to highly suspect that it may be caused by autonomic nervous system dysfunction.
However, before diagnosing autonomic nervous system dysfunction, it is essential to rule out physiological abnormalities, so undergoing multiple tests is necessary; do not be afraid or embarrassed.
Health is very important, and a definitive diagnosis is crucial for appropriate treatment.
Wishing you a speedy recovery.

Reply Date: 2023/09/26

More Info

Based on your description, it seems you are experiencing a range of symptoms that could indeed be related to autonomic nervous system (ANS) disorders, particularly in the context of stress and anxiety. The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, digestion, respiratory rate, and reflexes. It consists of two main branches: the sympathetic nervous system, which prepares the body for "fight or flight" responses, and the parasympathetic nervous system, which promotes "rest and digest" functions.

Your symptoms, including shoulder and neck pain, numbness in your right arm and hand, gastrointestinal issues, and feelings of breathlessness, can all be manifestations of autonomic dysregulation. Stress can exacerbate these symptoms, leading to a cycle of anxiety and physical discomfort. The fact that you have a history of stress-related symptoms, such as gastrointestinal irregularities and feelings of disconnection or derealization, further supports the possibility of an autonomic nervous system disorder.

It's important to note that autonomic dysregulation can lead to a variety of physical symptoms, including muscle tension, pain, and sensory disturbances like numbness or tingling. These symptoms can be particularly pronounced during periods of high stress, as the body may remain in a heightened state of arousal, leading to increased muscle tension and altered sensory processing.

Given your concerns about potential neurological issues, it is understandable to feel apprehensive about seeking further medical evaluation. However, it is crucial to address your symptoms comprehensively. While it is possible that your symptoms are related to stress and anxiety, it is also important to rule out any underlying medical conditions that may require attention.

Here are some steps you can take to manage your symptoms and concerns:
1. Consult a Specialist: While you may feel hesitant about visiting a neurologist or other specialists, it is essential to have a thorough evaluation to rule out any serious conditions. A neurologist can perform tests to assess nerve function and determine if there are any underlying neurological issues.

2. Stress Management Techniques: Incorporating stress reduction techniques into your daily routine can be beneficial. Practices such as mindfulness meditation, yoga, deep breathing exercises, and regular physical activity can help alleviate stress and improve your overall well-being.

3. Cognitive Behavioral Therapy (CBT): If you are experiencing anxiety or stress-related symptoms, consider seeking therapy. CBT is an effective treatment for anxiety and can help you develop coping strategies to manage your symptoms.

4. Medication Review: Since you are currently taking medications for ADHD and sleep, it may be helpful to discuss your symptoms with your prescribing physician. They can evaluate whether your current medications are contributing to your symptoms and make adjustments if necessary.

5. Lifestyle Modifications: Ensure you are maintaining a balanced diet, getting adequate sleep, and engaging in regular physical activity. These lifestyle factors can significantly impact your physical and mental health.

6. Follow-Up: Keep track of your symptoms and any changes you notice. Regular follow-up with your healthcare provider can help monitor your condition and adjust your treatment plan as needed.

In conclusion, while your symptoms may be indicative of autonomic nervous system dysregulation, it is essential to seek a comprehensive evaluation to rule out any serious underlying conditions. By addressing both the physical and psychological aspects of your symptoms, you can work towards achieving better health and well-being. Remember, seeking help is not a waste of resources; it is a proactive step towards understanding and managing your health.

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