Recurring Anxiety Symptoms: Causes and Treatment Options

Symptoms may recur repeatedly?

Hello Dr.
Ding, I apologize for frequently asking questions.
I would like to inquire again.
Previously, I had anxiety disorder and was on medication for a while.
Later, I felt better and stopped taking the medication.
For the next six months, I felt completely normal.
However, in the past few months, I have been experiencing symptoms such as warmth in my hands and feet, tingling in my extremities, and restlessness, occurring every 20 days and lasting for 4 to 5 days.
Are these symptoms a recurrence of my anxiety disorder? I previously had an autonomic nervous system examination, and the doctor said everything was normal.
Why am I experiencing these symptoms? Each episode is very distressing.
I would like to ask the doctor what these symptoms could mean.
Additionally, I would like to know if anxiety disorder could be caused by a deficiency of something.
Can anxiety disorder be completely cured without medication? Is anxiety disorder a condition that can be fully resolved? I am very concerned about the side effects of medication.
Thank you!

Niming, 60~69 year old female. Ask Date: 2014/02/11

Dr. Ding Shuyan reply Psychiatry

Hello, I would like to share some insights regarding the concept of disease.
There is a category of diseases, particularly physical illnesses, that do not exist in a so-called healthy state, such as cancer or fractures.
This objective abnormal condition is independent of the sick person's perception of their illness, attitude, or subjective feelings of pain; it simply exists or does not exist.

On the other hand, most mental illnesses have symptoms that can also be experienced, to some extent, by so-called "normal" individuals; they are not strictly binary states of presence or absence.
For example, feelings of anxiety and depression are experiences that nearly everyone has encountered at some point.
To determine whether these emotions reach an abnormal level or constitute a disorder, one must consider the severity of the symptoms, the individual's subjective experience of distress, and the impact of these symptoms on daily functioning.
The boundaries can sometimes be ambiguous and subjective.
Whether your discomfort is a recurrence of an anxiety disorder should be discussed collaboratively with your physician.
It is important to remember that symptoms similar to anxiety or autonomic nervous system dysregulation can also be influenced by external factors such as stress, diet, and irregular lifestyle, which are potential triggers you should consider.
Anxiety disorders generally tend to be recurrent, often due to personality traits, coping skills, and stressors that are not easily removed.
However, because anxiety is primarily a psychological issue, the potential for recovery is quite significant.
If there are considerable changes in personality and coping abilities, the likelihood of future recurrences diminishes, and the severity of any re-emerging anxiety symptoms is less likely to be disruptive.
This aspect is certainly more optimistic compared to the challenge of regrowing a lost hand.
Taking medication is not inherently negative; for students, anxiety can affect their exam performance, and if medication helps them perform adequately and gain admission to their desired school, what is the downside? The key is to weigh the benefits and drawbacks of medication; extremes in either direction are unnecessary.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2014/02/11

More Info

Understanding recurring anxiety symptoms can be quite complex, especially when considering the interplay of psychological and physiological factors. Your experience of anxiety symptoms resurfacing after a period of feeling well is not uncommon. Anxiety disorders, including panic disorder and generalized anxiety disorder, can often be cyclical in nature.
The symptoms you describe—tingling in the hands and feet, feelings of restlessness, and episodes occurring every 20 days lasting 4 to 5 days—may indeed indicate a recurrence of anxiety. These symptoms can be manifestations of anxiety attacks or heightened anxiety states. It's important to note that anxiety can present with a variety of physical symptoms, including those affecting the autonomic nervous system, which might explain the sensations of heat and tingling.
Even though previous tests for autonomic nervous system function came back normal, anxiety can still produce physical symptoms that mimic other medical conditions. Stress and anxiety can lead to hyperventilation, which can cause tingling and numbness in extremities, as well as feelings of lightheadedness or heart palpitations.
Regarding your question about the causes of anxiety, several factors can contribute to anxiety disorders, including genetic predisposition, environmental stressors, and biochemical imbalances in the brain. Neurotransmitters such as serotonin, norepinephrine, and gamma-aminobutyric acid (GABA) play significant roles in mood regulation. A deficiency or imbalance in these neurotransmitters can contribute to anxiety symptoms.
As for the treatment options, it is essential to understand that while medication can be effective, it is not the only avenue for managing anxiety. Cognitive-behavioral therapy (CBT) has been shown to be effective in treating anxiety disorders and can provide you with tools to manage your symptoms without the need for medication. Mindfulness practices, relaxation techniques, and regular physical activity can also help reduce anxiety levels.
You mentioned concerns about medication side effects, which is a valid concern for many individuals. While medications like SSRIs (selective serotonin reuptake inhibitors) and benzodiazepines can be effective, they do come with potential side effects. It’s crucial to have an open dialogue with your healthcare provider about your fears and to explore all treatment options, including non-pharmacological approaches.

In terms of whether anxiety can be "cured," it is often more about management than a complete cure. Many individuals learn to manage their anxiety effectively through a combination of therapy, lifestyle changes, and sometimes medication. The goal is to reduce the frequency and intensity of anxiety episodes and to improve your overall quality of life.

If you are experiencing significant distress from your symptoms, it would be advisable to consult with a mental health professional. They can help you assess your current situation, explore treatment options, and develop a personalized plan that addresses your concerns about medication while also providing effective strategies for managing anxiety. Remember, seeking help is a sign of strength, and there are many resources available to support you in your journey toward feeling better.

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