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Anxiety and Stress Disorders

Identifying Anxiety Disorders

03/24/2006

Question:

I have diabetes and heart disease in my family --I used crack cocaine for about 6 years -- I have been clean for over 6 years -- I went to the e.r. with chest pain a few years ago-- everything was o.k.- pulled chest muscle-- I tested positive for H.pylori was treated and everything was fine-- then the panic attacks started-- some in the daytime mostly at night--go to sleep wake in a few hours with rapid pulse shortness of breath -- symptoms of panic attack-- I cut out caffeine and they stopped for a while but returned -- they were less intense -- I recently was put on achiphex for stomach pain-ulcer or reflux-- I feel very anxious most of the time for no reason-- I am constantly checking my pulse in fear-- I recently went to athird shift job(have worked 1st most of my life) I go to night class and take an online class and I have two children-- could this be a heart condition? lung problem? B-12 deficiancy? stomach? panic?- I just want to feel normal again-- please help

Answer:

When you describe yourself as "anxious most of the time for no reason," then I think you need to seriously consider an anxiety disorder as the cause.  You mention a number of other medical conditions that concern you -- heart, lung, vitamins, stomach -- yet you describe evaluations by doctors that have revealed only minor or no medical problems associated with those conditions.

Many people can't seem to believe that an anxiety disorder can make them feel so physically ill -- yet common symptoms of anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, and hot flashes. People with anxiety may feel lightheaded or out of breath. They also may feel nauseated or have to go to the bathroom frequently.  They may seem unable to relax, and they may startle more easily than other people. They tend to have difficulty concentrating, too. Often, they have trouble falling or staying asleep.

Anxiety disorders occur when brain cells and their neurotransmitters (chemicals that the brain uses to communicate) get out of balance. Outside experiences and behaviors can both exacerbate or improve the anxiety.

The weblinks for this answer are good sources for more information on anxiety.  If you have not already done so, making an appointment with your primary care physician for a complete physical exam is a good idea.  You do want to make sure your anxiety is not worsened by additional medical problems.  Your physician may begin treatment for you for your anxiety, or may refer you for counseling or therapy.  Both medications (usually the selective serotonin reuptake inhibitors, like fluoxetine, sertraline and other) and therapy (especially cognitive-behavioral therapy) are effective in treating anxiety disorders. 

Good luck.

Related Resources:

anxiety disorders of america
NIH NIMH anxiety

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati