As a psychiatrist, I have treated patients who have experienced unexplained symptoms. These patients have been to numerous doctors and specialists who performed numerous laboratory and imaging studies, all of which were normal, in addition to normal physical findings. Eventually, many of these patients were referred to psychiatry, as the normal laboratory and physical findings suggest a psychogenic cause. Below are 14 hidden symptoms of anxiety that you may have:
- Headache:
- Muscle tension and aches; on edge:
- Short of breath:
- Irritability:
- Fainting, drop attacks:
- Not able to relax:
- Difficulty concentrating:
- Insomnia:
- Feelings of detachment:
- Lump in throat:
- Trembling, shaking:
- Nausea:
- Sweating:
- Chest pain/heart palpitations:
Headache may be a telltale sign of stress in general. A good dose of worrying can make this worse, as in generalized anxiety disorder. Having a headache may allow one to take time out and rest, effectively removing that person from a stressful situation (or from one’s own worrisome thoughts).
Being on edge and hypervigilant about the environment can lead to muscle tension and aches, as seen in generalized anxiety disorder and post-traumatic stress disorder. Massage or taking a hot bath may alleviate this.
The inability to catch one’s breath may be a harbinger of a panic attack, which may be part of a panic disorder. When one is short of breath, it may be helpful to breathe into a paper bag. This helps to slow down the breathing, and the person is then able to take deep breaths and able to calm down.
Irritability may be due to being stressed out from excessive worrying, as seen in generalized anxiety disorder. Being worried, tense, fearful and sleep-deprived is not a happy state, but rather a miserable one, which leads to irritability.
Someone who has been fainting and having drop attacks may have been to the doctor for workup of seizure disorder or cardiac problems. If physical findings are normal, then an anxiety disorder may be present, such as panic disorder. The panic attacks may induce fainting, as the rapid breathing is shallow, and not enough oxygen gets to the bloodstream and brain. As stated above, it may be helpful to breathe into a paper bag, as this helps the person to slow down their breathing and take more deep breaths. Deep breaths more effectively oxygenate the bloodstream than shallow ones, and thereby oxygenates the brain, preventing fainting.
Ever go camping or to the beach and you find yourself not able to relax? Consider generalized anxiety disorder for someone who is not able to relax due to excessive worries. For these people, passive relaxation (ie lying on a beach) may not be helpful. Something more active, like walking or meditation, may be helpful, to distract the mind away from its worrisome thoughts.
Anxiety can make concentration and completion of tasks difficult, such as in generalized anxiety disorder. And when one can`t finish tasks, this only compounds the problem, and makes the anxiety worse. This can be a vicious cycle, unless the cycle is broken, like when one gets help for their anxiety.
Having problems with sleep may be indicative of anxiety. Anxious thoughts can keep one awake at night. But this sleep deprivation can make the anxiety worse. When the anxiety is treated, then sleep improves.
Feelings of detachment or having out of body experiences may be indicative of a serious anxiety disorder such as post-traumatic stress disorder. People who suffer from this have a feeling that everything is unreal. This can be quite distressing, as they feel like they are going insane. Get professional help immediately if you have this.
Have you ever had a lump in your throat and had difficulty swallowing? Fear, worry and stress often accompany the lump in the throat. Patients with this complaint many times end up seeing an ENT doctor (ear, nose, throat). If the work-up does not reveal a physical cause, then a referral to a psychiatrist is in order.
Trembling and shaking may be indicative of a panic attack, as seen in panic disorder. This is ultimately indicative of extreme fear, if not from a physical cause.
Anxiety, stress and worrying can induce nausea and gastrointestinal upset. Nausea from anxiety often is associated with loss of appetite. So with anxiety, comes poor nutrition, sleep deprivation, and irritability, leading to even worsening distress and worsening anxiety. These hidden symptoms do not occur in isolation…rather they occur as a constellation of symptoms.
When people are nervous or highly anxious, they sweat. Sweating may also be a harbinger for a panic attack, as seen in panic disorder.
This one is a common presentation to an emergency room, where someone presents as having a heart attack, but physical and laboratory findings are normal. Consider a panic attack as seen in panic disorder, for this presentation.
In summary, the body gives telltale signs and clues that one may have anxiety. Certainly, anxiety disorders are not diagnosed with just an isolated symptom. Rather, these hidden symptoms occur as part of a constellation of symptoms. If one of the above hidden symptoms appears with no other physical explanation, then one should consider anxiety.
Sir, My bp which was not unknown to me shot up to 200/100 + and for a short while I took medication but realized that it is not really helping. I took a dose of Alparzplam 25 mg and my bp is down to normal. I take the dose daily and today is the 4th day. I had and have many worries but no crisis. I was not aware of the anxiety if I had any. Why does Alprazolam helf so much? Ratnakar.
Dear Ratnakar,
Obviously, I have not examined you, so I can’t give specific medical advice. Please visit your doctor to evaluate your problems with blood pressure. If there is no medical cause for the increased blood pressure, then an evaluation for anxiety may be in order.
Anxiety can be associated with increased blood pressure, as anxiety triggers the fight or flight response, which leads to increased heart rate. Anxiety medications such as alprazolam (Xanax) can help reduce anxiety symptoms, such as increased heart rate, and bring the blood pressure down.
But as I initially stated, please visit with your doctor, as you may have a medical cause for your increased blood pressure.
Sincerely,
Dr. Carlo