There is a close and complex relationship between physical and mental health. Having both a medical condition and a psychological disorder can make it difficult to cope and to make the right treatment decisions. Here is a brief overview of some common medical conditions that may resemble anxiety disorders and tips for managing the overlap:

Anxiety disorders often have a physical component – symptoms such as racing heart, upset stomach, and general restlessness may accompany the uncomfortable thoughts and feelings that characterize these disorders. However, in some cases, these symptoms may actually be exacerbated by an underlying health condition. An example is the wide array of symptoms that may result from cardiovascular disease, the most notable of which include chest pain and shortness of breath. Other cardiac conditions such as arrhythmia and tachycardia may cause irregular or elevated heart rate. Especially for individuals who have had a heart attack, these symptoms may be extremely frightening.

Much like cardiac problems, respiratory conditions can closely resemble classic anxiety symptoms, especially shortness of breath and chest tightness. Conditions such as asthma and the collection of diseases known as chronic obstructive pulmonary disease (COPD) cause such symptoms by affecting airflow through the lungs. Airway blockages are also among the causes of sleep apnea, a condition of abnormal breathing during sleep, which can cause sufferers to experience breathlessness among awakening and may contribute to cognitive problems such as difficulty concentrating during the day.

At some point, you have probably experienced the feeling of “butterflies” in your stomach when you are stressed. There is a strong connection between the gut and the mind; a disruption in either can have a profound impact on the other. Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, commonly cause upset stomach and abdominal pain, as well as bowel urgency. Irritable bowel syndrome (IBS) consists of similar symptoms to IBD and is worsened by anxious sensitivity to body sensations.

Symptoms of IBS and IBD can sometimes be affected by nutritional choices, with caffeine being a commonly implicated substance due to its stimulating impact on bowel activity. Independent of these disorders, caffeine is also associated with numerous other symptoms that may mimic and contribute to anxiety – nausea, racing heart, and restlessness, to name a few. An excess or deficiency of other nutrients can also cause symptoms that resemble anxiety. A prime example is vitamin B12 deficiency, which is associated with symptoms such as nausea, numbness and tingling, and difficulties with thinking and remembering.

Diseases that affect the body’s endocrine system and metabolism are frequently the cause of anxiety-like physical symptoms that go unnoticed and undiagnosed. Perhaps the best known of these conditions is diabetes, which affects the body’s ability to make or use insulin, a hormone important to the process of transforming food into energy. Symptoms of diabetes include numbness and tingling, fatigue, and blurred vision. Another endocrine condition, hyperthyroidism, causes increased production of the hormone thyroxine, which accelerates metabolism and leads to sweating, racing heart, tremors, and nervous energy. Adrenal dysfunction, including Addison’s disease, occurs when the body does not produce enough of the stress hormone cortisol, resulting in a host of symptoms such as acute fatigue, nausea, low blood pressure, and pain.

Neurological conditions are often diagnosed alongside anxiety disorders, owing to the wide variety of symptoms that result from changes to the brain. Conditions such as Parkinson’s disease and multiple sclerosis (MS) both can result in tremors and impaired coordination. MS, a deterioration of myelin cells in the central nervous system, frequently also causes fatigue and problems with vision. Other diseases, such as Lyme disease, may also affect the nervous system when untreated and may lead to racing and irregular heartbeat, dizziness, shortness of breath, and numbness and tingling.

Finally, disorders characterized by chronic pain, particularly those that are difficult to diagnose, are often mistaken for anxiety. A common feature of fibromyalgia, which causes musculoskeletal pain and fatigue, includes a sort of “brain fog” that can make concentration difficult. The pain and changes in estrogen levels that accompany endometriosis, a condition in which the tissue that lines the inside of the uterus grows outside the uterus, can also result in anxious feelings. The pain caused by these conditions is often dismissed by doctors as psychosomatic (an emotional problem manifesting as a physical problem) and may be attributed falsely to an anxiety disorder.

With so much overlap among the conditions discussed here (as well as many others), it can be hard to figure out what kind of treatment is needed to treat your specific symptoms. Here are some tips that can help:

1. Stay up to date on your preventative care, including annual examinations and regular blood work. This maximizes your chances of finding out quickly if any common physical indicators of disease (e.g., vitamin insufficiencies, hormonal imbalances) are out of the normal range.
2. Work with a multidisciplinary team of healthcare professionals. Your therapist and medical doctors can cooperate to ensure that everyone involved in your treatment has the most complete understanding possible of your condition.
3. Be mindful of your own symptom patterns. Do your physical symptoms always precede feelings of anxiety? Do they start at the same time? Do you have any physical symptoms that aren’t typical of anxiety disorders, or vice versa?
4. Important note: Anxiety disorders can sometimes include persistent worry about potential medical problems even in the absence of such problems. It is important to seek a balance of advocating for yourself in healthcare settings while also accepting that some uncertainty about our health is inevitable.

Need help or support?

If you or a loved one are struggling with anxiety or any other mental health concerns, know that you are not alone. If you are a parent or a caregiver and are seeking additional information about these diagnoses and how you can best support your child, our office provides parent training with the SPACE program. Please see our November 2021 Newsletter for more information on SPACE.

For these or any other mental health concerns, please contact The OCD & Anxiety Center at (630) 522-3124 or info@theocdandanxietycenter.com. We have offices in Oak Brook and Orland Park and our clinicians specialize in helping individuals overcome anxiety disorders, Obsessive-Compulsive Disorders, and other co-occurring mental health issues. We also provide telehealth services that are available in Illinois, Indiana, Georgia, and Iowa.

At The OCD & Anxiety Center, we can provide treatment both in the office and at off-site locations (your home, mall, school, etc.). We will work closely with you to create an individualized treatment plan and discuss the appropriate frequency of visits needed to achieve your treatment goals. We look forward to hearing from you and working with you to conquer your anxiety!

Katie Mangen is a Masters level therapist at The OCD & Anxiety Center in Oak Brook, IL and Orland Park, IL. She is currently working on her PhD at Northern Illinois University.  She specializes in treating all forms of OCD and anxiety in children, teens, and adults. He provides Exposure and Response Prevention Therapy and is comfortable working in and outside the office, wherever anxiety happens.