Mind & Body

What could your anxiety be trying to tell you, really?

As the average person’s understanding of mental health expands, we have gotten better at understanding how anxiety can physically manifest. But what you probably don’t know is that these common symptoms, such as shortness of breath and sudden fear, can actually be indications of a physical condition. We consulted a couple of doctors to help discern what might be going on.

A racing heart, sweaty palms and that sinking feeling of dread. You’d be right if you said these were all symptoms of anxiety – but you’d also be correct if you said these could all be less-recognised signals of asthma, angina or an overactive thyroid.

Anxiety is a serious mental-health condition that causes feelings of worry and can also be accompanied by physical symptoms, such as rapid breathing and heart palpitations. It currently affects more than two million Australians each year and, according to new research, medical conditions can mimic its symptoms.

“It’s more common for people to not recognise that anxiety is underlying their physical symptoms because it’s harder to accept,” notes Dr Ginni Mansberg.

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“But if you have things like heart palpitations, chest tightness, trembling and abdominal pains, your doctor will always run tests to make sure it’s not a physical condition.”

GP Dr Sam Hay adds, “If a patient presents with a cluster of physical symptoms that could come under anxiety, the doctor will run tests but will also do a tactful screening of the patient’s mental health. Once that’s done, they can focus on potential physical reasons for the patient’s issues.”

Anxiety can affect you both physically and mentally, so your GP should always be your first port of call to help you work out the real cause of your concerns.

Curious to understand if your anxiety could be a clue to something else? Here’s what your symptoms could also mean:

Your hormones are out of whack

Since your endocrine system (the collection of glands responsible for hormone regulation) and your nervous system (the network of nerves that send messages to your brain) are closely interrelated, endocrine dysfunctions can sometimes present as neurological problems.

The most common examples of this can be seen in thyroid conditions.

“If you have an overactive thyroid, it’s not uncommon for your heart to react with palpitations,” Dr Mansberg explains to Body+Soul.

“You may also experience fatigue and tummy upsets like diarrhoea.”

An underactive thyroid can also mimic symptoms of anxiety, but you’ll also feel tired, cold, have trouble processing information and experience memory loss.

At a time of significant hormone fluctuation, Dr Mansberg notes that menopause can also manifest as anxiety symptoms, causing women who have never suffered mental-health issues to feel moody and experience physical symptoms such as flushing, dizziness, heart palpitations and nausea.

You have inflammation

“A lot of inflammatory conditions could cause you to feel fatigued and experience muscle and joint pain, and unfortunately the same sorts of symptoms can happen when you get anxious,” says Dr Hay.

As well as causing localised pain, rheumatologic disorders, such as lupus (a disorder that causes your immune system to attack itself) or rheumatoid arthritis (an autoimmune disease that causes joint damage) can also present as anxiety symptoms, such as fatigue, dizziness, chest pain and tremors.

If you have rheumatoid arthritis, though, a key sign your “anxiety” isn’t just that is that you’ll feel pain in specific parts of your body.

“You may have pain in your thumb, knee, ankle or big toe, and you don’t get that localised joint pain or swelling with anxiety,” explains Dr Hay.

“That’s one of the first things your doctor will distinguish – whether there is any obvious joint disease that could point to a rheumatologic problem or more non-specific aches, pains and fatigue related to anxiety.”

Your gut health needs attention

It’s not news that your gastrointestinal system and brain share a connection. Feelings of stress can cause you to feel nauseous or experience diarrhoea and heartburn, and intestinal troubles may cause anxiety and depression, too.

“It’s normal to be having symptoms such as abdominal discomfort if you’re experiencing emotional distress,” Dr Hay tells Body+Soul, but he also notes that severe or constant cramping, bloating and bowel fluctuations may be a sign of irritable bowel syndrome (IBS).

IBS currently affects around one in five Australians and causes your bowel to be especially sensitive to both physical and emotional forms of stress. It can also leave you feeling more susceptible to feelings of anxiety.

Other gastrointestinal issues such as reflux, indigestion and peptic ulcer disease can also masquerade as anxiety symptoms, leading you to experience one or a combination of fatigue, dry mouth, flushing, chest pain and sweating.

Your heart is under unusual stress

“When you’re anxious or stressed you stimulate your sympathetic system, which is known as your fight-or-flight system,” says Dr Hay.

“As a result, you get muscle tension, your heart rate goes up, your breathing gets faster, your vision narrows and you get tingling in your lips.”

Heart issues such as angina can also make you feel a sense of discomfort in your chest or like your heart is racing, and according to Dr Mansberg, cardiac conditions such as mitral valve prolapse or Barlow syndrome (a weak valve in the heart) often cause palpitations.

“These palpitations will wake you up in the middle of the night with intense pangs of anxiety,” she explains.

Because of the similarities, it can be challenging to know whether you’re experiencing a cardiac condition or anxiety, which makes it even more important to visit your doctor for testing.

You’re experiencing respiratory troubles

When your sympathetic nervous system goes into overdrive, it can lead to rapid breathing and this, coupled with a racing heart and chest discomfort, is how a panic attack feels – but it could be lung trouble.

“These symptoms are the same as those caused by asthma,” Dr Hay notes. Even if you weren’t diagnosed with the condition as a child, it’s possible to develop asthma in adulthood, so it’s important to visit a doctor to rule it out.

Respiratory conditions, including sleep apnoea, can also sometimes cause you to stop breathing while you snooze, which makes you wake up feeling disoriented and breathless – so pay attention to when you experience your symptoms.

Don’t panic!

Before you self-diagnose, follow these tips from Dr Sam Hay

“Pay attention to your physical symptoms. If they fluctuate alongside your anxiety, it means they may not be related to another medical condition. If symptoms don’t go away, accelerate or make your anxiety worse, it’s even more reason to seek help sooner.”

“Anxiety and depression aren’t just about sadness and worry. There are physical symptoms to mental-health conditions, so don’t self-diagnose.”

“Visit your doctor to rule everything out. If my patients are worried about symptoms, I’m happy for them to see me and I’ll do what I can to reassure them and address their anxiety.”