Anxiety Due to a Medical Condition

What is anxiety due to a medical condition?

Anxiety due to a medical condition means that a medical problem causes symptoms such as feeling nervous, worried, or jittery. You may have panic attacks or feel that something terrible is going to happen.

This disorder is different from being nervous and worried about your illness. If you have this disorder, your medical condition physically causes anxiety.

How does it occur?

Many medical conditions change the amounts of chemicals called neurotransmitters in your nervous system. Too little or too much of these chemicals can cause mood problems. Many medical problems upset the balance of neurotransmitters in your body, such as:

• heart failure or abnormal heart rhythms
• brain or nervous system problems such as encephalitis, strokes, and head injuries
• hormone imbalances caused by pituitary, thyroid, or adrenal gland problems, or by diabetes
• breathing problems such as shallow, rapid breathing; pneumonia; or chronic lung disease
• withdrawal from sedatives or pain medicines.

Certain medicines that you take for a medical problem may cause or add to the symptoms of anxiety. Some of these medicines are:

• decongestants such as pseudoephedrine (Sudafed)
• bronchodilators
• insulin
• medicines for Parkinson's disease
• steroids.

What are the symptoms?

Besides feeling nervous and worried, you may also:

• Think that bad things will happen or that you will never get better.
• Have trouble falling asleep or wake up often during the night.
• Lose weight because you don't feel like eating.
• Fear that you are losing control of yourself and will go crazy or will die.
• Have chills, hot flashes, sweating, shaking, or numbness.
• Feel your heart race or pound.
• Have trouble concentrating or remembering things.
• Have trouble breathing or swallowing due to muscle tightness.
• Feel pain in your chest, stomach, or abdomen.
• Throw up or have nausea or diarrhea without a clear physical cause.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and any drug or alcohol use. You may have some lab tests to rule out other medical problems.

How is it treated?

Do not try to overcome anxiety by yourself. There may be a treatment for your medical problem that will reduce your nervousness and worry. If not, you may be able to treat the anxiety with psychotherapy or antianxiety medicines. Discuss the options with your healthcare provider or therapist.

Medicines

Several medicines can help treat anxiety. Your healthcare provider will work with you to select the best one for you. Some medicines are:

• antianxiety medications such as lorazepam (Ativan), diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and buspirone (BuSpar)
• antidepressants such as clomipramine (Anafranil), imipramine (Tofranil), nortriptyline (Aventyl HCl, Pamelor), desipramine (Norpramin), escitalopram (Lexapro), citalopram (Celexa), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and venlafaxine (Effexor)

Psychotherapy

If your medical problem has been treated and you still have problems with anxiety, seeing a psychiatrist or psychotherapist can help. Therapy may last a short time or may last for many months. Two kinds of therapy are very helpful for anxiety problems: cognitive behavioral therapy (CBT) and systematic desensitization.

Natural and Alternative Treatments

• Herbs and Supplements. Claims have been made that certain herbal and dietary products (kava root, lemon balm, lavender, passion flower, valerian) help control anxiety problems. None of these herbs will treat or prevent panic attacks. No herb or dietary supplement has been proven to relieve anxiety.
• Biofeedback. Through biofeedback you learn to control body functions such as muscle tension or brain wave patterns. Biofeedback can help with tension, anxiety, and concentration.
• Massage Therapy. Massage therapy may help lower stress and muscle tension. These changes may be very helpful to reduce your anxiety.
• Relaxation Therapies. Learning ways to relax can help with anxiety, along with medicines and psychotherapy. Yoga and meditation may also be helpful.
• Hypnotherapy. Hypnosis can help you learn to control anxiety symptoms and things that trigger your anxiety.
• Art and Music Therapies. Some people find art and music therapy, along with medicines and psychotherapy, help to control anxiety.

How long will the effects last?

As your physical condition improves your anxiety will usually improve. However, if your health remains poor, anxiety may continue. Seek professional help to overcome anxiety, or at least reduce it.

What can I do to help myself or my loved one?

Taking care of yourself is very important. Stay as physically and socially active as you can. Have regular sleeping and eating patterns. Focus on positives in your life rather than your illness. Check with your healthcare provider before you take any new medicines. To help prevent anxiety:

• Learn which activities help you feel better and do them often.
• Talk to your family and friends.
• Stay socially active.
• Eat a healthy diet.
• Do not abuse alcohol or drugs.
• Avoid caffeine.
• Exercise regularly.
• Learn ways to lower stress, such as breathing and muscle relaxation exercises.

Get emergency help immediately if you or a loved one have serious thoughts of suicide or harming others, or if you have chest pain.