Medical Conditions That Provoke Or Mimic Symptoms Of Anxiety Disorder - Types Of Anxiety Disorders: Anxiety Disorder

Content provided by the Faculty of the Harvard Medical School

Medical conditions that provoke or mimic symptoms of anxiety disorder

The experience: A woman, age 56, has recently become jittery, tense, anxious, and irritable. She's also losing weight. Seeing the marked change in her behavior, her husband and children ask what's bothering her, but she doesn't know. She isn't under any unusual stress at work or at home. Desperate for an explanation, as well as relief, she goes to her doctor for a checkup. The doctor diagnoses an overactive thyroid. The woman begins taking thyroid medication, and the symptoms disappear in days.

Symptoms: Symptoms vary depending on the specific condition causing them, but may include anxiety, panic attacks, obsessions, or compulsions. These symptoms cause significant distress or interfere with functioning at work, at home, and in ordinary social situations.

Cause: Any condition that changes the hormonal activity of the sympathetic nervous system (see "Cause" under "Panic disorder"), such as an overactive thyroid (hyperthyroidism), can mimic the sensation of anxiety. And conditions that stimulate the sympathetic nervous system, including low blood sugar and asthma, can also trigger anxiety symptoms. In addition, people who have heart disease or asthma may feel anxious about having a heart attack or asthma attack, a phenomenon known as anticipatory anxiety.

The most common illnesses or categories of illnesses that can cause anxiety symptoms:

• Cardiovascular conditions include angina pectoris, arrhythmias, congestive heart failure, and valvular disease. A heart attack can also cause anxiety symptoms.

• Neurological conditions include vertigo and seizure disorders.

• Peptic ulcer disease causes sores in the lining of the stomach or duodenum (the first part of the small intestine).

• Respiratory conditions include asthma and hyperventilation syndrome, the tendency to breathe so quickly and deeply that you become dizzy.

• Endocrine disorders are caused by hormonal imbalances. They include hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), and pheochromocytoma, a tumor of the adrenal gland that secretes excess amounts of adrenaline. They also include diabetes, hyperglycemia (high blood sugar), and hypoglycemia (low blood sugar).

Prevalence: The incidence varies with the medical condition as well as the anxiety disorder. One study found that the incidence of panic disorder is 20% among asthmatics and 50% among people with chest pain. Among people with diabetes, the rate of phobia is about 19%, while the rate of generalized anxiety disorder is 17%.

Who's at risk: People with dozens of medical conditions are at risk because these illnesses can cause chemical changes in the brain that induce anxiety symptoms.

Effective treatments: Treating the underlying medical condition usually relieves the anxiety symptoms.

Last updated:	September 05, 2008