Anxiety disorders — Is it really all in your head?

Posted by Filza Hussain, M.D.
September 09, 2015

Blog_Anxiety_webThis was her third trip to the emergency room in two days. She had been home watching TV, when all of a sudden, her heart started racing, she felt her face flush, her hands tingle and it was hard to catch her breath. She was scared, because she felt like she was dying. She started crying uncontrollably, making it all the more difficult to breathe. She was frustrated with the emergency room, because they felt as a healthy 20-year-old who had a thorough medical work-up completed two days ago, she isn’t having a heart attack, but, rather, an anxiety attack.

The above scenario is not an uncommon one, especially the frustration where a person may feel that the doctors are not taking her seriously or telling her “it’s all in her head.” In a way, they are not entirely wrong, as it is all in the head. Here’s why.

We all experience some anxiety at different periods in time. It’s the brain’s way of getting us ready to face or escape danger, or deal with stressful situations. For example, anxiety before exams can make one study more and, hence, do well on a test. However, at times, the anxiety can be quite severe or exaggerated in relation to the actual situation. This can lead to intense physical sensations, anxious thoughts, worries and avoidant behaviors to the point that they impact one’s life. An example would be skipping school the day of a test because one is so anxious or having a panic attack to the point that one can’t take a test.

But why does anxiety manifest with physical symptoms?

Filza Hussain, M.D.Consider this simplified explanation. The brain is an extremely powerful organ. It is, in a way, the central command center for the rest of the body and has an influence over all the different organ systems. When this central command system is hijacked by anxiety, the anxiety has free reign to cause havoc in the different organ systems, creating actual physical symptoms, even though there is nothing wrong with the organ itself.

Primary care and emergency room doctors usually are the first line of defense. Their methodical approach to first rule out medical causes, such as thyroid, heart and other hormonal problems, and then diagnose an anxiety disorder is a positive approach to diagnosing an anxiety disorder.

The good news is anxiety disorders are manageable. There are medications to help in the short or long term. There also are a number of nonmedication ways of managing anxiety. They include reducing stress, exercising, practicing breathing exercises and yoga techniques. Cognitive behavioral therapy, which teaches your brain to change thought patterns, also can help. So when you hear “it’s an anxiety disorder,” don’t despair or think no one is taking you seriously. Rejoice in the fact that there is no life-threatening medical problem causing your symptoms, and ask your doctor about the best way for you to gain control over anxiety.

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