Anxiety is like the “aloha” of mental illnesses; it has several different meanings, except none are evocative of greeting, peace or paradise. Not only can anxiety be a symptom of chronic illness, it can also be a chronic illness itself, as well as an intensely painful emotion that makes your worst fears seem real over time or in intense, debilitating bursts. It’s not unusual then for people with severe symptoms of anxiety to distrust diagnoses, become convinced that they’ll lose their health if they don’t obsessively, and fruitlessly, search for an answer. If, however, you use anxiety as a motivation to do research and explore alternatives, you can find good ways of managing it. That way, your anxiety, in whatever form it takes, won’t make achieving some form of aloha impossible.
-Dr. Lastname
All my life I have been a bundle of nerves and was eventually diagnosed with Generalized Anxiety Disorder. Recently, however, I have been experiencing debilitating physical symptoms that led me to believe that I have other medical issues that are being overlooked. I’ve been getting chest pains (which sent me to the ER and the doctors confirmed it wasn’t a heart attack), fatigue, trouble sleeping, nausea that comes and goes, brain fog, trouble seeing sometimes…most recently I developed the most annoying symptom, uncontrollable muscle twitches all over my body. My primary care physician told me this is all just anxiety manifesting itself, but the symptoms are so physical at this point that it is driving me to make appointments with specialists to find out what’s wrong before I totally lose it mentally. My goal is to find out whether this is just anxiety or something that could be even worse.
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As you obviously already know, it’s important to seek a treatable or curable cause of anxiety because sometimes the symptoms actually are caused by a dangerous and/or treatable medical condition. Indeed, the fact that you can possibly uncover curable or controllable causes of your symptoms, like thyroid disease, means you have an obligation to put yourself through a thorough medical evaluation. In fact, your impulse to be careful and cautious is one of anxiety’s few perks, and one of the only worth indulging.
On the other hand, the fact that you’re anxious does mean that, once you think you’re onto something, it can be very hard to let go of, even after an evaluation doesn’t turn up anything. At that point, the endless, anxiety-fueled search for and obsession with the “real” problem will only make your existing problems worse.
Unfortunately, it is true that some doctors may automatically assume that, because you have anxiety, you’re not really physically sick and the problems are all in your head. If you’re worried that your primary care doctor or medical specialist is making that assumption and hasn’t done a complete evaluation, do your own research, prepare your own questions, and use a second opinion to ensure that the evaluation you received was as complete as possible. If your queries are more factual than emotional then they’ll be much harder for a doctor to dismiss.
The risk, however, is that your research opens the floodgates for you to anxiously obsess over your issues and press you to keep looking until you receive a diagnosis that will satisfy you and give you a sense of control. Then you’re trapped in an endless search that can make you feel even more helpless and alienated. By refusing to accept that you can’t cure or control your anxiety, you’ll turn it into a massive problem that will end up controling you.
So, once your doctors have actually done a good search for the medical causes of your symptoms, you have to face the fact that you’re stuck with a syndrome that isn’t curable or easy to manage. If your anxiety makes that difficult, remind yourself that there’s much that doctors don’t know and the best you can do about any set of symptoms is get doctors to check out what they do know. After that, it’s all management, no matter what symptoms you’re suffering from or what the presumed diagnosis is.
And one of the main reasons anxiety is hard to manage is the same reason that it makes your diagnosis so hard to accept; anxiety distorts your thoughts, telling you that your life is falling apart, your health crumbling, and that there’s nothing more important than finding someone who can save you from total helplessness.
Your goal then isn’t to find a cure for anxiety or a possible other, mysterious medical diagnosis; it’s to do what you can to diminish the power and intensity of your symptoms so they don’t prevent you from focusing on the truly important things in life, like making a living and being a good person. Yes, anxiety feels terrible and interferes with work and relationships. But you can also find books, friends, therapists and support groups that can help you regain your perspective, oppose false thinking, and do what’s important in spite of the toll anxiety takes on your body.
In addition, you can explore other non-medical treatments that may reduce your symptoms, like meditation and biofeedback, because they’re lowest in cost and risk. Then, if you think it’s necessary, review the medication options for treating anxiety, knowing that the most powerful treatments have the highest risks and that there is, as yet, no low-risk medication that controls anxiety for everyone under all circumstances. There are, however, many medications that can be partially helpful some of the time and one may work for you.
Anxiety can make any problem feel like the end of the world, but with enough dedication and support, you can still work towards a better life and keep the anxiety armageddon at bay.
STATEMENT:
“I haven’t found a cause for my twitchy muscles and anxiety tells me I’m a wreck and out of control, but I know better. If I’ve done a good job of ruling out medical conditions and still don’t have any answers for my symptoms, I will learn the ins and outs of living with them while doing all I can to live a full life and be a good person.”
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