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Posted: March 20, 2009 12:30 a.m.

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Medical conditions can mimic or provoke anxiety symptoms

A 56-year-old man has recently become jittery, tense, anxious and irritable. In addition, he has experienced unexplained weight loss. His wife and children repeatedly ask what's wrong with him, and he keeps saying, "I don't know." He isn't under any major stress that he can identify. So, tired of the semi-conscious worry and fear that they will continuously nag at him, he goes to his doctor for a check-up. The doctor diagnoses an overactive thyroid, treats his condition and the symptoms disappear.

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

Any condition that changes the hormonal activity of the sympathetic nervous system, 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 an asthma attack, a phenomenon known as anticipatory anxiety.

The following are the most common illnesses or categories of illnesses that can mimic or provoke anxiety symptoms.

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

• Neurological conditions, including vertigo and seizure disorders.

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

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

• Endocrine disorders, which involve 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.

People with any of a large number of medical conditions are at risk because these illnesses can cause chemical changes in the brain that induce anxiety symptoms. So, before deciding that something psychologically is responsible, it is important to first rule out potential underlying medical causes and/or contributions to your symptoms. Treating the underlying medical condition usually relieves the anxiety symptoms.

Peggy Nolen is a licensed professional counselor in Covington. Her areas of interest include anxiety, depression, recovery from traumatic experience and problems with drugs and alcohol. She can be reached at (770) 3134-5924.

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