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Anxiety and Stress Disorders

Mutiple Sympotms and Discerning Disorders

01/08/2007

Question:

My 30 year old daughter suffers panic attacks but is having severe ongoing almost non stop symptoms that she is wondering now if it is something other than a panic attack. Symptoms include "heart hurting", numbness in the feet, legs and arms, extreme weakness in the legs, dizzy, blurred vision. Is that also a symptom of any other illness she should be tested for? This has been going on almost non stop for 2 weeks.

Answer:

Certainly all the symptoms you describe can be associated with anxiety and panic disorders.  Panic disorders, however, are characteristically sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. During these attacks, people with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest pain, or smothering sensations. Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing control.  Symptoms often peak in about 10 - 15 minutes, but may go on for sometime.  However, it is NOT a panic attack if symptoms last 2 full weeks.

Generalized anxiety disorder (GAD), on the other hand, is characterized excessive worry about a variety of everyday problems (and has been going on for at least 6 months). People with GAD can't seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They can't relax, startle easily, and have difficulty concentrating and with sleep.  Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.

It is also important to note that other illnesses not related to anxiety can produce some of the physical symptoms you describe as well.  That is why it is important to talk to your primary care doctor as well as your mental health professional.  They will take a more thorough history, and decide if further testing is required.

Good Luck.

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati