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Friday, May 24, 2013
Anxiety and Stress Disorders
Identifying the Symptoms of Anxiety and Emotional Disorders
For the last month I have been experiencing strange symptoms. I had an ER visit due to palpitations, numbness in arms, severely constricted veins, and feeling like I was going to pass out (of course I felt a great deal of anxiety also, but I`m not sure whether that was just a result of the symptoms) and was found on that visit to have low blood sugar. I`ve been tested for hypoglycemia and diabetes. I have neither. I frequently eat very low carb and I have had bulimia for 15 years and have recently correlated the symptoms I have with times when I have a full stomach. I was put on Xanax to control the anxiety (which helps some, but doesn`t necessarily stop it), but I worry this may be related to some damage that the bulimia may have caused, since, in the past, a full stomach did not make me upset (especially if it was full of foods that I didn`t feel guilty for eating). I worry that my symptoms are being dismissed as emotional and anxiety-driven, when there may actually be a medical cause (likely brought on by my years of bulimia), such as a heart, pancreas, gallbladder or liver problems. Do you have any advice regarding whether a full stomach might put pressure on any organs or have an effect that for any reason might cause these symptoms, such as dumping syndrome or anything that could be related?
All of the symptoms you are describing have been known to be associated with anxiety and other emotional disorders. Whether that is the case for you, only your health care providers can determine. The "physical" problems brought on by bulimia/induced vomiting are usually esophogeal and related to stomach acids damaging the lower esophagus -- leading to symptoms of heartburn and upper abdominal discomfort. These can be worse with a full meal. However, the emotional disease behind bulimia can cause many serious problems as well.
Xanax is usually considered a temporary treatment for anxiety disorders -- lost lasting treatment requires medications like selective serotonin reuptake inhibitors (zoloft, lexapro, etc.), counseling (cognitive behavioral therapy) or both. With treatment, many anxiety disorders improve greatly, but treatment usually takes months to years, so it is important to continue ongoing treatment.
Nancy Elder, MD
College of Medicine
University of Cincinnati