Anxiety is a disorder in which people become so anxious that even trivial issues result in them experiencing a range of psychosomatic symptoms. They live in constant fear of the unknown and end up trying all kinds of remedies to find relief.
During an episode, an individual experiences palpitations, sweaty palms, tremors, dry mouth, tightening of the chest and neck muscles, difficulty with breathing, dizziness and is gripped by a fear of losing control. When these symptoms become overwhelming, the individual starts to panic.
What is rarely mentioned are the other symptoms that appear as a result of the anxiety attack. They include severe intractable headaches, upper body aches, severe lower backache, abdominal muscle cramps and an unremitting feeling of tiredness and lack of energy even after long hours of sleep.
Often, patients attend their doctor for their pain — headaches, backaches — or for their tiredness, but say nothing about their anxiety, so it is easily missed by the medical practitioner. They are given analgesics, which may include the addictive types, and tonics, but the symptoms are never relieved.
During a panic or anxiety episode the muscles go into severe involuntary spasms and this can cause small tears in the muscle fibres. These muscle spasms are the cause of the headaches, backaches, tight chest and feeling of tiredness. The tiredness is a result of the muscles being tight for days or weeks and the effect is similar to doing many hours of heavy weight training. The only difference is that with weight training the muscles do not get tight so they recover the next day, whereas with a panic attack the muscle can remain in spasm, which explains the chronic nature of the headaches, backaches and generalised muscle fatigue.
The intractable pain disturbs sleep so the individual becomes sleep deprived. At work, they lack concentration and become irritable. This behaviour can make them unpopular at work and they end up being isolated, which makes them depressed.
They might be diagnosed and treated for their depression but their anxiety could be missed.
Chest pain is another common symptom of a panic attack. Many fear that they are having a heart attack. Failure to diagnose anxiety and panic disorders has resulted in incorrect diagnoses, such as motor neuron disease, angina, strokes, acute migraine and fibromyalgia syndrome. Patients are sent from one costly specialist to another and undergo electrocardiography, angiograms or MRI scans.
In one example of misdiagnosis, a young mother developed pain and weakness of her limbs. She was seen by a general practitioner, then an orthopaedic surgeon and finally a neurologist, who told her that she had motor neuron disease and that the condition has no cure. This left her depressed. But after she was correctly diagnosed and treated for anxiety, she recovered.
Anxiety can affect anyone and at any stage in one’s life, depending on the circumstances that trigger the attack. One of the most common causes of anxiety is insecurity and the fear of the unknown. This insecurity could be about finances or a relationship.
Often, patients who suffer from intractable pain worry that they have terrible illnesses such as cancer. This fear is compounded when pain treatment doesn’t help and the doctors cannot tell their patients what the cause for their pain is.
When patients do not know the cause of their pain, they fear they are going to die and they worry about their children.
Among the most common and overprescribed medications for anxiety are the highly addictive benzodiazepines, which should not be prescribed for long periods.
Patients diagnosed with anxiety should be taught about the condition and ways of dealing with this life-long condition. Psychotherapy, cognitive behaviour therapy and relaxation techniques should be the mainstay of treatment for anxiety.
A simple breathing technique works wonders for these patients but they must practice it regularly.
If anxiety is not diagnosed early then patients can end up leading very miserable lives at work, home and in their relationships.
If you experience any of the symptoms of anxiety, it would be wise to seek professional help before you end up with severe depression and all the other unpleasant consequences associated with long-standing anxiety.
Dr Ellapen Rapiti is a family physician in Cape Town, specialising in child and mental health and addiction counselling