Health and Psychology

There are many medical conditions that mimic symptoms of anxiety,  All psychiatric diagnoses start with a request that medical conditions be ruled out before a psychiatric diagnosis is considered.  In addition there should be a history of symptoms of anxiety that gradually escalate over time.  Anxiety is not generally sudden in onset.  Most anxiety disorders start in childhood or by early adulthood.  Symptoms of anxiety occuring later in life are unusual.  Any symptoms of anxiety that are accompanied by neurological symptoms such as changes in smell, taste, behavior, hallucinations, headache, or unusual or paranormal experiences should be medically evluated.  Many drugs, chemicals, food additives and herbs can cause anxiety.  

The major medical causes of anxiety can be remembered by the letters THINC MED:

• Tumors. These often present with a range of psychiatric symptoms. For example, pheochromocytomas produce adrenaline and often present as anxiety or panic attacks. However, episodes of panic related to pheochromocytomas include severe headache and are not accompanied by catastrophic thinking.  Meningeomas may cause personality changes in addition to anxiety symptoms.  Anxiety symptoms with headache should be evaluated medically.

• Hormones. Hyperthyroidism, hypothyroidism, parathryoid disorders and adrenal disorders may present with symptoms that mimic anxiety disorders. Such physical symptoms as increased sensitivity to heat, weight loss, restlessness, difficulty sleeping, and tremor suggest a physical cause for the anxiety-like symptoms. In some women, estrogen can produce anxiety symptoms.

• Infectious diseases. Some infectious diseases may also present with psychiatric symptoms. For example, untreated streptococcal infection may lead to onset of tics (Sydenham’s chorea) that resemble the symptoms of obsessive-compulsive disorder. Symptoms resolve with treatment of the infection. Lyme disease can be associated with psychiatric symptoms, including anxiety.

• Nutrition. Vitamin deficiency or excess, malabsorption, and poor nutrition can mimic a range of emotional disorders. Vitamin B12 deficiency and anemia can present with anxiety symptoms and, in some cases, cause symptoms of panic attacks.

• Central nervous system. Head trauma—even when it is mild—can result in psychiatric symptoms, including those of anxiety.  Anxiety symptoms are especially common in right hemisphere brain injuries in right handed people.  

• Miscellaneous. Wilson’s disease, an inherited disorder that interferes with the metabolism of copper, can present with features similar to schizophrenia, bipolar disorder, and anxiety disorders. The psychiatric symptoms often begin during adolescence. Wilson’s disease is progressive in nature, causing damage to the liver and brain. A distinctive physical characteristic is a brownish ring surrounding the cornea of the eye. Porphyia a hereditary disorder of blood metabolism can also cause psychiatric symptoms. 

• Electrolyte abnormalities and environmental toxins. Long-term exposure to insecticides (organophosphates) can result in anxiety and restlessness.

• Drugs. OTC, homeopathic, prescribed, or illicit drugs can produce a wide range of psychological symptoms. Alcohol withdrawal, cocaine, and stimulants can also result in anxiety symptoms.

If you have concerns about your symptoms, have had prior ineffective treatment for anxiety or depression, feel free to contact our office, 818-389-8384.