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Have cough, indigestion, shortness of breath and heart palpitations. Is this due to anxiety?

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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Wed, 16 Jan 2013 in Schizophrenia
Question: I have anxiety. Over the years, it has always been about my health. About 1 month ago, I noticed I was having heart palpitation. I started to focus on them constantly and literally could feel every beat of it. I started researching them and saw all kind of horrible causes. I then started to feel a pressure in my chest, which has now led to shortness of breath and a cough. I feel like these symptoms are a product of my mind? or at least this is what everyone is telling me. I don't understand how they can be constant. My anxiety over this is through the roof. I have started having loose stool that is really yellow and have constant indigestion. Having a hard time eating anything.
We have increased my medication. My Dr is sending me to a cardiologist but I don't think he is too worried. I had a heart workup 3 years ago that was normal (EKG, even recorder, stress test). Could anxiety really be causing all of these symptoms?
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Answered by Dr. Jonas Sundarakumar 47 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you must be going through a difficult time dealing with your anxiety and especially, the recent physical symptoms. Now, it is indeed true that anxiety can manifest itself with not only psychological symptoms but a variety of physical symptoms also. You have mentioned a recent completed cardiac evaluation turned out negative. Moreover, considering your young age, you are unlikely to have any major medical risk factors contributing to a cardiac disease. In such a case, it is important to consider the possibility that the underlying anxiety is manifesting itself as different physical symptoms.

Now, this does NOT mean that 'everything is in your head' and that you are simply imagining the symptoms. Not at all. It has been found that anxiety disorders are associated with certain neuro-chemical imbalances in the brain and this can cause the person's pain and sensory threshold to get lowered and he / she can become 'hypersensitive' to sensory stimuli, and therefore have symptoms of discomfort, heaviness, pain, tingling, etc. The other mechanism which could explain your shortness of breath is what is called a "hyperventillation syndrome", which is something very commonly associated with anxiety disorders. Here the sub-conscious anxiety results in the person breathing too fast or too deeply. This further results in imbalance in the oxygen-carbon dioxide levels and goes on to cause other symptoms like chest pain, dizziness, etc.

Once a person starts experiencing these physical symptoms (which are in fact, a product of anxiety), he / she becomes more worried about these and then this worry / anxiety itself then starts worsening the symptoms more. So, this becomes a viscious cycle, leaving the person with more symptoms and suffering.

Now, of course, it is important to rule out any medical causes before making a conclusion that your symptoms are enxiety-related. So, your doctor has done the right thing by asking for an specialist cardiac evaluation. I would suggest that you wait for the results, but keep your mind open to the fact that your recent problems could very well be due to anxiety. Digestive symptoms like acidity, indigestion, bowel irregulatities, etc. are also very common symptoms associated with anxiety.

If your medical work-up is negative, then I would suggest that it would be worthwhile to consult a psychiatrist for a detailed psychological assessment. If your symptoms are predominantly anxiety-related, then there are effective treatment options - in the form of medication or counselling / psychotherapy which will help you overcome your problems.There are also several psychological techniques and relaxation therapies, for example, progressive muscle relaxation, applied relaxation, biofeedback, etc. which can yield effective and long-lasting results. Additionally, you can also try simple relaxation techniques like XXXXXXX breathing, yoga, etc. which can be quite helpful. Regular physical exercise helps in relieving both the physical as well as psychological symptoms of anxiety and also helps you stay more functional.

I hope this has been informative and useful to you.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Jonas Sundarakumar 8 minutes later
The problem with me i find is that i dont know when to stop. A negatuve heart workup will have me worried about other things like my lungs. I think i have health anxiety. And when i get ficused on sinething its like a downward spiral. I am unable to function and the worry is constant. Thanks for your reply. I am just so scared.
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Answered by Dr. Jonas Sundarakumar 11 hours later
Hello again,

Yes, I agree with you that you seem to be having a lot of health anxiety, which is termed as a somatoform disorder. But don't worry, there are effective psychological therapies like CBT (Cognitive Behaviour Therapy) which can help you overcome these unecessary worrisome thoughts. The positive thing is that you seem to be having a fairly good insight into your problems, which is in fact, one of the crucial factors in treatment. Now, that you are able to realize the nature of your problem, the next thing to do is to take systematic steps to deal with this problem. This will be definitely difficult initially and that is why you need professional help and guidance.

So, don't worry, with appropriate therapy and sincere, persistent efforts, I'm sure you will soon be able to overcome your problem.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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