Anxiety, stress, and tension

Considerations:
Stress is not a disease and is a normal part of everyone's life. Stress is not necessarily good or bad; however, reactions to stress can vary considerably, and some of these reactions are undesirable. The most frequent undesirable reaction is anxiety.

Anxiety is often accompanied by twitching or trembling , muscle tension, headaches , sweating , irritability, fatigue , nightmares , memory problems, sexual impotence , sleeplessness , dry mouth, or difficulty swallowing .

The degree of anxiety is much more a function of the individual than the degree of stress. The risk of anxiety increases with stress, a family history of neurosis, fatigue or overwork, or the recurrence of situations that have been previously stressful or harmful.

Insomnia and an inability to concentrate are common symptoms of anxiety which can lead to a vicious cycle that makes the problem worse. The symptoms are effects, not causes. Focusing on the insomnia or on the lack of concentration as the problem is not the solution.

Common Causes:
  • actual danger
  • physical and emotional stress
  • grief (such as from death of a loved one or loss of a job)
  • drugs including caffeine , cold remedies (Cough/Cold Combinations - oral), sympathomimetics, decongestants (Antihistamines and Decongestants - oral), bronchodilators, tricyclic antidepressants, and thyroid supplements
  • withdrawal from drugs
  • poor diet
  • hyperventilation syndrome
  • hyperthyroidism

Note: There may be other causes of anxiety. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for anxiety, occurring alone or in combination with other problems.

Home Care:
Finding the cause of the anxiety is a required first step in resolving a problem with stress.

Avoid becoming dependent on

Call Your Healthcare Provider If:

  • you are unable to work because of anxiety, self-treatment has failed, or the cause of the anxiety is unknown.
  • there is a sudden feeling of panic.
  • problems cannot be resolved without outside, professional help.

A mental health care professional may be appropriate to consult. Remember, your primary health care provider is an additional resource but is not necessarily the first or the best place to seek help for these problems.

What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting anxiety, stress, or tension in detail may include:

  • What other symptoms are also present?
  • What physical symptoms develop that make you feel anxious?
  • What physical symptoms do you have that you are worried about?
  • What makes the anxiety better?
  • What makes it worse?

A general physical examination will be performed. The level of consciousness will be assessed and behavior noted.

If the anxiety is not accompanied by other physical signs and symptoms, a psychological cause may be suspected. A referral for psychiatric evaluation may be necessary.

Diagnostic tests may include lab studies to rule out medical conditions, such as hyperthyroidism , that produce anxiety.

After seeing your health care provider:
You may want to add a diagnosis related to anxiety to your personal medical record.