Medical conditions that can present as anxiety

What is anxiety?

Anxiety is a normal emotion that everyone experiences from time to time when faced with a stressful situation. However, anxiety may be due to an anxiety disorder when individuals experience severe or persistent symptoms of anxiety that impact their wellbeing.

Common anxiety disorders include ^[1]:

• Generalized anxiety disorder: an ongoing and persistent feeling of anxiety, causing symptoms such as restlessness, excessive worrying, and impaired daily functioning.
• Panic disorder: characterized by recurring panic attacks and a persistent fear of further panic attacks occurring.
• Social anxiety disorder: (also known as social phobia) causing severe anxiety, and sometimes panic attacks, when faced with specific or general social situations, such as performance, being stared at, or interacting with others.
• Phobias: an intense and irrational fear of a specific object or situation, such as arachnophobia, a fear of spiders, and aerophobia, a fear of flying.

Although no longer included as anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) may also present with some of the same symptoms as anxiety disorders ^[2].

Anxiety symptoms can differ from person to person. Symptoms of anxiety disorders can include ^[1][2]:

• Excessive and uncontrollable worrying
• Irritability
• Sleep disturbances
• Feelings of dread and fear
• Tension in the muscles
• Chills or hot flushes
• Panic attacks
• Tiredness and fatigue
• Stomach issues, such as nausea, vomiting, diarrhea, and pain
• Increased heart rate and breathing rate
• Shaking

Many of these symptoms can also occur in the context of medical conditions, potentially causing issues in diagnosing.

Someone may experience anxiety symptoms and not realize that they have an underlying condition that has been missed. Alternatively, they may seek professional advice due to their physical symptoms and, if no physical health condition is discovered, may not receive an appropriate diagnosis relating to anxiety ^[3].  

Which medical conditions cause symptoms similar to anxiety?

There are numerous medical conditions that can cause emotional and physical symptoms of anxiety, so it is important to always consult a professional if you experience any concerning symptoms.

Research indicates that mental and physical health are connected and can greatly influence one another. When one worsens, this could cause the other to worsen as well ^[4].

Endocrine disorders

Endocrine disorders or diseases are a group of conditions that are caused by changes or abnormalities in the glands that release hormones or the organs that are affected by these hormones ^[5].

Common endocrine disorders and hormonal conditions that can cause anxiety symptoms include diabetes, hyperthyroidism and hypothyroidism, Addison’s disease, and menopause, as well as tumors occurring in the hormonal glands.

These conditions can cause symptoms that are similar to anxiety symptoms, such as ^[6][7][8]:

• Changes in mood, including irritability and nervousness
• Fatigue
• Stomach pain and upset
• Changes in appetite and weight
• Increased heart rate
• Shaking
• Sleep disturbances

Neurological conditions

Changes in the brain, such as those caused by lesions, tumors, traumatic brain injury, infections, and certain types of dementia, can cause anxiety symptoms such as ^{[3][9][10][11]}:

• Changes in mood, including irritability, suspicion, and worrying
• Impaired cognitive abilities, such as decreased concentration
• Tiredness
• Sleep disturbances

Research has shown that the part of the brain that is affected or damaged by these conditions influences the occurrence of anxiety symptoms. For example, one study indicates that a tumor on the right side of the brain causes higher levels of anxiety than a tumor on the left side of the brain ^[9].

Stomach and digestive issues

There are several gastrointestinal issues that are linked to anxiety. These issues can be caused by persistent anxiety or contribute to the development or worsening of an anxiety disorder.

Gastrointestinal issues that can cause an overlap in anxiety-presenting symptoms could include irritable bowel syndrome (IBS), peptic ulcers, and inflammatory bowel disease (IBD). Symptoms of this medical conditions can include ^[4][12][13]:

• Nausea
• Vomiting
• Diarrhea
• Stomach pain and discomfort
• Sweating
• Tiredness
• Muscle tension

New and ongoing research indicates a clear link between gut and brain health, suggesting that the stomach and brain directly influence one another. Many people live with a gastrointestinal condition such as these for many years before receiving treatment for a mental health condition and finding that their stomach issues significantly reduce ^[4][13].

Heart conditions

Various types of heart conditions can cause similar physical symptoms to those that occur with anxiety, including ^[14]:

• Increased heart rate and palpitations
• Increased respiratory rate
• Trouble breathing
• Chest pain
• Dizziness
• Fatigue
• Shaking
• Tremors
• Sweating

Many people who experience panic attacks become concerned that they are experiencing a heart attack, due to the similarity in symptoms. Similarly, ongoing anxiety symptoms can also contribute to worsening heart health ^[14].

Lung conditions

Various types of lung conditions, such as asthma, COPD, and sleep apnea can present with physical symptoms that are similar to those that occur with anxiety, such as ^[15][16]:

• Increased respiratory rate
• Breathing difficulties
• Chest pain
• Increased heart rate
• Dizziness
• Sleep disturbances

Nutritional issues and vitamin deficiency

Various nutrition and vitamin deficiencies can contribute to the development of anxiety, including low levels of B12 and magnesium. Nutrition has been found to greatly impact mental wellbeing as well as physical health. Poor nutrition can contribute to symptoms such as fatigue, increased heart rate, irritability, and stomach issues, as well as changes in mood ^[17][18].

Getting an anxiety diagnosis

If you experience any physical or emotional symptoms of anxiety, it is important to seek professional advice and treatment. It may be that there is an underlying medical condition that has caused your anxiety symptoms. Alternatively, you may be diagnosed with an anxiety disorder and will be advised on appropriate treatment for this condition ^[1][4].

It is important for your doctor to know all of your symptoms and medical history so that they can make the right diagnosis, provide the correct treatment, and prevent a worsening of symptoms.

If your anxiety symptoms have emerged recently and suddenly, with no childhood or family history of anxiety or other mental health conditions, or you experience memory loss or impaired functioning, it could be that you have a medical condition that has not yet been diagnosed ^[3][4].

Your doctor will need to know about any medications or illicit substances that you have taken recently, as well as the amount of alcohol or caffeine that you consume, as the use or withdrawal of these substances can cause anxiety symptoms ^[3].

If you have a medical condition, anxiety, or a combination of physical and mental health conditions, your doctor will be able to advise and prescribe appropriate treatment to help you manage your symptoms.

Treatment for anxiety disorders can include medications, such as antidepressants, and therapy, such as cognitive behavioral therapy. Maintaining a healthy lifestyle can also help to reduce symptoms of anxiety, such as eating a healthy diet, exercising, and sleeping well ^[1][18].