ThVanessa Walko was in her late 20s, and she got shaved — and then got it again and again. Because she is allergic to bacteria, her illness turns into scarlet fever several times within a few months. She soon began having heart problems. After spending a day in the sun selling jewelry at an art gallery, she nearly died. A friend rushed her to the emergency room, where the doctor asked if she had a family history of people falling in their 20s. When Wilco said no, the doctor told her to learn to manage her stress better and sent her home.
“I don’t know if I could convey how arrogant and petty he was,” recalls Wilko, 41, who lived in Evanston, a patient. “Delirious. I had to check in with her: ‘Did you catch all that?’
Walko knew something was wrong – yes, the doctors say, they continued to clear up her symptoms. After doing online research, she discovered that her boyfriend was likely a strep carrier, meaning he was harboring strep bacteria in his throat while he was still asymptomatic. She says seven different doctors rejected her theory, before one finally agreed to test Wilko’s friend — who tested positive for Strep.
This unlocked the key to her physical recovery, although emotional scars remained. “We have to be able to put our faith in doctors,” she says. “If something is cut and dried, like a broken bone or a heart attack or cancer, doctors are like, ‘Great. We have a plan. But if it’s something that requires nuance and thinking outside of their training, they get intimidated and turn it away.”
Walilko’s experience is not unique: Researchers, doctors, and patients alike have found that He routinely refuses Real medical symptoms that have nothing to do with mental health such as anxiety. Online, people shared viral stories about medical lighting, describing the ways doctors treated their symptoms appendicitisfor Heart diseaseor Even cancer To worry.
Why do doctors assume he’s anxious?
There are a variety of reasons why this is common, says Dr. Robert Gee, assistant dean of student affairs and professor of behavioral sciences at Ross University School of Medicine. Symptoms of anxiety overlap with symptoms of other medical issues, making it easy for both patients and doctors to mistake a physical condition for mental health, he points out. And if a patient has a history of anxiety, his provider is usually quick to assume that the physical symptoms are a recurrence, rather than a sign of something new.
Other research It has been found that doctors’ lack of knowledge is partly to blame. Limited time with patients also plays a role. “This is a big factor for doctors,” Gee says. Some may be tempted to diagnose anxiety because it seems like the simplest explanation, especially when symptoms are vague—such as “I’m so tired all the time”—and when diagnostic tests don’t provide a clear explanation. “It’s complicated,” he says. “Some diseases begin with mild symptoms that look a lot like anxiety before the more obvious signs appear.”
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The consequences of misdiagnosis can be significant. “Patients may suffer longer, without proper treatment, which may make their health worse,” says Gee. “Ironically, saying it’s ‘just a worry’ can make them more anxious, because they should worry that their concerns are not being taken seriously.” He adds that a loss of confidence can discourage people from seeking further care.
We asked experts how likely symptoms are to be diagnosed as anxiety.
Digestive system problems
anxiety can cause Your stomach has to give up and down, making you feel nauseous and leading to cramping, bloating, or diarrhea. But it could be food-borne illnesses, gastroesophageal reflux disease (GERD), gallbladder problems, irritable bowel syndrome, peptic ulcers, and any number of other gastrointestinal issues. Endoscopy, stool testing, or ultrasound can help establish an accurate diagnosis. says Dr. Monica Roots, a psychiatrist who is co-founder and president of Bend Health, which provides mental health care to children.
Roots often sees children who have been referred by their pediatrician for anxiety — but are actually suffering from something else, like a stomach problem. It makes sense to ask: “Do you feel this all the time, or only when you’re stressed, like if you have a test at school? Are there specific foods you’ve noticed that change how your stomach feels? Are you very tired all the time? Do you throw up?” Answers can help reveal whether something else is being overlooked. If she suspects mental health is not the culprit, she collaborates with the patient’s primary care physician to ensure the child receives more in-depth testing.
Racing heart
If your heart is beating fast — more than 100 beats per minute — or feels like it is fluttering, you are very well He may suffer from anxiety. When you are in a state of high arousal and stress, the fight-or-flight response kicks in, causing your heart rate to rise. However, it’s also possible that you have a heart problem, says Dr. Saima Shekari, a cardiologist in Women’s Health at VCU Health Pauley Heart Center. “It could indicate an irregular heartbeat or a problem with the thyroid,” she says. You often experience rapid heartbeats.)
Many Shikari patients are women with symptoms of heart disease who were initially diagnosed with anxiety. “Unfortunately, a lot of women are told that when they experience palpitations, they feel anxious,” she says. “If you happen to go to the doctor when you’re not experiencing your symptoms at that moment, I can understand how people would say, ‘Well, maybe it’s not coming from your heart.’ That’s why it’s helpful to track your symptoms, especially by using a wearable. You’ll be able to Than telling your doctor, “This is what Apple Watch And it showed,” she adds.
Chest pain
Anxiety can make your chest feel tight, like the insides are burning or being squeezed. But chest pain can also indicate a heart attack, or may be caused by acid reflux, a lung condition, or even asthma, Gee says. Doctors can use EKGs, chest scans or tests for acid levels to rule out these conditions – while also checking stress levels.
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“This is something that I think doctors struggle with in general: asking for the patient’s perspective,” Gee says, “what we want is for patients to tell us, in their own words, what they think might be going on with their chest pain: any mitigating factors, any aggravating factors, any antecedents, any consequences of Her various activities, and how they affect her at home and at work and her activities.”
Fatigue or weakness
Feeling tired all the time is one of the most common — and mysterious — symptoms that patients describe. There is no single test to pinpoint the root cause of fatigue, which is why doctors often blame it on anxiety or depression. “Unfortunately it is a sign of many different things,” Shikari says. “You can be tired because you have congestive heart failure, and it’s not pumping blood as efficiently as you need to. You can be tired because you have an arrhythmia, and your heart is in overdrive. You can be tired because your thyroid isn’t working the way it needs to, so you’re really tired.” You can experience fatigue because you have digestive upset and you’re absorbing things and nutritionally diminished.”
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Relentless fatigue can also indicate diabetes, insomnia, or chronic fatigue syndrome, among other conditions. Ideally, the exam will include a thyroid test, checking your blood sugar, and a sleep study to zero in on what’s really leading you.
shortness of breath
If you’ve ever had severe anxiety or a panic attack, you understand what it’s like to feel like you’re gasping for air. While shortness of breath is a common mental health symptom, it can also indicate a respiratory condition such as asthma, a chest infection, or a host of heart problems, among other potential concerns. “Dyspnea is what we call an angle equivalent,” Shikari says. “Some people don’t have chest pain — they have shortness of breath, and that’s a sign of a heart attack. Shortness of breath can also come with heart failure or an irregular heartbeat.” This is why it’s so important for doctors to perform Comprehensive testing, she says.
Migraine or severe headache
Headaches are definitely stress-related. How many times have you had to pop out Tylenol after a tough day at work? says Dr. Sam Ceterie, a cardiologist at Cedars-Sinai and a senior clinical investigator at the National Heart Institute. For example, a headache could indicate a Transient ischemic attack or Case like Epilepsy, multiple sclerosis, or fibromyalgia.
Head pain is also associated with sinus problems, vision issues, and high blood pressure — which is why it’s important for doctors to take a detailed history and order tests such as an MRI or CT scan. If you suffer from frequent headaches, keeping track of details such as when they start, how long they last, and how severe they are can help your doctor determine the cause.
Vertigo or vertigo
In the throes of anxiety, you may feel like the world is spinning. But dizziness can also indicate inner ear problems, low blood sugar, anemia, or a sudden drop in blood pressure. “There could be a neurological basis or some type of neurological issue or syndrome like epilepsy,” Gee says.
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In addition, dizziness associated Circumstances It is traditionally difficult to diagnosesuch as multiple sclerosis. Ideally, doctors should test your ear function, check your blood pressure, and look at your blood sugar and iron levels.
Sweating, flushing, or feeling hot
Anxiety can lead to sweating and flushing, especially during panic attacks. But conditions such as an overactive thyroid, menopauseor early, it can be the beginning of a serious infection, too, GEE. Blood work, including thyroid testing and hormone testing, can help doctors figure out the best course of action. So active listening is possible. “Communication skills are very important in this,” he says.
GEE recommends that doctors ask open-ended questions and make it clear that they are hearing what patients are saying while remaining non-judgmental. This can encourage people to share not only details of their current illness, but also their social history, family history and past medical history, he says — all of which can shed light. “I’m a seasoned doctor, and I have to catch myself making a snap judgment, ‘Oh, I’ve seen this before,’” he says. “You have to keep an open mind.”
