[18F] Experiencing stress-related physical symptoms

Patient Description

An 18-year-old female reports experiencing stress that has manifested into physical symptoms, including frequent eye twitching, chest pain, and muscle aches. The eye twitching has been occurring for about two weeks, happening 5-10 times daily, lasting 3 to 30 seconds, and is often triggered by stressful or upsetting thoughts. The chest pain is described as sharp initially, then fading to a dull ache, sometimes radiating into the arm, and is rated as a 5 out of 10 in severity. The patient also experiences heart palpitations, particularly when stressed, and notes changes in sleep patterns, either sleeping too much or too little, along with high caffeine intake. The patient has a history of anxiety diagnosed four years ago and has previously been on Prozac (20mg for about a month) and Zoloft (25mg for about a year), both of which were discontinued due to worsening anxiety and side effects such as morning anxiety and emotional numbness. No known allergies or other medications are currently being taken.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, it's possible that your symptoms are related to stress and anxiety. Here's a breakdown of what might be happening:

  • Stress and Anxiety: Stress and anxiety can manifest physically in various ways, including eye twitching, chest pain, muscle aches, headaches, fatigue, and palpitations. These symptoms can be exacerbated by high caffeine intake and irregular sleep patterns. Eye twitching, in particular, is often linked to stress, fatigue, and caffeine consumption.
    • Typical Treatments: Managing stress and anxiety often involves a combination of lifestyle changes, therapy, and sometimes medication. Cognitive-behavioral therapy (CBT) is a common approach to help manage anxiety. Medications like SSRIs (e.g., Prozac, Zoloft) are sometimes prescribed, but it's important to work with a healthcare provider to find the right treatment plan.

What you can do

Here are some steps you can take to help manage your symptoms:

  1. Reduce Caffeine Intake: Try to gradually reduce your caffeine consumption, as it can contribute to anxiety and physical symptoms like eye twitching and palpitations.

  2. Establish a Sleep Routine: Aim for a consistent sleep schedule to help regulate your body's internal clock. Try to go to bed and wake up at the same time each day.

  3. Practice Relaxation Techniques: Techniques such as deep breathing, meditation, or yoga can help reduce stress and anxiety levels.

  4. Stay Active: Regular physical activity can help reduce stress and improve mood. Even a short daily walk can be beneficial.

  5. Consider Professional Help: If your symptoms persist, consider reaching out to a mental health professional for support. They can help you explore therapy options or discuss medication if needed.

  6. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, and gain insights. This information can be valuable to share with your healthcare provider.

What you should look out for

While your symptoms are likely related to stress and anxiety, it's important to be aware of any changes or worsening of symptoms:

  • Seek Medical Attention If:
    • Your chest pain becomes severe or is accompanied by shortness of breath, dizziness, or fainting.
    • You experience new or worsening symptoms that concern you.

Remember, it's always a good idea to consult with a healthcare professional for a formal diagnosis and personalized treatment plan. They can help you navigate your symptoms and find the best approach for your situation.

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4 mo ago

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People Also Ask


Can stress and anxiety cause physical symptoms like eye twitching and chest pain?

Yes, stress and anxiety can manifest physically in various ways, including eye twitching, chest pain, muscle aches, headaches, fatigue, and palpitations. These symptoms can be exacerbated by high caffeine intake and irregular sleep patterns.


How can caffeine intake affect anxiety and related symptoms?

Caffeine is a stimulant that can increase heart rate and exacerbate anxiety symptoms, such as palpitations and eye twitching. Reducing caffeine intake can help alleviate these symptoms.


What are some effective ways to manage stress and anxiety without medication?

Effective non-medication strategies for managing stress and anxiety include practicing relaxation techniques like deep breathing, meditation, or yoga, maintaining a regular sleep schedule, reducing caffeine intake, and engaging in regular physical activity.


When should I seek medical attention for chest pain related to anxiety?

You should seek medical attention if your chest pain becomes severe or is accompanied by shortness of breath, dizziness, or fainting, or if you experience new or worsening symptoms that concern you.


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