[51F] Experiencing anxiety and related symptoms

Patient Description

A 51-year-old female has been experiencing anxiety for about a year, with symptoms including irritability and a desire to break things. The anxiety is worse in the evenings and is exacerbated by work stress. It has been affecting her sleep and concentration, causing difficulty falling and staying asleep, and leading to exhaustion and irritability. The patient has been diagnosed with idiopathic intracranial hypertension (IIH) and experiences a constant headache since having lumbar punctures, with pain intensity varying with stress and atmospheric pressure. The patient also reports brain fog, chest tightness, and an awareness of her heartbeat, which have been present for about 2 hours at the time of reporting. Additionally, she experiences an upset stomach and shortness of breath. She finds relief from anxiety through walking and meditating. She has an allergy to codeine and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Anxiety Disorder: Chronic feelings of worry, nervousness, or stress that interfere with your daily activities could be a sign of an anxiety disorder. Other symptoms can include trouble sleeping or concentrating, feeling tense or irritable, and physical symptoms like headaches or feeling easily fatigued.

    • Treatment often involves a combination of psychotherapy (talk therapy), cognitive behavioral therapy, and medication.
  • Chronic Tension Headaches: These are often associated with stress and can cause constant pain, often described as a band-like sensation around the head. They can be exacerbated by stress or changes in atmospheric pressure.

    • Treatment typically involves pain relievers, stress management, and sometimes preventive medications.
  • Pseudotumor Cerebri (Idiopathic Intracranial Hypertension): This condition occurs when the pressure inside your skull (intracranial pressure) increases for no obvious reason. Symptoms can include a headache, vision problems, and pulsatile tinnitus (a whooshing sound in your ears).

    • Treatment often involves medications to reduce the cerebrospinal fluid and, in some cases, surgery.
  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause symptoms like an upset stomach and chest discomfort.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In some cases, prescription medications or surgery might be needed.
  • Dyspnea (Shortness of Breath): This can be a symptom of many different conditions, including heart and lung diseases, anxiety, or high blood pressure. Given your history of anxiety and the other symptoms you're experiencing, it's possible that your shortness of breath is related to your anxiety.

    • Treatment depends on the underlying cause.

What you can do

You should definitely seek medical attention to get a proper diagnosis and treatment. Here are some things you can do in the meantime:

  1. Continue with your walking and meditation, as these seem to help with your anxiety.
  2. Try to identify and manage sources of stress in your life, as stress seems to exacerbate your symptoms.
  3. Keep a symptom diary, noting when each symptom occurs, its severity, and any potential triggers. This can help your healthcare provider diagnose your condition.
  4. Stay hydrated and eat a balanced diet. This can help with general health and well-being.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain or discomfort
  • Trouble breathing or shortness of breath that is getting worse
  • Fainting or loss of consciousness
  • Severe headache or a headache that is getting worse
  • Any new or worsening symptoms

Please remember that while I strive to provide accurate and helpful information, I am an AI and this advice should not replace a consultation with a healthcare provider.

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11 mo ago

People Also Ask


What are the common symptoms of idiopathic intracranial hypertension (IIH)?

Common symptoms of idiopathic intracranial hypertension (IIH) include headaches, vision problems, pulsatile tinnitus (a whooshing sound in the ears), and sometimes nausea or vomiting. The condition is characterized by increased pressure inside the skull without an obvious cause.


How can anxiety affect sleep and concentration?

Anxiety can lead to difficulty falling asleep or staying asleep, which can result in poor sleep quality. It can also cause racing thoughts or excessive worry, making it hard to concentrate on tasks. This can lead to fatigue and irritability during the day.


What lifestyle changes can help manage anxiety symptoms?

Lifestyle changes that can help manage anxiety symptoms include regular physical activity, practicing relaxation techniques such as meditation or yoga, maintaining a healthy diet, getting adequate sleep, and avoiding caffeine and alcohol. It's also important to identify and manage stressors in your life.


What are the potential triggers for tension headaches?

Potential triggers for tension headaches include stress, poor posture, lack of sleep, dehydration, and changes in atmospheric pressure. Identifying and managing these triggers can help reduce the frequency and severity of headaches.


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