[61F] Experiencing anxiety with dizziness and headaches

Patient Description

A 61-year-old female presents with a long-standing history of anxiety, spanning over 20 years, which has been significantly impacting her daily life. She describes her anxiety as causing a sensation of her heart feeling 'afraid,' but without chest pain, shortness of breath, or palpitations. Accompanying her anxiety are symptoms of dizziness and headaches, which she rates as a 5-7 out of 10 in severity, typically worse in the mornings and late afternoons. The dizziness is described as a sensation of swaying, bobbing, or bouncing, and is associated with a feeling of the floor moving while walking. She has a diagnosis of vestibular migraines and persistent positional dizziness, which have been present for 8 years. Additionally, she experiences sudden headaches and transient fuzzy vision in one eye, especially when anxious. The patient has a family history of AFib in her father and anxiety in her mother. She also has hypothyroidism and is a smoker. No other pre-existing conditions or chronic illnesses were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, you are experiencing a number of symptoms that could be related to a variety of conditions. Here are some possibilities:

  • Anxiety Disorder: You've mentioned having a long history of anxiety, with ruminating thoughts and fears about your health. Anxiety can cause a wide range of physical symptoms, including dizziness, headaches, and feelings of unease or fear.

    • Treatment often involves a combination of therapy, medication, and self-care strategies.
  • Vestibular Migraines: You've mentioned a diagnosis of vestibular migraines, which can cause symptoms like dizziness, balance problems, and visual disturbances. These symptoms can be triggered or worsened by stress and anxiety.

    • Treatment typically involves medications to prevent migraines and manage symptoms, as well as lifestyle changes to reduce triggers.
  • Hypothyroidism: You've mentioned a diagnosis of hypothyroidism, which can cause fatigue, weakness, and other symptoms. If your thyroid hormone levels are not well-controlled, this could contribute to your symptoms.

    • Treatment typically involves taking a synthetic thyroid hormone to replace the hormone your body isn't making enough of.

Please note that these are possibilities based on the information you've provided, and it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

What you can do

  1. Consult with a healthcare professional: They can provide a formal assessment, order relevant tests if necessary, and develop a treatment plan tailored to your needs.

  2. Practice self-care: Regular exercise, a healthy diet, adequate sleep, and stress management techniques can help manage symptoms of anxiety and improve overall health.

  3. Monitor your symptoms: Keep track of your symptoms and any potential triggers. This information can be helpful for your healthcare provider.

What you should look out for

Reasons to seek immediate medical attention:

  • If you experience severe chest pain or pressure, especially if it's accompanied by other symptoms like shortness of breath, arm pain, or jaw pain. These could be signs of a heart attack.
  • If you have a severe headache that comes on suddenly, or if you have a headache accompanied by a fever, stiff neck, confusion, seizures, double vision, weakness, numbness, or difficulty speaking. These could be signs of a serious condition, such as a stroke or meningitis.
  • If you have thoughts of harming yourself or others. If you're feeling suicidal, it's important to get help right away.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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10 mo ago

People Also Ask


What are vestibular migraines and how are they treated?

Vestibular migraines are a type of migraine that involves dizziness, balance problems, and visual disturbances. They can be treated with medications to prevent migraines and manage symptoms, as well as lifestyle changes to reduce triggers such as stress and certain foods.


How can anxiety affect physical health and what are some management strategies?

Anxiety can cause a range of physical symptoms including dizziness, headaches, and a sensation of fear. Management strategies include therapy, medication, regular exercise, a healthy diet, adequate sleep, and stress management techniques.


What is persistent positional dizziness and how can it be managed?

Persistent positional dizziness is a condition where dizziness is triggered by changes in head position. It can be managed through vestibular rehabilitation therapy, medications, and lifestyle adjustments to avoid triggers.


How does hypothyroidism contribute to symptoms like dizziness and headaches?

Hypothyroidism can lead to symptoms like fatigue, dizziness, and headaches due to low levels of thyroid hormones. Treatment involves taking synthetic thyroid hormones to normalize hormone levels, which can help alleviate these symptoms.


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