Can anxiety cause weakness

Contents

How Anxiety Can Make Your Legs Feel Like Jelly

Anxiety, despite what many think, actually does have a “useful” purpose. While anxiety comes with many difficult symptoms, it also signals to your body when you should be afraid (when your “fight/flight” response should be activated). This physiological reaction occurs when a harmful event, attack, or threat is perceived.

Unfortunately, many people experience life with their fight or flight system constantly activated. For these individuals, the physiological reaction occurs regardless of whether something actually triggers it or not. This is hard, as the fight or flight response is quite strenuous on the body. One of the symptoms that many complain about is weak legs, or “jelly legs.”

With jelly legs, standing can feel unusual and may be accompanied by dizziness or balance issues. The dizziness and/or balance problems may be related to the inherent leg weakness, or be an additional symptom of the overall anxiety.

What Creates the Jelly Leg Feeling?

There are several factors that may contribute to the feeling of jelly legs. One of the most common is a result of the adrenaline produced in response to the physiological response of “fight or flight.”

When adrenaline rushes through the body, blood goes to the places that your body feels need it most. That means that your blood is rushing to your heart, your brain, and possibly various muscles, and to do that it rushes out of your legs and makes them feel more like jelly.

Other Causes of Jelly Leg

The sensation of “jelly legs” may also be attributed to the muscle weakness that occurs when the body is flooded with adrenaline. Adrenaline causes the muscles to be in a constant state of tension, and eventually, they will become weak. Also, anxiety can cause changes to one’s breathing that can result in weakened muscles and changes in blood pressure.

How to Tell the Difference Between Anxiety Weak Legs and Something More Serious?

Many people suffering from jelly legs worry they are experiencing a more serious physical problem. While weak legs can be a scary feeling (in that it may feel difficult to stand), jelly legs are fairly common. Nonetheless, it is always appropriate to speak to a medical professional if there is a concern. A doctor can diagnose or rule out any potential underlying health issues. Yet, certain factors may help in determining if the jelly legs are a result of anxiety, or a more significant, underlying condition:

  • Temporary – Generally, the sensation of jelly legs associated with anxiety is temporary. Weak legs tend to regain some of their strength when the anxiety dissipates. They may recur often as you go through anxiety, but they won’t be a constant symptom.
  • Strength – Usually weak legs due to anxiety will regain most of their strength. This is not entirely the case as dizziness and hyperventilation can genuinely cause legs to be a bit weaker than normal (as can adrenaline rushes), but leg strength is usually not affected – especially in the long term.
  • Other Symptoms – Weak legs from anxiety are usually accompanied by other anxiety symptoms. Jelly legs from anxiety usually come with anxious thoughts, rapid heartbeat, and other signs of anxiety.

The problem with anxiety and jelly legs (along with the other difficult symptoms of anxiety) is in the difficulty determining the cause of the symptoms. Nevertheless, there are some general differences between anxiety and a more serious, underlying health condition that could help one recognize whether or not his or her experience is anxiety related.

How to Cure and Prevent Jelly Legs

Anxiety, while at times overwhelming, is treatable. There are ways to manage anxiety in the moment as well as long term treatment options.

Some tools and skills to help manage anxiety in the moment include:

  • Go Walking – If you’re not feeling too dizzy (a common symptom of anxiety), try going for a walk. Walking gets the blood flowing and it takes your mind off of your legs. It’s also a reminder that you have leg strength.
  • Close Your Eyes – If you do have a bit of dizziness leading to your weak leg feeling, close your eyes for a while as long it’s safe to do so. Your weak legs are generally the result of feeling dizzy, so with your eyes closed that dizziness will affect you less.
  • Mantra Meditation – There is some debate in the medical community about whether or not mantra meditation is beneficial for anxiety in the long term. However, in the short term, it can help calm you down because it acts as a breathing distraction. The mantras focus your mental energy away from your anxiety, while the meditation gets your breathing under control so that you experience less over-breathing.

These aren’t long term solutions, but in the moment, using these skills may help decrease the intensity of the anxiety and alleviate some of the challenging symptoms, including weak legs.

Long-term treatment options may include:

There are various approaches to managing anxiety long-term. Some of these approaches may help decrease one’s vulnerability to anxiety altogether, or lessen the intensity of the anxiety when it is experienced.

  • Herbal Solutions Several natural herbs are effective for controlling anxiety.
  • Anxiety Medications Many medications can reduce anxiety, although they may come with side effects.
  • Therapy Therapy can also be effective at reducing anxiety.

Generally, the best place to start is by thoroughly researching anxiety and getting an idea of which symptoms are effecting you and how.

Top 15 Symptoms of Anxiety Mistaken for Other Conditions

You know your tell-tale symptoms of anxiety if you’ve ever had an anxiety attack or panic attack.

But one of the worst things about the symptoms are that you never know if you should treat them as a real medical emergency or just a side effect of your anxiety.

Unfortunately it is true that there are numerous medical conditions that can cause sensations and symptoms which mimic anxiety.

So What can You Do?

The best thing to do is remember that your anxiety can distort your thinking and judgement, and the fact that your brain is not calibrated to deal with such sensations rationally at this time.

When your anxiety attack has passed or reduced in severity, it is recommended to see a doctor, because they will be able to tell anxiety symptoms from actual medical condition symptoms. This is and of itself is reassuring to many people.

“Pain is inevitable. Suffering is optional” – Haruki Murakami

The following are but a few of the many troubling symptoms of anxiety:

1. Chest Pain or Discomfort – shooting pains, twitching or burning muscles, numbness, a fullness in the chest area that can be mistaken for heart problems or heart attack symptoms, causing more anxiety.

2. Shortness of Breath– Difficulty getting a full breath, a feeling that breathing is forced and too much work. Becoming overly aware of each breath, as if your breathing is “on manual”, rather than automatic, along with the fear that if you don’t keep consciously taking each breath, you will stop breathing and die. Can be mistaken as asthma symptoms, or obsessive compulsive disorder.

Shortness of breath symptoms are usually due to hyperventilation. Hyperventilation is when your body is getting too much oxygen and is pushing out too much carbon dioxide. This can make you feel like you’re not breathing enough.

3. Heart Palpitations– feelings that your heart is pounding or racing. Can be felt in your chest, throat, or neck.

Anxiety elevates the body’s level of cortisol and adrenaline. These in turn can interfere with normal functioning of the parasympathetic nervous system, and result in overstimulation of the vagus nerve.

Vagus nerve induced palpitations are felt as a thud, a hollow fluttery sensation, or a skipped beat, depending on at what point during the heart’s normal rhythm the vagus nerve fires. The anxiety of feeling palpitations can cause you further anxiety and increased vagus nerve stimulation. Can be mistaken for tachycardia or heart attack symptoms.

4. Weak Legs- feeling like your legs are jelly-like, or rubbery, weak and shaky and won’t hold you up when you walk. Or your legs and knees can feel too stiff too move. You can also feel this in your arms as well.

This is a common anxiety stress response. We’ve all heard the expression “going weak in the knees” referring to sudden shock or fear.

Often anxious people mistake this response for some serious disease, like Muscular Sclerosis, Muscular dystrophy, Amyotrophic lateral sclerosis (ALS) or a stroke. Weak legs from stress are not caused by a serious disease, and is not a cause for alarm.

5. Choking – a feeling of tightness in the throat, or sensations as if there is something stuck in your throat, or a feeling you have a lump in your throat. Also gasping, gagging, or having to swallow hard for no reason. Can be mistaken for going into anaphylactic shock, especially if the person has allergies. A common stress reaction.

6. Seeing spots– spots in the periphery or center of vision. Can be either with eyes closed or open. Also flashing lights, or ryes sensitive to light. A response to stress. Can be mistaken for visual migraines.

Scientists know that the adrenaline surge that happens with the activation of the fight or flight stress response seems to change some people’s vision. The changes take the form of tunnel vision, where the eyes focus on whatever is directly in front of you and the rest of the visual field is blurred out. Coupled with this tunnel vision is a heightened sensitivity to light through dilation of the pupils.

Anxiety also tends to produce sensory hyper-awareness, so it is possible that you feel like you’re experiencing some kind of physiological problem even though these spots are natural, and no cause for worry.

7. Ringing in the ears– Worried that you’ve suddenly developed tinnitus? Could just be an anxiety symptom. This can be the classic high-pitched ringing, or low rumbling, chirping, swooshing, sloshing, buzzing, whooshing, humming or throbbing sound.

The actual cause of tinnitus is still unclear to science, but there has been a link established between anxiety and stress and ringing ears. One theory is that anxiety causes a type of “hypersensitivity,” where you become extremely aware of every single pain, feeling, or sensation in your body. It is possible that some people have a very mild, virtually imperceptible tinnitus, and their anxiety makes them overly sensitive to it, plus their anxiety keeps them from ignoring it.

8. Jaw Pain– caused by teeth grinding and carrying stress tension in the jaw. Also can feel like you cannot open your mouth all the way. Can be mistaken for Temporomandibular joint dysfunction.

Although jaw clenching is the most common cause, any facial muscle tension from stress can lead to jaw pain. Your body’s stress hormones can tense your muscles automatically, without any conscious action from you.

9. Nausea– feeling like your stomach is upset, distressed, unsettled along with an urge to vomit. A very common symptom of fear, stress, and anxiety.

Nausea caused by stress can make you think you have gallbladder disease, food poisoning, early pregnancy, seasickness, Irritable Bowel Syndrome or stomach cancer.

10. Dizziness- feeling lightheaded, dizzy, the room is suddenly spinning. Sometimes on top of that, people have the feeling that they might faint or pass out. All are common stress, fear, and anxiety symptoms .

Can be misdiagnosed as vertigo or migraine, since some doctors are not aware that dizziness is often caused by stress and anxiety. New research has established a considerable link between the two.

11. Back Pain– Yes, back pain, back stiffness, soreness or muscles spasms, can actually be anxiety related stress symptoms.

12. Sweating– Sudden uncontrolled sweating, hot or cold sweats for no reason, and hot flashes. A stress response often associated with anxiety and panic attacks. Can be misdiagnosed as menopausal hot flashes, Diabetes mellitus, Diabetic neuropathy, shingles, Orthostatic hypotension, and Fibromyalgia.

13. Brain Fog– difficulty concentrating, thinking, forming thoughts. Thinking can feel like it is muddled or impaired. Some people call this symptom being “foggy-headed”, “spaced out” or “clued out” . This stress response can be mistaken for low blood sugar, food allergies, seasonal allergies, dehydration, or depression. Anxiety sufferers may have panic thoughts that they have Lyme disease, mercury poisoning, fibromyalgia, or dementia.

In fact, brain fog is more often your mind’s way of telling you to relax, and is brought on by prolonged stress, burn out, and feeling overwhelmed.

14. Stomach Distress– bloating, diarrhea, excessive belching or burping, acid reflux, constipation, feeling like butterflies in your stomach, vomiting, sharp lower bowel pain. Can all be due to anxiety related stress. These may be misdiagnosed as ulcers, Irritable Bowel Syndrome, Crohn’s Disease, and uterine fibroids.

15. Numbness– part of your skin or body feels numb, tingly or frozen with anesthesia. There also can be a feeling of pins and needles, or burning skin sensations.
During an anxiety response, you can hyperventilate, and this can cause parts of your body to feel numb. And when you hyperventilate your body constricts blood vessels, preventing blood flow to various areas of your body, leading to the numbness. Tyr breathing slower and more steadily if this happens and see if the numbness goes away.

A Normal Reaction

Anxiety is actually a normal reaction to danger. Everybody feels anxiety to some degree and frequency.

Anxiety is a body-mind response to the awareness of potential danger, or to thinking fearfully about the perceived danger.

It only becomes a “disorder” when it interfere with your normal functioning.

There is no quick cure for anxiety. You will need to figure out the type of underlying anxiety issues you have, and treat the anxiety directly.

As soon as your anxiety issues are resolved, your physical symptoms should finally go away.

Top Photo by Scott Swigart

Does Anxiety or Depression Cause Physical Weakness?

Q2. I’ve had a lot of things happen in the past that I should have gotten help for, and recently a lot of things have left me feeling helpless and hopeless. My husband wants to know why I want to isolate myself all the time. I have no energy, no motivation. I’m easily irritated, and I feel that I just don’t care anymore. I know I need help. All I want to do is cry, and I get so upset my body shakes. I feel as if I’m losing control, and I don’t know how to deal with the past, or any new stress that comes along. Please help. What do I need to do next?

Although a diagnosis should not be made on the basis of such a short description, it sounds very much as if you may be in the midst of what is called a major depressive episode. First, you should not feel alone — at least 1 in 10 people (and maybe closer to 1 in 5) will suffer from depression in his or her lifetime; typically, the first episode develops during a period of increased stress.

If you haven’t done so already, you should let your husband know just how bad you are feeling and — with or without his help — make an appointment to see your primary care physician or, if you’d rather, an experienced mental health professional. (You can also search for psychotherapists in your area on Revolution Health, an Everyday Health partner Web site.)

If this seems like too big a step, try talking with a friend or another family member — you may be surprised to find out that he or she has also had experience with this common condition. The most important thing to keep in mind now is that there are many effective treatments for depression, and it is likely that with the appropriate therapy, you can begin to feel better within a matter of weeks. Moreover, if your first choice of therapy is not helpful, it’s important to continue to pursue treatment until you find one that works, because these treatments (both therapy and medications) can help most people with depression.

Q3. Is it possible to be depressed and anxious at the same time? Ever since Hurricane Charley, it seems like the littlest thing will set me off. Before Charley I was the kind of person that would let things slide off my shoulders, and I never worried about anything. Now the smallest thing sets me off like a time bomb.

Depression and anxiety are closely related conditions, both in terms of what’s happening in the brain and the clinical features (symptoms). Most people with depression have at least some anxiety and vice versa.

Based on your description, you may have developed a particular form of anxiety known as post-traumatic stress disorder. This illness can follow traumatic events such as war, domestic abuse, rape or, as in your case, natural disasters. Symptoms can begin soon after the event, or as long as six months later. You should find a doctor or therapist who is knowledgeable about both conditions and talk about treatment options.

Q4. How common is it for someone to have depression, anxiety, stress, and maybe even bipolar disorder at the same time? My default emotional state is down, but I also get very anxious at times, and I have a hard time handling stressful situations. I want to get treated, but I’ve heard that a lot of people get misdiagnosed and end up on the wrong drug(s). Thanks for any help!

At least 50 percent of people who have major depressive disorder also have significant anxiety symptoms, and approximately 10 percent to 20 percent of people who are depressed also have had periods of abnormal upward mood swings (that is, mania or hypomania); stress is commonly associated with all three conditions — major depressive disorder, depression, and bipolar disorder.

Anxious depressions and bipolar depressions tend to be somewhat more difficult to treat than “uncomplicated” depression. Although misdiagnosis can occur, underdiagnosis and undertreatment are more common problems. The best way to minimize the effects of misdiagnosis or to reduce the likelihood of being placed on the wrong treatment is to establish a strong collaborative relationship with your treatment provider and not be bashful about letting him or her know if something doesn’t make sense or isn’t working.

Q5. Our 24-year-old son just returned from the Army and has been diagnosed with post-traumatic stress disorder (PTSD) with major depression. He served one year in Korea and one year in Iraq. He has also separated from his wife and has moved in with us. He has no job, no money, and no motivation to do anything. What can we do to help him get over this and back into his own life?

— Stacy, Oaklahoma

A significant proportion of soldiers returning from combat have PTSD, and depression is a very common co-occurring or complicating condition. In addition to having to adapt to the return to civilian life after several years overseas and having to cope with the distressing symptoms of PTSD (such as nightmares and heightened anxiety) and depression (such as low energy and decreased motivation), your son faces the additional challenges of unemployment and what I assume is an unwelcome marital separation. These particular stressful life events are associated with an increased risk of depression even in people who do not have PTSD.

The first and most important thing that you can do is to have a heart-to-heart talk with your son to make sure that he knows that you are in his corner and will support his efforts to recover in every way that you can, which will include ensuring that he is receiving adequate treatment for PTSD and depression. Although people with PTSD and depression can sometimes recover without appropriate treatment, his chances of feeling better and getting back on track with his life will be greatly enhanced if he is receiving treatment for both of these conditions.

A second way that you can help him is to ensure that he is being evaluated for eligibility for veterans’ benefits for service-related health problems. A third is to try your best to help make sure that your son is living a healthy lifestyle, including regular bedtimes and wake times, exercise, and minimizing the use of alcohol and drugs.

Learn more in the Everyday Health Depression Center.

Fibromyalgia

This condition resembles CFS. However, in fibromyalgia the muscles also become very tender to touch and they tire extremely easily. They are not usually wasted and can demonstrate normal (although uncomfortable) strength on formal testing. People with fibromyalgia tend to complain more of the pain than the tiredness or weakness.

Underactive thyroid (hypothyroidism)

In this condition a shortage of thyroid hormone leads to generalised tiredness. In untreated hypothyroidism, muscle degeneration and wasting can develop. This can be severe and difficult to reverse. Hypothyroidism is a common condition but it is usually picked up early and treated before long-lasting muscle problems can result.

Electrolyte disorders and lack of fluid in the body (dehydration)

Problems of the balance of salts in the body, including dehydration through not drinking enough, cause muscle tiredness. This may be severe in extreme cases, such as dehydration during a marathon. Muscles work less well when there is an imbalance in the salts in the blood.

Conditions of muscle inflammation

Inflammatory diseases of muscle typically affect older adults and include conditions such as polymyalgia rheumatica (muscles of the shoulders and thighs become tender and weak), polymyositis and dermatomyositis. Some of these conditions respond well to steroids (which need to be taken for many months before the condition resolves). Unfortunately, as explained above, steroids also cause muscle wasting and weakness.

Conditions of generalised tissue inflammation such as systemic lupus erythematosus and rheumatoid arthritis can cause muscle weakness. In a small proportion of cases of rheumatoid arthritis, muscle weakness and tiredness may be the only sign of the disease for some considerable time.

Cancers

Cancers can cause muscle damage directly but the presence of cancer anywhere in the body can also cause generalised muscle tiredness. In advanced disease, general weight loss will also lead to true muscle weakness. Muscle weakness is not usually the first sign of a cancer but occurs later in the condition.

Nerve conditions which damage muscles

Conditions affecting nerves tend to lead to true muscle weakness. This is because if the nerve to a muscle fibre stops working, the muscle fibre can’t work either and it will become floppy and eventually shrivel.

Neurological conditions: muscle weakness can be caused by cerebrovascular disease such as stroke and brain haemorrhage and spinal injury Tumours in the brain can also lead to muscle weakness. Muscles which become partially or completely paralysed lose their normal strength and will eventually waste. Some recovery is possible but it will be slow and may not be complete.

Spine-related conditions: when nerves are damaged as they emerge from the spine (such as when you ‘slip’ a disc in the lower back or neck), weakness can result. When the discs slip out, they press on nerves headed lower down in the body. The weakness affects only the muscles served by the irritated or compressed nerve.

Other uncommon nerve conditions:
Multiple sclerosis (MS): this is caused by damage to nerves in the brain and spinal cord and can cause sudden paralysis. This can recover partially but does not always do so.

Guillain-Barré syndrome: this is a post-viral paralysing disease which causes weakness and loss of muscle function from the fingers and toes upwards. It may last many months, although complete recovery is usual.

Parkinson’s disease: this is a progressive disorder of both movement and mood, mainly affecting people aged over 60. In addition to muscle weakness, people with Parkinson’s disease notice tremor and stiffness. They often have difficulty in starting and stopping movements and they are often depressed.

Rare causes of muscular weakness

Genetic conditions affecting muscles

Muscular dystrophies: these are inherited diseases which affect muscles. They are rare disorders but the best known and most common is Duchenne muscular dystrophy. This occurs in children and leads to gradual loss of muscle power from toddler-hood.

Some rare muscular dystrophies: these can present in adulthood and include Charcot-Marie-Tooth syndrome and the facioscapulohumeral dystrophies. They also cause gradual loss of power and function in muscles. Those who have these conditions may become wheelchair-bound.

Sarcoidosis: this is a rare disease in which clumps of cells (granulomas) form in skin, lungs and soft tissues, including muscles. The condition usually goes away after a few years.

Amyloidosis: also rare, this condition involves deposits of an ‘unhelpful’ abnormal protein called amyloid throughout the body, including muscles and kidneys.

Other rare causes: direct damage to muscles can occur in rare inherited metabolic conditions. Examples include:

  • Glycogen storage diseases (in which glycogen, a carbohydrate, infiltrates muscles as well as other organs).
  • Even rarer, mitochondrial diseases which occur when the energy systems inside muscle cells don’t work properly.

Myotonic dystrophy: this is a rare genetic muscle disorder in which muscles become extremely tired. Myotonic dystrophies are passed down through families and they tend to occur earlier and become worse as they move through the generations.

Conditions affecting nerves

Motor neurone disease (MND): this is a progressive disorder of the nerves which affects all parts of the body. Most forms of MND begin at the outer extremities, hands and feet and gradually move inwards. The condition can take months or years to progress but people with MND often quickly develop profound muscle weakness and wasting.

MND is most often seen in male patients over 50 years of age but there have been many notable exceptions to this, including the scientist Stephen Hawking.

Myasthenia gravis: this condition is an uncommon muscle disorder in which muscles tire rapidly with a very long recovery time. This can be so extreme that patients can’t keep their eyelids lifted and speech can become slurred.

Poisons: poisonous substances also cause muscle weakness and paralysis through their effect on nerves. Examples are organophosphates (used in farming and sadly as chemical weapons) and botulinum toxin (used in Botox®, both for cosmetic and for therapeutic reasons). In the case of organophosphates, the weakness and paralysis symptoms may be permanent.

Addison’s disease

Addison’s disease is a rare condition of underactivity of the adrenal gland, leading to a shortage of steroids in the blood and to abnormalities of the blood’s salts. It tends to come on gradually. Patients can also develop unexpected tanning (pigmentation) of the skin. Weight loss is common but the symptoms are often vague. Muscle fatigue may be mild and is often an early symptom. The disease can be very difficult to spot and special tests are needed to confirm it.

Other rare hormonal causes of muscle weakness include acromegaly (excessive levels of a hormone called growth hormone), underactivity of the pituitary gland (hypopituitarism) and severe vitamin D deficiency.

I have muscle weakness – what will the doctor do?

If you have muscle weakness and visit your doctor, they will first need to know the following:

  • How it began and long you have had it for.
  • Whether it is getting worse, better or staying the same.
  • Whether you are otherwise well, are losing weight or have travelled abroad recently.
  • What medicines or other drugs you have been taking and whether there are any muscle problems in your family.

Your doctor will need to examine you to see which muscles are affected and whether you have true or perceived muscle weakness. They will check to see whether your muscles are tender to touch (which suggests they are inflamed) or unusually ‘fatigable’. They may want to watch you walk.

They will then need to test your nerves to see whether the muscles are getting the right signals to act. Your doctor may need to test your central nervous system, including your balance and co-ordination. They may need to perform blood tests to look for abnormalities of hormones, salts and blood cells.

If none of these tests reveal the cause then your doctor may order the following:

  • Nerve studies to make sure the nerves are conducting properly.
  • A muscle biopsy to see whether the muscles themselves show signs of inflammation or damage. A biopsy is a procedure where a small sample is taken to look at under the microscope.
  • Body scans such as CT or MRI to look for conditions elsewhere in the body which may affect muscle power and function.

The pattern and severity of weakness, associated symptoms, medication use, and family history help the doctor to determine the cause of your weakness.

In the physical examination, the doctor should objectively note down your loss of strength, conduct a neurological survey and search for patterns of weakness and other abnormalities.

Summary

There are many possible causes of muscle weakness. These range from common to rare, serious to minor, temporary to permanent. Fortunately, most cases of muscle weakness which lack obvious cause are reversible. Muscle weakness is rarely the only sign of serious underlying disease.

If you have persisting muscle weakness, particularly if it severe, localised, painful or present for more than two to three weeks, you should visit your doctor.

Once your doctor has talked to you about your symptoms, they will be able to offer some guidance as to the likely cause. They will also be able to tell you if there are any serious concerns about your symptoms and will be able to refer you for further testing if required.

How to Control Muscle Weakness Associated with Anxiety

Muscle weakness is a potentially frightening anxiety symptom. The experience can be really distressing, leading to severe tension and worry, which only serve to make the anxiety worse. Ultimately, feeling that you don’t have the physical strength to live a normal life can really make things difficult. In this article, we explore the link between anxiety and feelings of muscular weakness, suggesting several coping techniques that you can use. Read on to learn more.

Anxiety Causes Muscle Weakness

Anxiety problems are known to cause feelings of muscle weakness. However, you should visit a doctor if you’re experiencing this, in order to make sure that there isn’t another medical or physical explanation. Most often, however, the muscle weakness that you feel is likely to be linked to your anxiety. While it can be distressing and irritating, these feelings of muscular fatigue, tingling or numbness are not harmful in and of themselves.

However, is this really a case of your muscles being temporarily weakened, or is this just your anxiety playing tricks on your mind? Muscle weakness is generally subjective. While some people do have problems standing or sitting, few are “testing” the muscle to see if the muscle is actually weaker. There are several different issues that lead to this perceived feeling of weakness. They include:

  • Hyperventilation When you breathe too quickly, or take in too much air, this is known as hyperventilation. Hyperventilation is extremely common for those with anxiety, potentially causing muscle weakness by reducing blood flow to the extremities. It’s not dangerous, but it can cause your muscles to feel weak, tingly, or light, along with many other symptoms.
  • Fight or Flight During the fight or flight response, anxiety causes several changes in the body. These include an increased heart rate, higher blood pressure, faster breathing, and changes in blood flow. One of the effects of these changes is the sensation that the muscles are weakened. They may not actually be weaker, but the complex bodily and hormonal changes may cause your muscles to feel that way.
  • Muscle Tension and Fatigue Anxiety also leads to both muscle fatigue, due to the way that stress causes your muscles to tense and your body to tire. This can tire your muscles to such a degree that it feels as though they have less strength than they did previously.
  • Perceived Weakness Finally, anxiety tends to make you over-sensitive to what’s happening in your body. This means that you may interpret a feeling of muscle weakness as being worse than it is, which in turn can further fuel your anxiety. In reality, however, you may find that the muscle weakness is just a matter of perception – “all in your mind”, in other words.

These are some of the potential causes of muscle weakness linked to anxiety. There may be other links as well – anxiety can affect many different aspects of your body. Some people may feel more lightheaded, as though they’re going to faint and this can cause a feeling of muscle weakness as well. Others may not eat or drink enough as a result of their anxiety, causing actual muscle weakness and fatigue.

The Best Ways to Control Anxiety Related Muscle Weakness

Muscle weakness is a tricky issue. On the one hand, when it’s caused by anxiety it’s not dangerous; and in some cases, it’s just a matter of perception and your muscles are not really weakened. On the other hand, living with muscle weakness can be stressful, often increasing the level of anxiety that you feel.

There are several strategies you can use to decrease the feeling of having weak muscles. These include:

  • Walking Often your muscles aren’t actually weak. They’re simply feeling that way. So go for a walk, and show your brain that your muscles are fine. Walking is good for blood flow and keeps your muscles active, which – while it won’t cure muscle weakness altogether – is useful for overcoming some of the stress. If you prefer to do other forms of physical activity, including stretching and/or yoga exercises, that ought to help as well.
  • Breathing Slow, concentrated breaths will reduce the effects of hyperventilation. Make sure that you’re not breathing too quickly or in a shallow manner. Breathe slowly, deep into your belly. Each breath should take as long as 15 seconds from the time you start breathing in until the time you finish exhaling. Try to hold your breath for a few seconds between the inhale and the exhale.
  • Mental Distractions Remember, part of the goal is simply not to focus on your muscles as much because that level of focus can make them feel weaker than they are. Distracting yourself through mental exercises, phone calls, time in nature, music or meditation can help. The exact distraction that you employ doesn’t matter all that much – what’s important is that you find an enjoyable activity that you can use to temporarily take your mind off of what’s happening in your body.

These strategies aren’t going to reduce your muscle weakness every time. Sometimes, for example, you’re genuinely tired and your there’s a good reason for why your body is feeling that way. Sometimes the anxiety that you feel may seem so overwhelming that you believe these exercises won’t have much of an impact.

At times, there is no quick fix available. Nonetheless, the techniques that we have discussed today can prove helpful in managing sensations of muscle weakness and reducing your overall anxiety levels. If you want to take things one step further, think more broadly about your anxiety and ways that you can address this. For example:

  • Cognitive Behavioral Therapy
  • Anxiety Reducing Medications (when prescribed by a doctor or psychiatrist)
  • Self-Help for Anxiety

You can read more about these types of treatments on our anxiety treatment page. By tackling the underlying problem – i.e. the anxiety – at its root, you stand the best chance of overcoming your muscle weakness.

Muscle Weakness Anxiety Symptoms

Written by: Jim Folk.
Medically reviewed by: Vitaly Liashko, MD, FRCPS(C)
Last updated: December 8, 2019

Muscle weakness anxiety symptoms can affect any muscle or group of muscles in the body, such as arms, legs, back, neck, fingers, toes, etc. Even though weak, tired, and heavy feeling muscles can be unnerving, they are common anxiety disorder symptoms. This article explains how they feel, why anxiety causes them, and what you can do to stop them.

Muscle weakness anxiety symptoms can feel like:

  • A muscle or group of muscles feel unusually weak, tired, heavy, rubbery, or odd.
  • Some people describe this symptom as their muscles feel wobbly, numb, shaky, and tired.
  • A muscle or group of muscles seem difficult or impossible to move, relax, or loosen.
  • It feels like a muscle or group of muscles seem unusually frail, fatigued, and underpowered. No matter what you do, their “weakness” doesn’t change.
  • It feels like a muscle or group of muscles aren’t properly supporting your body or movements due to feeling limp, listless, and worn out.
  • Others describe their muscles as feeling like they won’t work right or too limp to use correctly.
  • Others describe this symptom as feeling like their muscles are unusually heavy or “numb” feeling.
  • Others describe this symptom as that they don’t have confidence in their muscles because they don’t feel as strong as they used to.
  • Others have said that their muscles feel so weak that they are unsure their muscles will support their body.
  • Other descriptions include weak hands, feet, legs, arms, neck, back, head, and face muscles. They can feel so weak that you become concerned you have a serious medical problem, such as MS, ALS, or Parkinson’s Disease.

Anxiety induced muscle weakness can affect any muscle or group of muscles. It can also involve one particular muscle or group of muscles, or can randomly shift from one muscle or group of muscles to another. It can also include several different muscles or groups of muscles at the same time, or feel like your entire body is weak.

Muscle weakness anxiety symptoms can appear for a few moments and then disappear, can last for minutes or hours, or can persist indefinitely. It can also occur or be more noticeable and bothersome when trying to relax, go to sleep, or when waking up. This anxiety symptom can also be more problematic when you are trying to use the affected muscle or group of muscles, such as when walking or lifting.

The degree and intensity of this muscle weakness anxiety symptom can vary from person to person. For example, one or a group of muscles can be only mildly weak for one person, whereas the weak and tiredness can be intensely noticeable and severely restricting for another person.

Muscle weakness can affect ANY muscle or group of muscles in the body. Many of those who experience stress and anxiety comment about weak muscles in the head and face, mouth, back of the head and neck, back and top of the shoulders, chest, arms, legs, hands, stomach, lower back, groin, and feet.

Some people experience significant discomfort due to their muscle weakness anxiety symptoms. Some people also find their muscle weakness so restricting and debilitating that it impedes physical activity and impairs a normal lifestyle. Some people even become bedridden because they feel so weak.

This muscle weakness anxiety symptom can occur when anxious, stressed, or with other panic attack symptoms, or can happen for no apparent reason. It can also be mildly noticeable, moderately bothersome, or exceedingly problematic. It can change from day to day and even moment to moment.

All combinations and variations are common.

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Why does anxiety cause muscle weakness?

Medical Advisory

Anxiety can cause muscle weakness in many ways. It can also cause both a “feeling” of muscle weakness and actual muscle weakness. Here are six of the most common ways anxiety causes muscle weakness symptoms:

1. Stress Response

Anxiety activates the stress response, otherwise known as the fight or flight response. The stress response causes many physiological, psychological, and emotional changes that equip the body for emergency action.

Some of these changes include:

  • Stimulates the body, including the nervous system.
  • Tightens muscles.
  • Shunts blood away from parts of the body less important for emergency action (such as the digestive system) and to parts that are more important (brain, and muscles).
  • Elevates heart rate.
  • Increases respiration.
  • Increases blood pressure.

To name a few.

These changes can cause “sensations,” such as feeling like your muscles are “weak.” Experiencing weak, tired, or “heavy” muscles is a common stress response experience. Many people notice this type of weakness when afraid. “Weak in the knees” is a common expression heard from people who are anxious, nervous, or afraid.

For a more detailed explanation about the many changes, see our “Stress Response” article.

2. Hyperventilation and Hypoventilation

The fight or flight response also causes the body to change its breathing pattern from a slow, deeper breath to either rapid, deeper breaths (hyperventilation) or rapid, shallow breaths (Tachypnea). When your breathing changes to either of these patterns, carbon dioxide (CO2) levels in the bloodstream decrease. A reduction in CO2 can cause many symptoms, including lightheadedness, feeling faint, and feeling like your muscles are weak, heavy, and tired.

Some people hold their breath or under breathe when they are stressed or anxious, causing Hypoventilation (not enough oxygen). Not enough oxygen increases CO2 in the blood, which can also cause the sensations of feeling lightheaded, faint, and having weak muscles.

3. Low blood sugar

The stress response stresses the body because of the many physiological, psychological, and emotional changes it causes. Stress taxes the body’s energy resources. If you are experiencing an extended episode of anxiety, your body can deplete its energy resources quickly, causing a reduction in blood sugar. Low blood sugar, even if low within the normal range, can cause symptoms, including lightheadedness, fatigue, and weak, tired, and heavy feeling muscles.

4. Fatigue and Sleep deprivation

Extended periods of stress or anxiety can cause fatigue. Fatigue can cause a number of symptoms, including lightheadedness, concentration problems, and muscle weakness.

Moreover, stress can cause problems with sleep. Sleep deprivation can also cause symptoms, including feeling dizzy and having weak and tired muscles.

5. Perception of muscle weakness and soreness

Many people with anxiety disorder become inward-focused on it and its symptoms. Sometimes this inward focus can create the “perception” of muscle weakness when there isn’t an actual physical cause.

We explain “Inward Focused Thinking” and how to stop it in chapter 6 in the Recovery Support area.

6. Hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly. When stress responses occur too frequently or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering, which can cause it to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants. Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated. “Weak muscles” is a common indication of hyperstimulation.

There are several ways hyperstimulation can cause muscle weakness anxiety symptoms, including muscle tension and muscle fatigue, sensory anomalies, and chronic fatigue, to name a few. We explain this in more detail in the “Muscle Weakness and Soreness” symptom in the symptoms section (chapter 9) in the Recovery Support area.

For more information about hyperstimulation and the many ways it can affect the body, visit our “Stress-response Hyperstimulation” article.

How to get rid of muscle weakness anxiety symptoms?

Stress Response

When this symptom is caused by apprehensive behavior and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the active stress response, this anxiety symptom should subside. Keep in mind it can take up to 20 minutes or more for the body to recover from a major stress response. This is normal and shouldn’t be a cause for concern.

Hyper- or Hypoventilation

When this symptom is caused by hyper- or hypoventilation, regulating your breathing will alleviate it as your blood CO2 levels return to normal values and stabilize. As they do, the muscle weakness feeling should subside.

Low blood sugar

When this symptom is caused by low blood sugar, eating a nutritious snack or meal can restore blood sugar to a normal level. As blood sugar returns to a healthy level, this muscle weakness feeling should let up.

Fatigue or sleep deprivation

When muscle weakness is caused by fatigue and sleep deprivation, increasing rest and getting regular good sleep can restore normal energy. As your body recovers from fatigue and sleep loss, weak feeling muscles should disappear.

Perception

When this symptom is caused by perception, changing the focus of your attention can eliminate the “perceived” notion of weakness. Distraction is an effective way of changing your focus.

Again, you can learn more about “Inward Focused Thinking” and how to stop it in chapter 6 in the Recovery Support area.

Hyperstimulation

When this anxiety symptom is caused by hyperstimulation, such as from overly apprehensive behavior, it can take much longer for the body to calm down and recover, and to the point where this anxiety symptom subsides.

Reducing your body’s stress and giving it time to recover should eliminate weak feeling muscles. But you have to keep in mind that it can take a long time to recover from hyperstimulation. Reducing the body’s stress overall generally doesn’t happen quickly. You may need to reduce your body’s stress for a few weeks or more before you see this symptom subside.

Nevertheless, when your body has completely recovered from hyperstimulation, it will stop producing symptoms of hyperstimulation, including the muscle weakness anxiety symptoms.

Regular exercise, light weight training, getting fresh air, relaxed breathing, and eating a healthy and balanced diet can also help alleviate this symptom in time. Worrying about the muscle weakness feeling is not helpful since worry stresses the body.

For a more detailed explanation about anxiety symptoms, including the muscle weakness anxiety symptom, why symptoms can persist long after the stress response has ended, common barriers to recovery from hyperstimulation and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

Anxiety muscle weakness frequently asked questions

Can anxiety cause weakness in arms and legs?

Yes! Having weakness in the arms and legs is a common symptom of anxiety disorder. For more information, read why does anxiety cause a weak and heavy legs feeling. You can also read how to get rid of weak and heavy feeling legs.

There are many medical conditions and medications that can cause weakness in arms and legs. You should discuss this symptom with your doctor to rule out a medical cause.

What causes sudden weakness in legs?

Anxiety can cause sudden weakness in legs. Anxiety can cause a sudden weakness in many other parts of the body, as well. For more information, read why anxiety can cause sudden weakness in legs. You can also read how to get rid of sudden weakness in legs.

There are many medical conditions and medications that can cause sudden weakness in legs. You should discuss this symptom with your doctor to rule out a medical cause

Why do my legs feel weak and heavy?

Stress, including anxiety-caused stress, can make your legs feel weak and heavy. Weak and heavy legs is a common symptom of overly apprehensive behavior. For more information, read why anxiety can cause weak and heavy legs. You can also read how to get rid of weak and heavy legs.

There are many medical conditions and medications that can cause legs to feel weak and heavy. You should discuss this symptom with your doctor to rule out a medical cause.

Stress, including anxiety-caused stress, can make your legs feel weak and tired. Many people experience legs that feel weak and tired when they are anxious, stressed, or afraid. For more information, read why anxiety can cause a weak and tired feeling in the legs. You can also read how to get rid of legs that feel weak and tired.

There are many medical conditions and medications that can cause legs to feel weak and tired. You should discuss this symptom with your doctor to rule out a medical cause.

Why do my muscles feel so weak?

There can be many reasons why muscles feel so weak. Stress, including anxiety-caused stress is one reason. For more information, read why anxiety can cause muscles to feel so weak. You can also read how to get rid of muscles that feel so weak.

Since some medical conditions and medications can cause muscles to feel weak, we recommend discussing this symptom with your doctor to rule out a medical cause.

What causes weakness in arms and legs?

Anxiety and chronic stress can cause weakness in the arms and legs. For more information, you can read why anxiety can cause weakness in the arms and legs. You can also read how to get rid of anxiety-caused weakness in the arms and legs.

Since some medical conditions and medications can cause weakness in the arms and legs, we recommend discussing this symptom with your doctor to rule out a medical cause.

Can anxiety cause long term muscle weakness?

Yes! Anxiety stresses the body, and a body that becomes chronically stressed can exhibit long-lasting symptoms, including long-term muscle weakness. For more information, you can read why anxiety can cause long term muscle weakness. You can also read how to get rid of long term muscle weakness.

There are also some medical conditions and medications that can cause long term muscle weakness. We recommend discussing this symptom with your doctor to rule out a medical cause.

Can anxiety cause muscle weakness and twitching?

Yes! Just as anxiety can cause weak feeling muscles, it can also cause muscle twitching. Consequently, anxiety can cause both muscle weakness and twitching at the same time. For more information, you can read more about the anxiety muscle twitching symptom.

There are also some medical conditions and medications that can cause muscle weakness and twitching. We recommend discussing this symptom with your doctor to rule out a medical cause.

Can anxiety cause muscle weakness on one side of body?

Yes! Anxiety-caused muscle weakness can affect any muscle or group of muscles. It can also cause muscle weakness on one side of the body. Anxiety-caused muscle weakness can also affect one side of the body, and then migrate to the other side, and involve both sides. All combinations and variations are common.

There are also some medical conditions and medications that can cause muscle weakness on one side of the body. We recommend discussing this symptom with your doctor to rule out a medical cause.

Can health anxiety cause muscle weakness?

Yes! Any type of anxiety, including health anxiety, can cause anxiety symptoms, including muscle weakness. Health anxiety is one of the more common causes of anxiety disorder. Working with an experienced anxiety disorder therapist is the most effective way to overcome health anxiety.

Can general anxiety disorder cause muscle weakness?

Yes! Any type of anxiety, including generalized anxiety disorder, can cause anxiety symptoms, including muscle weakness. Generalized anxiety is one of the more common causes of anxiety disorder. Working with an experienced anxiety disorder therapist is the most effective way to overcome anxiety disorder, including generalized anxiety disorder and its symptoms, including muscle weakness.

Can anxiety cause a feeling of muscle weakness?

Yes! Anxiety can cause both a feeling of muscle weakness and actual muscle weakness. For more information, you can read why anxiety can cause a feeling of muscle weakness. You can also read how to get rid of a feeling of muscle weakness.

Since there are many medical conditions and medications that can cause a feeling of muscle weakness, we recommend discussing this symptom with your doctor to rule out a medical cause.

Anxiety Therapy

If you are having difficulty with anxiety, its symptoms, and troublesome worry, you might want to connect with one of our recommended anxiety disorder therapists. Working with an experienced anxiety disorder therapist is the most effective way to overcome problematic anxiety.

All of our recommended therapists have experienced anxiety disorder, have successfully overcome it, and are medication-free. Their years of personal and professional experience make them an excellent choice to work with on your road to recovery.

Visit our “Why Therapy” and “What Makes Our Therapists Unique” articles for more information.

The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed – the underlying factors that motivate apprehensive behavior – a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety’s underlying factors is the best way to overcome problematic anxiety.

Additional Resources:

  • For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
  • Anxiety and panic attacks symptoms can be powerful experiences. Find out what they are and how to stop them.
  • How to stop an anxiety attack and panic.
  • Free online anxiety tests to screen for anxiety. Two minute tests with instant results. Such as:
    • Anxiety Test
    • Anxiety Disorder Test
    • OCD Test
    • Social Anxiety Test
    • Generalized Anxiety Test
  • Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.

Return to Anxiety Disorders Signs and Symptoms section.

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including muscle weakness anxiety symptoms.

1. Selye, Hans. “Results Of The Dissection.” The Stress of Life. New York: McGraw-Hill Book, 1956. N. pag. Print

2. Folk, Jim and Folk, Marilyn. “Stress Response.” anxietycentre.com, Nov. 2019.

4. Meuret, Alicia E., and Thomas Ritz. “Hyperventilation in Panic Disorder and Asthma: Empirical Evidence and Clinical Strategies.” NCBI PubMed, U.S. National Library of Medicine, Oct. 2010.

5. “Dizziness.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Sept. 2018.

7. Kim, Sung Kyun, et al. “Relationship between Sleep Quality and Dizziness.” PLOS ONE, Public Library of Science, 2018.

8. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

9. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

Panic Attack Symptoms: How They Trick You

When your body gets flooded with powerful panic attack symptoms, it’s no wonder that you fear that a terrible calamity is about to overwhelm you.

Consider the typical anxiety attack symptoms.

Typical Panic Attack Symptoms

People can experience a wide variety of powerful physical sensations as part of a panic attack. The most common sensations include:

* racing heart (and/or other changes in perceived heart activity, so that it might seem to beat louder, faster, harder, or slower, and perhaps miss beats as well.)

* chest pain, tightness, and heaviness

* feeling dizzy and/or light headed

* numbness and tingling in the hands and feet

* labored breathing, feeling short of breath, and hyperventilation

…and more

In addition, you may experience a variety of other physical discomforts, including:

* sweating

* feeling “hyper” and filled with energy

* stomach upset

* feeling pressure to urinate or empty your bowels

* weakness in major muscles, especially the legs

* dry mouth

* hot and cold flashes

Thoughts

These powerful and upsetting physical symptoms will scare people into experiencing a variety of symptomatic thoughts (yes, thoughts can be symptoms), such as:

* I’m dying

* I’m going crazy

* I’m about to faint or lose control

* I’m about to make a fool of myself

* I have to escape from here

* I have to pretend that nothing is wrong

* Stop thinking about this!

Behaviors

And the physical panic attack symptoms, coupled with the scary thoughts you experience, will probably lead you to certain characteristic behaviors, such as:

* Holding your breath

* Tensing up the major muscles of your body

* Fleeing the scene

* Trying to distract yourself

What causes panic attack symptoms?

Although these symptoms are powerful and unpleasant, and seem to indicate some terrible emergency, the truth is very different. Panic attacks feel scary, but are not dangerous.

What causes panic attack symptoms? There are two principal explanations.

Your Emergency Alert System

Most of the powerful and unwanted physical symptoms of a panic attack are the physical changes you would experience if you were suddenly faced with a threat, like a tiger, and your body quickly geared up to give you the energy and signal you needed to fight (or flee) for your life. These changes would be very useful if you were fighting a tiger, but very uncomfortable if you are not. Here’s what happens when your body mistakenly gets the signal of a tiger.

Your heart speeds up, to promote the energy you need to fight the tiger and stay alive. But when you’re just killing time in a waiting room, you experience it as disturbing.

Blood moves away from your digestive tract, and into your major muscles. That would be a good thing, if a large predator were trying to make a meal out of you, because there wouldn’t be any point in wasting energy digesting your own food. But when you’re only getting a haircut, you’ll notice uncomfortable sensations in your digestive tract as digestion suddenly stops.

Blood moves away from the surface of your skin, and into your muscles and deeper tissue. This is good, when you’re fighting a tiger, because you’ll probably get cut, and this change means you’ll lose less blood. But when you’re simply driving on a freeway, you’ll notice numbness, clamminess, and temperature changes in your skin, particularly your toes and fingers.

Your muscles tense up as you brace yourself to resist a physical assault. This will help you stay on your feet, always a plus when fighting a tiger. But it just seems upsetting when you’re in the grocery store.

All these preparations build up heat in your body, and so you sweat. This is good when you’re fighting a tiger, because sweating is how the body cools itself. In addition, whenever you’re being chased by a large, hairy predator, it’s good to be as slippery as possible. But it won’t seem so useful to you while meeting with your son’s math teacher.

So a lot of panic attack symptoms are the result of your brain getting fooled into sending out a signal of emergency, when there is no emergency to defend against.

Your Breathing

Many of the physical symptoms of a panic attack are caused by breathing in a short and shallow way. This kind of breathing leads directly to such symptoms as feeling lightheaded; chest pain or heaviness; increase in heart rate; numbness and tingling; dry mouth, and more. It also gives you the disturbing sensation of running out of air.

It’s my belief, based on 20 years of helping patients with panic disorder, that people with panic disorder tend to be bad breathers, and can benefit greatly from learning how to breathe more comfortably. Unfortunately, people who struggle with panic often don’t recognize that their breathing technique is causing them trouble. I also find that most explanations of how to do “deep breathing” leave out a crucial step, and this probably contributes to people’s skepticism about breathing exercises.

However, I think most people with panic will get a lot of benefit from working with their breathing in the manner I describe.

Your Watchdog Needs Retraining

If you experience recurrent panic attacks, you have a problem similar to the problem of an overprotective watchdog. A dog that barks at burglars is a good helper. A dog that barks at kids running across your lawn, and squirrels as well, that’s too much of a good thing. There’s nothing wrong with the dog. The dog just needs training, to distinguish the burglars from the kids. If you have panic attacks, it doesn’t mean there’s anything wrong with your body. It means that you, too, need retraining, because your brain is inadvertently sending you a signal of danger when there isn’t any, and that’s what leads to the panic symptoms.

You can start this retraining process by finding different ways of responding to panic. For a systematic guide through the process of desensitization to panic, take a look at my Panic Attacks Workbook.

If you’re looking for professional help in the Chicago area, I offer individual sessions in Chicago and Arlington Heights.

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Anxiety Disorders

Brain chemistry, environmental stresses and other factors are thought to play a role in the development of chronic anxiety. People with anxiety disorders often have a family history of anxiety disorders, mood disorders or substance abuse.

Difficulties such as poverty, early separation from a parent, family conflict, critical and strict parents, parents who are fearful and anxious, and the lack of a strong support system all can lead to chronic anxiety.

Some studies show that traumatic and stressful events – such as abuse, the death of a loved one, divorce or job loss – can bring on an anxiety disorder in vulnerable people.

Alcohol abuse and drug addiction also can bring on or worsen anxiety.

The primary symptoms of anxiety disorders are fear and worry. People with an anxiety disorder usually realize their anxiety is more intense than the situation warrants but cannot rid themselves of these irrational concerns. Anxiety disorders also are characterized by additional emotional and physical symptoms.

The following are the most common types of anxiety disorders and symptoms.However, each individual may experience symptoms differently.

Please note: Because anxiety disorder symptoms may resemble other physical or psychiatric conditions, you should see your doctor for a diagnosis.

Generalized anxiety disorder (GAD)

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders. People with GAD tend to worry constantly and continually anticipate disaster. They worry about their finances, their health, their job, world events and the future. Their worry often is out of proportion to reality. Generalized anxiety disorder begins gradually, usually in childhood or adolescence, but can begin in adulthood too. Depression in adolescence may be a strong predictor of GAD in adulthood. Depression commonly accompanies this anxiety disorder. It is more commonly seen in women and often occurs in relatives of those affected. Although GAD may be accompanied by depression, substance abuse or another anxiety disorder, impairment usually is mild. Generally, people with this disorder do not feel too restricted to be in social settings or a job. GAD affects about 5 percent of Americans in the course of their lives, and approximately 6.8 million American adults have it.

GAD symptoms include: Chronic, exaggerated worry, tension and irritability that appear to have no cause or are more intense than the situation requires. Physical signs, such as restlessness, trouble falling or staying asleep, headaches, trembling, twitching, muscle tension or sweating often accompany these psychological symptoms.

Panic attacks and panic disorders

Panic disorder is characterized by repeated, unexpected panic attacks – episodes of sudden fear and feelings of danger or impending doom, along with physical symptoms. The illness may be accompanied by depression or other serious conditions because the effects on people’s lives are not just limited to the attack itself. Some people avoid everyday activities such as driving or shopping, for fear of experiencing a panic attack in a potentially dangerous setting. Others avoid any other environment where they had such an attack in the past.

Panic disorders symptoms include: Repeated, unexpected panic attacks – episodes of sudden fear and feelings of danger or impending doom, along with physical symptoms such as heart palpitations, chest pain, lightheadedness or dizziness, nausea, shortness of breath, feelings of imminent danger, shaking or trembling, choking, fear of dying, sweating, feelings of unreality, numbness or tingling, hot flashes or chills, and a feeling of going crazy. Panic attacks strike without warning and usually last 15-30 minutes. Since many panic disorder symptoms mimic those found in illnesses such as heart disease, thyroid problems and breathing disorders, people with panic disorder often make multiple visits to emergency rooms or doctors’ offices, convinced they have a life-threatening illness.

Obsessive-compulsive disorder (OCD)

People with OCD are plagued by persistent, recurring thoughts that reflect exaggerated anxiety or fears. Typical obsessions include worrying about being contaminated with germs or fears of behaving improperly or acting violently. The obsessions may lead an individual to perform a ritual or routine such as washing hands, repeating phrases or hoarding.

OCD symptoms include: Obsessive thoughts and ritualistic behavior. Common obsessions include constant, irrational worry about dirt, germs or contamination; nagging feelings that something bad will happen if certain items aren’t in an exact place, position or order; fear that one’s negative or blasphemous thoughts or images will cause personal harm or harm to a loved one; preoccupation with losing or throwing away objects with little or no value; and obsessive thoughts about accidentally or purposefully injuring another person.

Common compulsions include repeatedly washing one’s hands, bathing or cleaning household items, often for hours at a time; checking and re-checking, several to hundreds of times per day, that the doors are locked, stove is turned off, hairdryer is unplugged, etc.; an inability to stop repeating a name, phrase or tune; an excessive, methodical and painstakingly slow approach to daily activities; and hording such as saving useless items like old newspapers or magazines, bottle caps or rubber bands.

Obsessions and rituals can substantially interfere with a person’s normal routine, schoolwork, job, family or social activities. Many hours of each day may be spent focusing on obsessive thoughts and performing rituals, so that normal concentration and the performing of daily functions become very difficult.

Children also can suffer from OCD, but unlike adults, children with OCD do not realize their obsessions and compulsions are excessive and ritualistic.

Social anxiety disorder or social phobia

Social anxiety disorder (SAD) is characterized by extreme anxiety about being judged by others or behaving in a way that might cause embarrassment or ridicule. This intense anxiety may lead to avoiding social situations. Performance anxiety (better known as stage fright) is the most common type of social phobia. Social phobia currently is estimated to be the third most common psychiatric disorder in the United States.

Social anxiety disorder symptoms: Extreme fear of being judged by others or behaving in a way that might cause embarrassment or ridicule. Specific SAD symptoms include blushing, sweating, trembling, nausea, rapid heartbeat, dizziness and headaches. Some people may have an intense fear of a single social or performance circumstance such as giving a speech, talking to a salesperson or making a phone call, but be perfectly comfortable in other social settings. Others may have a more generalized form of SAD, ranging from such behaviors as becoming anxious in a variety of routines, to clinging behavior and throwing tantrums. This intense anxiety may lead to avoiding social situations.

Phobias

A phobia is an unrealistic or exaggerated fear of a specific object, activity or situation that in reality presents little to no danger. Common phobias include fear of animals such as snakes and spiders, fear of flying and fear of heights. In the case of a severe phobia, one might go to extreme lengths to avoid the thing feared.

Phobia symptoms: Specific phobias are characterized by strong, irrational, involuntary fear reactions to a particular object, place or situation. The reactions to these fears lead the individual to dread confronting common, everyday situations, or avoid them altogether, even though they logically know there isn’t any threat of danger. The fear doesn’t make any sense, but nothing seems to be able to stop it. When confronted with the feared situation, someone with a phobia may even have a panic attack.

Post-traumatic stress disorder (PTSD)

PTSD can follow an exposure to a traumatic event such as a sexual or physical assault, witnessing a death, the unexpected death of a loved one or natural disaster. Researchers now know that anyone, even children, can develop PTSD if they have experienced, witnessed or participated in a traumatic occurrence – especially if the event was life-threatening.

PTSD symptoms: People with PTSD typically avoid situations that remind them of the traumatic event, because they provoke intense distress or even panic attacks. PTSD is characterized by three main types of symptoms, including: re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks and nightmares; emotional numbness and avoidance of places, people and activities that are reminders of the trauma; and increased arousal including difficulty sleeping and concentrating, feeling jumpy and becoming easily irritated and angered.

Reminder: Because anxiety disorder symptoms may resemble other physical or psychiatric conditions, you should see your doctor for a diagnosis.

The physical symptoms of anxiety don’t get as much attention as the mental and emotional effects. Which, understandable. The overwhelming worry and fear that characterize anxiety can be debilitating. But anxiety can wreak just as much havoc on the body as it can the mind. “From head to toe, almost every system can be impacted just by nature of your body releasing a lot of stress hormones,” Mona Potter, M.D., medical director at McLean Anxiety Mastery Program in Boston, tells SELF.

You have your fight-or-flight response to thank for your physical anxiety symptoms. Typically, it’s supposed to help you survive a threat by escaping or fending it off. In way-back-then, cavepeople days, that threat might have been something along the lines of a lion. If you have anxiety, though, your fear and worry are that threat, prompting your sympathetic nervous system, which controls involuntary processes like your breathing and heart rate, to kick into high gear. This leads your adrenal glands to release hormones such as adrenaline and cortisol, according to the Mayo Clinic. This domino effect is behind anxiety’s physical symptoms.

“When a person experiences anxiety, it’s essentially the fight-or-flight system kicking in and saying, ‘Danger!’” Neda Gould, Ph.D., a clinical psychologist and associate director of the Johns Hopkins Bayview Anxiety Disorders Clinic, tells SELF.

All told, it’s important to recognize these physical symptoms for what they are because if you don’t know what you’re dealing with, it is difficult to seek out the treatment you need to feel better. Here are some of the biggest physical symptoms of anxiety, plus when they could actually be signaling a panic attack.

1. Your heart is racing.

This is a classic sign of anxiety, according to the National Institute of Mental Health (NIMH). So remember how we just mentioned that your sympathetic nervous system controls your heart rate? When you’re dealing with something stressful and your adrenal glands churn out hormones like adrenaline and cortisol, receptors in your heart react by speeding up your heartbeat. This enables you to pump more blood to your big muscles so you could theoretically flee or combat a threat, Gould explains. But if you’re dealing with anxiety, that racing heart could just make you feel more nervous in a vicious cycle.

2. You’re short of breath.

Your blood circulates oxygen around your body. (It also transports carbon dioxide, a waste product, to your lungs so you can breathe it out.) When your stress response boosts how quickly you’re sending blood around your body, your breathing might increase to provide you with more oxygen.

If you breathe too quickly (also known as hyperventilation), you can actually enhance a lot of the physical anxiety symptoms on this list because your oxygen–carbon dioxide balance gets out of whack, according to the U.S. National Library of Medicine.

“That’s why we often talk about belly breathing, or diaphragmatic breathing,” says Dr. Potter. This is essentially breathing slowly and deeply by really using your diaphragm. (Tucked underneath your lungs, this is the main muscle involved in breathing.) By slowing down how quickly you’re breathing, you have more of a chance to get the oxygen you need, Dr. Potter explains.

3. You’re constantly exhausted.

A persistent feeling of fatigue is a common sign of anxiety, according to the NIMH. The reasons are twofold. For starters, that anxiety-activated uptick in stress hormones can keep you revved up on high alert, which can be seriously draining, says Dr. Potter. But there’s an additional complicating factor: Sleep and anxiety have a complicated relationship, which brings us to another typical physical side effect of anxiety…

4. Your sleep is all screwed up.

A person with anxiety might have a tough time falling asleep and/or staying asleep, or might have restless and unsatisfying sleep, according to the NIMH. Elevated levels of hormones like cortisol and adrenaline make it hard to get a good night’s sleep, since your buzzing body may not be able to relax enough to rest. The racing thoughts that can come with anxiety are no recipe for great sleep, either.

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