Is It All “In Your Head”?
How Anxiety Can Stop You Getting an Accurate Health Assessment
“I can’t tell if she’s really unwell or if her anxiety is causing it,” I told the nurse over the phone. “That’s the problem with anxiety,” she explained gently. “It often mimics other symptoms.”
My 10-year-old daughter sat on the couch with her hand pressed against her chest. She tried to describe the sharp pain but, as it came and went, she was struggling to explain it. She’d had a week of flu-like symptoms. “Will I be okay?” she asked every night, afraid to die in her sleep. After her flu symptoms ended, the chest pain and worrying carried on.
“Do kids get heart attacks?” she asked me.
“It’s very unlikely,” I reassured her.
The more she worried about it, the worse it became. I decided we needed to check it out properly. If I’ve learnt anything over the years about anxiety, it’s that writing off symptoms as “all in your head” is never a helpful thing to do.
My sister and I both struggled with anxiety disorders from a young age and also both have Crohn’s Disease, an inflammatory bowel disease. Crohn’s is often diagnosed in your early to mid-20s and my sister was the first to experience severe symptoms. When she ended up in the hospital, her family doctor had an unexpected response to the specialist’s Crohn’s diagnosis. He refused to believe it.
“I know her like the back of my hand,” he replied to the specialist in writing. “This isn’t Crohn’s. It’s her anxiety.”
My sister is a qualified nurse and knew he was wrong. She wasn’t able to hold down food or fluids. She was rapidly losing weight and had severe stomach pain, but her doctor was convinced. It was all in her head. Thankfully, the specialist disagreed and treated my sister for Crohn’s which, later tests confirmed, she did in fact have.
Many medical professionals now understand the importance of listening to all of their patients’ concerns. The old approach of dismissing ‘the worried well’, as patients with anxiety were sometimes called, is being challenged. Still, it’s difficult to separate anxiety symptoms and other symptoms.
It’s hard for those of us with anxiety too. As someone with a chronic disease, I experience odd and troubling symptoms all the time. In winter especially, I’m constantly in the doctor’s office. After a while, you start to doubt yourself. No one wants to waste anyone’s time worrying about symptoms that are “all in your head”. But that’s the key: anxiety itself is not all in our heads. It’s very much in our bodies.
Our mental and physical health are interlinked. Crohn’s Disease can triple the risk of anxiety disorders, and stress increases the chance of a Crohn’s flare-up. Other diseases are linked in similar ways. Can we really separate our minds from our bodies?
When my daughter described her chest pain, I decided it was important I didn’t write off her symptoms as just in her head either. Whether it was caused by anxiety or not, it didn’t change the real physical pain she was experiencing. We took a trip to the doctor’s office.
The first doctor was dismissive and raced us through the appointment. “No children get heart attacks,” he told her. He listened to her chest quickly and told her she was fine. She felt reassured for a few days, but the pain wouldn’t go away. I asked her what she wanted to do.
“I’d like to talk to another doctor,” she said. I was pretty sure by this point the chest pain was a mild panic attack. It only happened at night before bed, when she got most anxious about dying in her sleep.
“You can tell doctors anything, you know,” I told her. “You can talk about feeling worried.”
“Can you talk about stuff like that?” she said, amazed.
I nodded. “Of course!”
In the doctor’s office, I sat quietly and let my daughter do the talking. I wanted her to feel confident explaining what she thought was going on for her.
“It’s your body,” I told her in the car. “You’re the only one who really knows what’s going on.” She described her chest pain as the new doctor listened attentively. He asked questions and did a thorough check-up.
“What do you think is wrong?” he asked her at one point.
“I think it might be because I’m feeling anxious at night,” she said. I stayed silent, wondering how the doctor would respond.
“That’s very self-aware,” the doctor said. He waited while she explained more, and how she thought seeing her play therapist might be helpful. He nodded and spoke to her about how the mind and body are connected, and things that might help her chest feel better at night.
“That was really helpful!” she said in the car afterwards. Her shoulders lifted with confidence, and she beamed up at me.
“I’m proud of you for talking about what you needed,” I told her.
“Me too,” she said.
We implemented the different things the doctor suggested and, over a few weeks, the chest pain disappeared and she slept better and for longer.
My daughter’s first doctor hadn’t been wrong: it wasn’t a heart attack, but we already suspected that. He didn’t take her physical anxiety symptoms seriously or address them in any way. Anxiety is not “all in our heads”, it’s very much in our bodies too and that’s important to acknowledge and treat, as her second doctor did.
Anxiety and panic attacks can cause severe, very real physical symptoms, including heart problems, chest and stomach pain, headaches, dizziness and numb tingly limbs. Other times our anxiety masks physical problems with different underlying causes, like my sister’s Crohn’s disease.
Becoming self-aware can help us decide what to do with our symptoms. Understanding how a panic attack feels and how anxiety manifests in our bodies is a useful place to start. Then we can be better advocates for ourselves and our health. We can ask for what we need and get a second opinion when we know medical professionals haven’t listened well. Importantly, we can push for further investigation when we feel something else is underlying our symptoms.