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Treatment of depression, anxiety, and bulimia Headache, insomnia, anxiety, tremor, dizziness, nervousness, fatigue, poor concentration, agitation, nausea, diarrhea, decreased appetite, sweating, hot flashes, palpitations, twitching, impotence Stimulant medications Treatment of attention deficit disorder Nervousness, rapid heartbeat, disturbed sleep, panic feelings Thyroid replacement medications Treatment of hypothyroidism Hives, chest pain, irregular heartbeat, nervousness, shortness of breath

Interesting, isn’t it? Even medications for the treatment of anxiety can produce anxiety-like side effects. Of course, most people don’t experience such side effects with these medications, but they do occur. And many other prescribed drugs may have anxiety-like side effects. If you’re taking one or more prescription drugs and feel anxious, check with your doctor.

      

In addition, various over-the-counter medications sometimes have anxiety-mimicking side effects. These include antihistamines that can cause both drowsiness and insomnia as well as restlessness and rapid heartbeat. Decongestants can also cause rapid heartbeat as well as sweating, dizziness, and blurred vision. Also, many types of aspirin contain caffeine, which can produce symptoms of anxiety if consumed excessively. These medications can cause restlessness, heart palpitations, tension, shortness of breath, and irritability.

      Ingesting calmness into your diet

      Stress and anxiety often provoke people to binge on unhealthy foods and substances, which may lead to increased anxiety over the long run. In Chapter 11, we discuss foods that may help you calm your moods and alleviate your anxiety. Here, we tell you how to avoid foods or drinks that may worsen problems with anxiety.

      

Notice whether you have special sensitivities to certain types of food. Whenever you feel out of sorts or especially anxious for no particular reason, ask yourself what you’ve eaten in the past couple hours. Take notes for a few weeks. Although food sensitivities aren’t generally a major cause of anxiety, some people have adverse reactions to certain foods, such as nuts, wheat, dairy, shellfish, or soy. If your notes say that’s true for you, avoid these foods!

      Alcohol may be very tempting to people with anxiety. Although alcohol may relax you in small quantities, too many anxious people try to self-medicate by imbibing. People with anxiety disorders easily become addicted to alcohol. Furthermore, in excess, alcohol can lead to a variety of anxiety-like symptoms. For example, after a night of heavy drinking, alcohol can leave you feeling more anxious because it clears the system quickly and the body craves more. That craving can lead to addiction over time. Even a couple of glasses of wine in the evening may help you sleep initially but disturb the quality of your sleep leading to fatigue in the morning. So, anxious people need to be cautious about their use of alcohol.

      Caffeine can also spell trouble. Some people seem to thrive on triple espressos, but others find themselves up all night with the jitters. Caffeine lurks in most energy drinks as well as chocolate, so be careful if you’re sensitive to the effects of caffeine.

      

Speaking of energy drinks, these sometimes contain unusually large quantities of not only caffeine but also other stimulants. You’ll see herbal stimulants such as taurine, guarana (loaded with caffeine), ginseng, and ginkgo biloba, among others. Reported adverse effects include nervousness, sleeplessness, abnormal heart rhythms, and seizures. If you have excessive anxiety, you don’t want to be chugging down these concoctions.

      Finally, lots of people get nervous after eating too much sugar. Watch kids at birthday parties or Halloween. Adults can have the same reaction. Furthermore, sugar is bad for your body in a variety of ways, such as spiking blood glucose levels and contributing to metabolic syndrome (a condition that often leads to high blood pressure and diabetes).

      THE CHICKEN OR THE EGG: IRRITABLE BOWEL SYNDROME

      Irritable bowel syndrome (IBS) is a common condition that involves a variety of related problems, usually including cramps or pain in the abdomen, diarrhea, and/or constipation. These occur in people with no known physical problems in their digestive systems. IBS negatively impacts the quality of life for the 10 to 20 percent of the population, mainly women, who suffer from it. For many years, doctors told most of their patients that irritable bowel syndrome was caused by stress, worry, and anxiety.

      Genetic research has found various genes that may contribute to the emergence of IBS. However, the exact role that genes play in this disorder remains unclear. More research is needed.

There is no known cure for IBS, and treatments are targeted at symptoms. Various medications have been found to decrease some of the worst symptoms of IBS. In addition, psychotherapy that teaches relaxation techniques, biofeedback, and techniques for coping with anxiety and stress also improves IBS symptoms. So, at this point, no one really knows to what extent IBS is caused by physical causes, anxiety, or stress. It’s more likely, however, that the mind and body interact in important ways that can’t always be separated.

      Investigating medical anxiety imposters

More than a few types of diseases and medical conditions can create anxiety-like symptoms. That’s why we strongly recommend that you visit your doctor, especially if you’re experiencing significant anxiety for the first time. Your doctor can help you sort out whether you have a physical problem, a reaction to a medication, an emotionally based anxiety problem, or some combination of these. Table 3-2 lists just some of the medical conditions that produce anxiety symptoms.

      Getting sick can cause anxiety, too. For example, if you receive a serious diagnosis of heart disease, cancer, or a chronic progressive disorder, you may develop anxiety about dealing with the consequences of what you’ve been told. The techniques we give you for dealing with anxiety throughout this book can help you manage this type of anxiety as well.

TABLE 3-2 Medical Imposters

Medical Condition	What It Is	Anxiety-Like Symptoms
Hypoglycemia	Low blood sugar; sometimes associated with other disorders or can occur by itself. A common complication of diabetes.	Confusion; irritability; trembling; sweating; rapid heartbeat; weakness; cold, clammy feeling
Hyperthyroidism	Excess amount of thyroid hormone. Various causes.	Nervousness, restlessness, sweating, fatigue, sleep disturbance, nausea, tremor, diarrhea
Other hormonal imbalances	Various conditions associated with fluctuations in hormone levels, such as premenstrual syndrome (PMS), menopause, or postpartum. Highly variable symptoms.	Tension, irritability, headaches, mood swings, compulsive behavior, fatigue, panic
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