The role of anxiety in diagnosed illness.

Have you ever been told things like, "If you don't stop worrying so much you are going to give yourself an ulcer"? Or "You are going to give yourself a heart attack with how anxious you get." But is this really true? Can chronic anxiety cause illness or disease? This is actually not such a simple question to answer. In this post we are going to hear what the experts have to say as well as what the current research shows about whether or not chronic stress and anxiety can lead to the development of medical problems.

Does anxiety cause physical symptoms?

It is true that stress and anxiety is often experienced through bodily symptoms. We may sweat, tremble, or feel a tightness in our chest. Other physical symptoms of anxiety may include but not be limited to: Headache, stomachache, dizziness, diarrhea, sleep disturbances, tiredness, shortness of breath, rapid heart-beat, and chest pains. For those who experience panic attacks, it can feel like you are having a heart attack or that you are dying. But do these bodily reactions and sensations ever develop into a chronic medical condition or disease? We are going to find out.

Can anxiety cause you to get a stomach ulcer?

If you do a search of the literature on this topic, it seems that the experts are in disagreement about the answer to this question. For example, The National Women's Health and Information Center states that ulcers are caused by a germ called H. pylori and that stress does not cause ulcers but can make them worse. Yet other reports cite studies which implicate chronic anxiety in the direct cause of peptic ulcers. A 2003 issue of Psychiatric News   explains that while most peptic ulcer patients have H. pylori, only a small percentage of people with this bacterium actually get an ulcer. This fact led researchers to look for the cause. In a study published in the 2003 November/December issue of Psychosomatic Medicine, researchers did find a significant link between chronic anxiety and the development of peptic ulcers. They also found that the amount of worrying people do was correlated with their risk for peptic ulcers.

Although the experts may disagree on whether or not anxiety can induce the development of an ulcer, most would agree that anxiety may aggravate this condition.

Can anxiety cause heart disease?

Again, this is a tricky question to answer as there are so many contradictory answers cited in the literature. The answer, it seems, is largely dependent upon how the experts interpret the results of research on this topic. If you look at The National Women's Health and Information Center website you will see that they list heart disease, high blood pressure, and abnormal heart beats as being linked to long term stress. There is some research which seems to validate this suggested link. One Dutch study   reported in the journal Archives of General Psychiatry found that generalized anxiety disorder was associated with a 74 percent increased risk of cardiovascular events. Specifically they found that anxiety disorders appear to increase the risk of heart attack, stroke, heart failure, and death in people who have heart disease.

I know that for me personally, when you read the results of such studies your mind blots out everything else and keys in on the word, "death" as related to anxiety. It can become a case where reading the research about anxiety can actually cause anxiety. This happened to one of our members who wrote in with a question about his concerns over reading such studies associating heart disease and death with anxiety.   One of our Anxiety Connection experts, Richard G. Wirtz, Psy.D., wrote a response to this member which is a good reminder to us all when looking at any type of research:

"You have to look at the language carefully in order to be sure that "marginally" significant statistical differences are not being presented as if there is a terrible risk."

It does seem that certain studies make the news headlines more than others and those are the ones using dramatic language. It is wise to read the details of the actual study before it gets interpreted by the media.

Another relevant point to consider when talking about anxiety and heart disease is that anxiety symptoms can mimic a heart attack. Our anxiety expert, Richard Wirtz, cites a statistic given in his response that over one third of the people who go to the ER with complaints such as chest pain have no heart problems at all. Wirtz concludes that:

"Although there is no question that chronically high levels of anxiety has negative health consequences anxiety attacks and panic attacks do not cause death in otherwise healthy people."

This is consoling for those of us who feel as though we may be dying when we have an anxiety attack. It is good to remember that a panic attack in and of itself is not going to kill us.

Which brings us back to the original question: Can chronic anxiety cause disease?

An examination of the literature on the association between anxiety and medical problems such as peptic ulcers or heart disease shows how difficult it can be to find a straight answer to this question. I could list many other ailments and diseases associated with anxiety but for each case there are similar disagreements between experts. The research mainly shows an association between anxiety and disease but seldom if ever are you going to find a study proving that anxiety is a direct cause for developing any particular medical condition. This is because other factors come into play such as genetics, environmental factors, and our unique biochemistry. There are plenty of people who suffer from anxiety who don't have a peptic ulcer, heart disease or other medical conditions. About the best answer one can give to this question is that anxiety may increase your risk for developing certain diseases or medical ailments. But anxiety is just one factor of many which can up your odds for illness.