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> but would you say your anxiety is more 'mental' (e.g. catastrophic thinking) or 'physical' (e.g. shaking, butterflies in stomach etc.)?

Not the parent, but are there different types of anxiety?

For me, the most prevalent effects are faster heartbeat at anxious moments (this even happens in the morning after waking up) and elevated symptoms of tinnitus and muscle pain in the neck.

Interestingly, working hard mentally seems to make the anxiety go away, but at the end of the day it hits me back hard.

I wonder how such symptoms would be classified.



That's a unique mix of symptoms! Was just reading about tinnitus and apparently there's a high correlation with anxiety disorders. Are you under a lot of stress at the moment? I don't suppose you know if you clench or grind your teeth in your sleep, or perhaps have sleep apnoea?

Definitely many kinds of anxiety. I think there are two broad groups (which aren't mutually exclusive): 'physical' anxiety/panic/phobia (your body's fight or flight response spools up at inappropriate times), and 'mental' anxiety (either specific or generalised). PTSD is in many ways is like a panic disorder, except the stimuli are memories or sensory inputs similar to ones that were salient during a traumatic event.

I've got much more experience on the 'physical anxiety' side of things. I've found propranolol (a beta-blocker) to be extremely effective at suppressing physical anxiety. It's a very safe medication (unless you have asthma) and is non-narcotic. If your physical symptoms are troubling you, maybe raise this with your doctor. It's very cheap too. There have also been recent studies on treating PTSD sufferer's (with sleep episodes) with a similar kind of drug: alpha-adrenergic blockers (e.g. prazosin). This makes a lot of sense as it would also suppress the physical FoF response.

I've tried a number of anti-depressants in the past with little success. They have a low probability of success in monothreapy for anxiety. Lastly, I'd strongly advise steering clear of benzos (e.g valium), unless you need acute short-term releif and are under medical supervision. You build a tolerance to them very quickly, and they're very physically addictive. The withdrawal can cause grand mal seizures (literally translates to 'big bad' seizures) and potentially even kill you (for long-term high dose usage). At the very least, when you come off them you'll generally experience rebound anxiety, which is not pleasant.

If it's mostly physical, a you consider it a big enough impairment, I'd suggest meds might be a better option (unless there's a strong phobic aspect present [e.g. fear of spiders], in which case exposure therapy and CBT can be helpful). If it's more mental, maybe discuss your options with a GP and give talk therapy a try first.

Good luck with your health. Don't leave it all in the hands of doctors; research and come to your own views before rocking up at an appointment.


Thanks, that is a lot of information!

I was planning to see a doctor soon, so this might very well come helpful.

Yes, I am a teeth grinder. No sleep apnea, and only little stress. Could that provide additional clues?


It's possible that jaw clenching and grinding could cause the neck pain and tinnitus. Or it might be a sign of a disorder like this:

https://en.wikipedia.org/wiki/Temporomandibular_joint_dysfun...

And take a look at 'sleep bruxism' in the table on this page: https://en.wikipedia.org/wiki/Bruxism#Classification_by_temp...


Don't forget also that physical anxiety can trigger mental anxiety, and vice versa.


> Interestingly, working hard mentally seems to make the anxiety go away, but at the end of the day it hits me back hard.

Perhaps you focus well enough not to notice the physical effects. I know sometimes I'll stand up and realize I really need to take a bio break of some sort.




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