Can Anxiety Disorders Make You Sick?

Anxiety Disorder sufferers have long known that they are more susceptible to physical diseases.

But now a study headed by Jitender Sareen of the University of Manitoba has detailed just what Anxiety Disorders can do to you physically. 

It was proven several years ago that those with Anxiety Disorders are more prone to heart problems. This new study shows that people with Anxiety Disorders also have an increased risk of developing physical ailments, particularly thyroid diseases, respiratory diseases, gastrointestinal diseases, arthritis, allergies, and migraine diseases.

Early treatment of Anxiety Disorders is essential to warding off physical diseases caused by it. Sareen said,

Right now there is a long delay between someone developing an anxiety problem and seeking appropriate treatment — usually 10- 15 years. The hope is to get people with anxiety problems to go get help earlier. The treatments are quite effective if you get at it early before you get secondary [health conditions].

How many people have Anxiety Disorders?

30 to 60 million Americans have Anxiety Disorders

It is estimated that between 10 and 20 percent of the American people age 18 and older suffer from some sort of Anxiety Disorder: that’s 30 to 60 million people! According to the Anxiety Disorders Association of America (ADAA), the US economy loses over 42 billion dollars yearly due to undiagnosed, misdiagnosed and under-treated Anxiety Disorders. Less than one-third of those affected with Anxiety Disorder are treated, the ADAA found in a 1999 study.

Anxiety Disorders include Generalized Anxiety Disorder (GAD), Panic Disorder, Agoraphobia, Post Traumatic Stress Disorder (PTSD), Social Phobia (SAD) and Obsessive-Compulsive Disorder (OCD).

How the study was conducted

Although depression has long been linked to physical illness, evidence for an association between anxiety disorders and physical health problems is more recent. There have been numerous studies of the links between Anxiety Disorders and physical conditions. Sareen’s research is the first to sample a large number of people over a long period of time. These people not only reported their subjective feelings, but were checked by both physicians and psychologists.

4.181 adults were studied

The research studied 4,181 adults who were part of the German Health Survey, conducted between 1997 and 1999. The survey assessed whether participants had any physical illnesses through a questionnaire, a medical interview conducted by a primary care physician, and medical tests. Psychiatric interviews were conducted by a psychologist or physician, using internally recognized diagnostic criteria. 

A quality of life survey measuring factors such as physical functioning, pain and general health was also administered. To determine disability levels, participants reported how many days of the past 30 they were unable to perform their usual daily activities.

The study was published in the October 23, 2006 issue of the Archives of Internal Medicine.

The results of the study

Anxiety Disorders were associated significantly with physical illnesses. Of the 4,181 people in the study, 8.4 percent had an Anxiety Disorder, and 60.8 had a physical condition in the past month. Below are the percentages of people with each physical illness who also had Anxiety Disorder:

• Migraine disease – 20.3%
• Gastrointestinal diseases – 18.8%
• Respiratory diseases – 15.2%
• Thyroid disease – 14.8%
• Allergic conditions – 12%
• Arthritis – 10.7%

The researchers further noted that, phobic Anxiety symptoms have been linked to sudden cardiac death. They state that other clinical studies have associated Anxiety Disorders such as:

• Cardiac disease
• Cancer
• Hypertension
• Diabetes
• Autoimmune diseases
• Peptic ulcer disease
• Asthma 

Other studies have found a significant association between the presence of Anxiety Disorder diagnoses and self-reported physical disorders. And a large proportion of primary care doctor visits are due to the symptoms of Anxiety Disorders and the physical conditions they cause.

It is important to note that, of the individuals with both Anxiety Disorders and physical conditions, the majority developed the Anxiety Disorder first. This implies that the Anxiety Disorders had some role in developing the physical disorders.

In addition, those with both Anxiety Disorders and physical conditions were more likely to have a poorer quality of life as well as be disabled — unable to perform normal daily activities — at some point. Sareen said,

These findings extend previous work in clinical and community samples that noted an association between anxiety disorders and physical illnesses but also demonstrate the unique association of this comorbidity [having two or more chronic diseases simultaneously] with poor quality of life and disability.

Why Anxiety Disorders might be associated with physical illnesses

Sareen commented, 

The mechanisms of association between anxiety disorders and physical conditions remain unknown, although several possibilities should be considered.

The researchers state that among the possibilities for why anxiety disorders and physical conditions may be so closely connected are:

• A physical illness, particularly if life-threatening, may cause increased anxiety eventually leading to an Anxiety Disorder.
• An Anxiety Disorder may lead to an increased chance of illness as the result of biological changes caused by the Anxiety Disorder.
• An Anxiety Disorder may lead to another disorder, such as substance abuse, which in turn causes a physical illness.
• A medication for a physical illness may bring on or increase Anxiety symptoms.
• There may be common genetic, environmental, and/or personality factors that connect Anxiety Disorders and certain physical conditions.

All is not lost! Discovering and treating Anxiety Disorders early can lead to a more healthful life

Anxiety causes physical changes

This study points up the necessity of treating Anxiety Disorders early. Anxiety Disorders, particularly PTSD and Panic Disorder, cause actual physical changes in the body and brain over the long term. These changes make the Disorders worse and more difficult to treat. However, if Anxiety Disorders are discovered and treated early, these changes can be minimized or avoided entirely.

Whatever the reasons are for these connections, the researchers make clear that physicians need to assess for Anxiety Disorders as well as depression when treating patients for physical conditions. The researchers wrote,

Although there have been increased efforts to recognize and treat depression in the medically ill, our findings underscore the need to create similar programs to recognize and treat anxiety disorders in the medically ill. … [T]he current study suggests that anxiety disorders should be considered an important public health problem in the community.

What do you think?

Over and over, we read that treating Anxiety Disorders early can lead to a better quality of life, not only mentally, but physically as well. It is tragic that two-thirds of all Americans with Anxiety Disorders go untreated. If you or someone you know has symptoms of Anxiety Disorder, please, please set up an appointment for an evaluation today!

• If you have an Anxiety Disorder, have you experienced increased physical illnesses?
• Do you think that the findings of this study are overstated or understated?

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©2008 Anxiety, Panic & Health. All rights reserved.

Resources used in this post:
Canadian University Press Releases/Newswire. (2006, October 23). Anxiety Disorders Linked to Physical Conditions. Retrieved August 11, 2008 from Canadian University Press Releases/Newswire Web site: http://www.canadian-universities.net/News/Press-Releases/

Fenton, Cathleen Henning. (2006, October 23). Anxiety Disorders Closely Linked to Physical Conditions. Retrieved August 11, 2008 from About.com Web site: http://panicdisorder.about.com/od/comorbiddisorders/a/anxietyillness.htm

Leong, Christine. (2006, November 1). Anxiety association with physical health problems. Retrieved August 11, 2008 from Manitoban Online Web site: http://www.themanitoban.com/2006-2007/1101/107.Anxiety.association.with.physical.health.problems.php#_jmp0_

Mood and Anxiety Disorders Research Group. (2007). Jitender Sareen Biography. Retrieved August 11, 2008 from Mood and Anxiety Disorders Research Group Web site: http://www.mts.net/~wolven/madrg/jitend.htm

Sareen, Jitender; Jacobi, Frank; Cox, Brian J.; Belik, Shay-Lee; Clara, Ian; Stein, Murray B. (2006, October 23). Disability and Poor Quality of Life Associated with Comorbid Anxiety Disorders and Physical Conditions. Retrieved August 11, 2008 from Archives of Internal Medicine Web site: http://archinte.ama-assn.org/cgi/content/full/166/19/2109

Science Daily. (2006, October 24). Anxiety Disorders Linked To Physical Conditions. Retrieved June 26, 2008 from Science Daily Web site: http://www.sciencedaily.com/releases/2006/10/061024010331.htm

October_23_2006_ANXIETY_DISORDERS_LINKED_TO_PHYSICAL_CONDITIONS.html

Further reading:

Anxiety Disorders Associated with Migraine Disease — About.com