When we think about anxiety, we tend to consider what happens in the mind—the excessive worry and catastrophic fears—rather than what occurs in the body. And while many anxious people do make a beeline to a therapist, others visit a physician's office first. "They'll talk about chronic abdominal pain, pelvic pain, neck pain, headaches, or insomnia," says Lynne Lillie, MD, a family physician in Rochester, Minnesota, who serves on the American Academy of Family Physicians board of directors, but they often won't connect it to anxiety.

In my case, a racing heart and shortness of breath have propelled me to the emergency room several times, convinced I was having a heart attack. There have been other puzzling symptoms, too: dizziness, tingling feet, exhaustion. One year I saw more than a dozen doctors who tested me for, among other things, multiple sclerosis, brain cancer, chronic fatigue syndrome, and a heart ailment.

I've since learned a lot about anxiety and its symptoms. My primary care physician, Dr. G, is a skilled interpreter of my noisy body; she works with me to determine when I need a medical test, a round of therapy, or a massage. So I can better distinguish between anxiety and other issues, she's also helped me come up with this reliable four-step plan, which might be beneficial for you, too:

1. Identify the symptom.

Even people like me who've spent years researching and writing about anxiety can sometimes neglect to realize it might be the cause of what's ailing them. This explains how a double-time heartbeat after a latte can be perceived as a sign of a heart attack, for example. Fears of such sensations can in turn fuel anxiety-related symptoms, which can lead to more fear and then more symptoms in a negative feedback loop, says Arthur J. Barsky, MD, a professor of psychiatry at Harvard Medical School. Stopping to assess the original symptom gives me a better sense of what I'm facing.

2. Try the standard anxiety treatments.

When you think you might be dying, it may seem ludicrous to take some calming breaths. But when people receive appropriate treatment for their anxiety, the related symptoms often go away, too. After I was finally diagnosed with panic disorder, I was prescribed cognitive-behavioral therapy and, later on, antidepressants. Most of my physical symptoms, as well as my worries about them, soon disappeared. More recently, I've turned to mindfulness practices to help keep anxiety symptoms—from the familiar to the frightening—at bay.

3. Watch and wait.

Dr. G usually recommends that I try treatments for at least two weeks. During that time, I'm vigilant about doing yoga and getting enough sleep (sometimes she also has me take the antianxiety medication Klonopin for a few days) while paying attention to my body to see whether my symptoms ease up or change.

4. Know when to alter your approach.

Many anxiety-related symptoms do mimic those of serious medical problems, and research has found that anxiety can worsen conditions such as heart disease and chronic obstructive pulmonary disease. That's why I keep Dr. G in the loop and try to refrain from self-diagnosing. We've agreed that if I feel worse, we'll consult a specialist. A few years ago, I experienced a burning sensation in my lungs. I dutifully followed my plan, but this time it didn't help. So I consulted a pulmonologist, who told me the discomfort was likely a result of a common virus and should ease in a month or so. Fortunately, it did. Of course, I'm still relieved that I saw a specialist who could rule out other problems and give me a diagnosis—and peace of mind.

"Anxiety disorders have cost the U.S. about $63 billion a year, more than half of it attributable to doctor and hospital visits." – From On Edge

On Edge Andrea Petersen is the author of On Edge: A Journey Through Anxiety.


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