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Can anxiety cause weakness in legs: 10 Most Common Physical Symptoms of Anxiety : Intrepid Mental Wellness, PLLC: Psychiatric Nurse Practitioners


10 Most Common Physical Symptoms of Anxiety : Intrepid Mental Wellness, PLLC: Psychiatric Nurse Practitioners

10 Most Common Physical Symptoms of Anxiety


Anxiety and panic disorders can produce a wide range of distressing physical symptoms. Many people are unaware that their symptoms are caused by anxiety, which can make the problem worse, as many people worry that their symptoms are caused by an underlying disease, leading to further anxiety. This vicious circle can be broken by learning about anxiety and being able to recognize the physical symptoms. Here are the 10 most common physical symptoms of anxiety.



Fatigue is one of the most common symptoms associated with anxiety, panic disorder, chronic stress, depression and other mental health disorders. Chronic anxiety leaves the body and mind in a constant state of tension and high alertness. The mind is constantly scanning the external and internal environment for threats, leading to emotional distress and physical tension. This constant state of high alertness leads to mental and physical exhaustion, which will often persist even after a long sleep.


Increased Heart Rate

Anxiety is a natural response to danger and is needed for humans to survive. High levels of anxiety trigger changes in the body to help prepare for dealing with threats and danger, also known as the fight or flight response. However, if you’re living with chronic anxiety, your body and mind are often unable to tell the difference between real and imagined dangers, which means that the fight or flight response may be continually active. One of the first changes to occur during the fight or flight response is an increase in heart rate.  


Heart Palpitations

Heart palpitations are often one of the most distressing symptoms associated with anxiety, as they can feel scary and many people worry that they are having a heart attack, particularly when palpitations are combined with chest pain. Heart palpitations can feel like your heart is pounding, fluttering, beating too fast or missing beats. Some people can even feel their heart beating in their throat, neck or head. While heart palpitations can be scary, they usually pass within a few seconds.


Shortness of Breath

Shortness of breath is another distressing symptom that leads many people to worry that they are having a heart attack, choking or experiencing problems with their lungs. Shortness of breath is usually caused by breathing too quickly (hyperventilation), as the body is inhaling too much oxygen and exhaling too much carbon dioxide. Hyperventilation will not harm you, but you may feel as if you are choking, have a lump in your throat or are unable to take in enough air. 



Feeling dizzy, faint or unsteady is often the result of hyperventilation, although it may also be caused by other issues related to anxiety, such as muscle tension in the neck and shoulders. Many people feel lightheaded and worry that they might pass out during a panic attack, but some people with an anxiety disorder also experience chronic dizziness and problems with balance. 


Muscle Aches 

Muscle aches and joint pain can be caused by tension, as well as general poor health. Anxiety causes the muscles to tense up, which can lead to pain and stiffness in almost any area of the body. Constant stress and worry can also prevent the immune system from working properly, leading to decreased resistance to infection and disease. Infection increases inflammation in the body, which can cause a range of symptoms, including joint pain.


Muscle Weakness

Another common symptom of chronic anxiety is weakness in the muscles, most commonly experienced in the legs and sometimes the arms. During the fight or flight response, the body is preparing to take action against danger. One of the ways in which the body prepares for this action is to redirect blood flow to the areas most needed, including the legs, which are needed to run away from danger. Increased blood flow to the legs can make them feel weak, tingly or like jelly.



Headaches and migraines are often caused by tension, particularly in the neck and shoulders. Teeth grinding, facial tension, poor posture and hyperventilation can also cause headaches and migraines. Sharp pain, a dull ache or a feeling of pressure around the head and eyes are common symptoms associated with anxiety. As anxiety can also upset the balance of hormones in the body, some women notice an increase in migraines, as they can be triggered by changes in hormones.


Digestive Discomfort

Excess gas, bloating, stomach cramps, acid indigestion, heartburn, constipation and diarrhea can all be caused by stress and anxiety. Several digestive problems, including irritable bowel syndrome (IBS), have been linked to chronic stress and mental health problems. Anxiety can also increase the symptoms of food intolerance and sensitivities in some people.


Tingling Sensations

Pins and needles, tingling and numbness are common symptoms that mostly affect the extremities, but can also be experienced anywhere in the body. Tingling of the lips, face and arms can be particularly distressing, as many people worry they are having a stroke. Odd sensations in the body, including tingling and numbness, are usually the result of hyperventilation, but can also be caused by physical tension.


Anxiety can cause a wide range of distressing physical symptoms, but recognizing and accepting that these symptoms are temporary and harmless helps to alleviate fears and prevent further anxiety. The most common physical symptoms of anxiety include fatigue, increased heart rate, heart palpitations, shortness of breath, dizziness, muscle aches, muscle weakness, headaches, digestion, discomfort and tingling sensations.

Weak Legs Anxiety Symptom – anxietycentre.com

Having weak legs is a common symptom and sign of anxiety disorder.

Common weak legs anxiety symptoms descriptions include:

  • Your legs feel so weak that you think they won’t be able to support you.
  • Sometimes your legs feel so weak that you are concerned that you might not be able to walk or stand.
  • Your legs can also feel jelly-like, rubbery-feeling, and that you have to force yourself to walk.
  • Your legs can also feel like they are numb and you have a hard time feeling them.
  • Your legs feel unusually tired and heavy.
  • It also might feel like your legs or knees are too stiff to move, or that your legs won’t move as you would like them to.
  • Your legs feel so weak and stiff that you have to force them to move just so you can walk.
  • It can also feel like your legs are so weak and “rubbery” feeling that they are about to give out.
  • It can also feel like your legs are so weak and unsteady that you can’t trust them to hold you up.
  • We often hear anxious people say, “My legs feel so weak, stiff, and unsteady that I fear I’m going to collapse or fall over.”
  • Others have said that they’ve “lost confidence” in their legs and ability to walk normally because of the weakness and stiffness in their legs.
  • Yet, others have described this symptom as weak legs, weak shaky legs from anxiety, weak shaky legs fibromyalgia, weak legs shaky hands, off-balance feeling and weak legs, weak rubber legs, and weak arms and legs.

The weak legs anxiety symptom can affect one leg only, can shift and affect the other leg, can migrate back and forth between legs, or affect both legs at the same time.

This weak legs symptom can come and go rarely, occur frequently, or persist indefinitely. For example, you have weak legs once in a while and not that often, have them off and on, or have them all the time.

Weak legs can precede, accompany, or follow an escalation of other anxiety symptoms, or occur by itself.

Weak legs can precede, accompany, or follow an episode of nervousness, anxiety, fear, and chronic stress, or occur ‘out of the blue’ and for no apparent reason.

This symptom can range in intensity from slight, to moderate, to severe. It can also come in waves where it’s strong one moment and eases off the next.

This weak legs anxiety symptom can change from day to day and from moment to moment.

All of the above combinations and variations are common.

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What causes weak legs anxiety symptoms?

Medical Advisory

Anxiety can cause this symptom in two primary ways:

1. Effects of the stress response

The moment we believe we could be in danger, the body secretes stress hormones into the bloodstream where they travel to targeted spots to bring about specific physiological, psychological, and emotional changes that enhance the body’s ability to deal with a threat – to either fight or flee. This survival reaction is the reason why the stress response is often referred to as the fight or flight response, the emergency response, or the fight, flight, or freeze response (some people freeze when they are afraid like a “deer caught in headlights”).[1][2][3][4]

These body-wide changes can cause sensations. Having weak legs is commonly associated with an active stress response. Many people notice a “weak in the knees” feeling when they are nervous or afraid.

The intensity and frequency of the anxiety weak legs symptoms are often proportional to the degree of nervousness, anxiety, and fear. This is one of the reasons why weak legs are common symptoms of anxiety and panic attacks.

2. The effects of hyperstimulation (chronic stress)

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. When stress responses occur too frequently or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering, which can cause it to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants (also often referred to as “hyperarousal”).[5][6][7] Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated. “Weak legs” is a common indication of hyperstimulation (chronic stress).

Hyperstimulation (chronic stress) can affect the body in many ways, including causing muscle fatigue,[8] nervous system dysregulation,[9] and the misreporting of sensory information.[10][11]

The above combination of factors can cause many odd and bizarre sensory and muscle movement behaviors, sensations, and feelings, including feeling like your legs are unusually weak, heavy, tired, and stiff to move.

Unfortunately, many anxious people worry about their health. When this symptom occurs, they worry that their weak legs might be caused by a serious disease, such as Chronic Fatigue Syndrome (CFS), Muscular Sclerosis (MS), Muscular dystrophy (MD), Amyotrophic lateral sclerosis (ALS), stroke, or some other serious neurological disorder. This worry fuels stress, which can exacerbate weakness, unsteadiness, and stiffness in the legs.

Fortunately, stress-caused weak legs are not caused by a serious disease, and therefore, needn’t be a cause for concern. They are merely indications of anxiousness and chronic stress (hyperstimulation).

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How to get rid of weak legs anxiety symptoms?

1. Stop the active stress response

When this anxiety symptom is caused by apprehensive behavior and the accompanying stress response changes, calming yourself down will bring an end to the active stress response and its changes. As your body recovers from the active stress response, this anxiety symptom will subside. Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.

2. Eliminate hyperstimulation

When this anxiety symptom is caused by hyperstimulation (chronic stress), such as from overly apprehensive behavior, it may take much longer for the body to calm down and recover, and to the point where this anxiety symptom subsides.

Nevertheless, when the body has recovered from the effects of chronic stress, this anxiety symptom will subside. So again, this anxiety symptom needn’t be a cause for concern.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your rest and relaxation, and not worrying about your anxiety symptoms. Yes, weak, jelly-like, heavy, tired, and stiff legs anxiety symptoms can be bothersome, but again, when your body has recovered from the stress response or the effects of chronic stress (hyperstimulation), this symptom will subside.

If you are having difficulty containing your worrying, you may want to connect with one of our recommended anxiety disorder therapists. Working with an experienced anxiety disorder therapist is the most effective way to overcome anxiety disorder and its symptoms, including what seems like uncontrollable worry.

For a more detailed explanation about anxiety, anxiety symptoms, why anxiety symptoms can persist long after we think they should, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website. The anxiety symptom weak legs is more fully explained in the Symptoms section (chapter 9) in the Recovery Support area.

Additional comments

Yes, having weak legs, legs that don’t seem to feel or move normally, legs that feel overly tired, heavy, and stiff can make walking more challenging. In spite of the difficulty, you don’t have to worry about these types of symptoms. They are merely symptoms of stress, which will subside when you’ve sufficiently reduced your body’s stress.

Since worry stresses the body, worrying about this symptom will only cause it to persist. You want to contain your worry so that your body can recover. As it recovers, it eliminates stress-caused symptoms, including having weak, shaky, jelly-like, rubbery, heavy, tired, and stiff legs.

Again, if you are having trouble containing your worry, it would be beneficial to connect with one of our recommended anxiety disorder therapists to help you learn this important skill.

Weak legs anxiety symptoms FAQs

Why do my legs feel weak when I’m nervous?

When we’re nervous, the body activates the fight or flight response, which causes a number of body-wide changes that give the body an emergency boost when in danger. This boost can affect the muscles in the legs, making them feel weak. Many people notice a “weak in the knees” feeling when they are nervous, anxious, or afraid.

Why do my legs feel weak and tired?

There are two main reasons why your legs feel weak and tired.

  1. Nervousness, anxiety, and being afraid can cause your legs to feel weak and tired. For more information, read the previous sections of this web page.
  2. Stress can also make your legs feel weak and tired. Especially chronic stress because of how chronic stress can affect the muscles in the legs. For more information, read the previous sections of this web page.

Since there are medical reasons for weak and tired feeling legs, it’s best to discuss your symptoms with your doctor.

Can stress cause heavy legs?

Yes, stress can cause a heavy legs feeling. In fact, stress and chronic stress often cause heavy, tired, jelly-like, rubbery, weak, and stiff legs feelings because of how stress affects the body’s muscles, including those in the legs. For more information, read the previous sections of this web page.

Why do my legs feel heavy and tired?

There are two main reasons why your legs feel heavy and tired.

  1. Nervousness, anxiety, and being afraid can cause your legs to feel heavy and tired. For more information, read the previous sections of this web page.
  2. Stress can also make your legs feel heavy and tired. Especially chronic stress because of how chronic stress can affect the muscles in the legs. For more information, read the previous sections of this web page.

Since there are medical reasons for heavy and tired feeling legs, it’s best to discuss your symptoms with your doctor.

The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed – the underlying factors that motivate apprehensive behavior – a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety’s underlying factors is the best way to overcome problematic anxiety.

Available Therapists Make Appointment

Return to Anxiety Disorders Signs and Symptoms section.


1. Selye H. Endocrine reactions during stress. Anesthesia & Analgesia. 1956;35:182–193. [PubMed]

2. “Understanding the Stress Response – Harvard Health.” Harvard Health. N.p., n.d. Web. 23 May 2016.

3. “The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis.” DUJS Online. N.p., 03 Feb. 2011. Web. 19 May 2016.

4. “Stress.” University of Maryland Medical Center. N.p., n.d. Web. 16 May 2016.

5. Selye, H. (1956). The stress of life. New York, NY, US: McGraw-Hill.

6. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives. ” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

7. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

8. Karatzaferi, Christina, et al. “Muscle fatigue and muscle weakness: what we know and what we wish we did.” Frontiers in Physiology, 30 May 2013.

9. Z, Fatahi, et al. “Effect of acute and subchronic stress on electrical activity of basolateral amygdala neurons in conditioned place preference paradigm: An electrophysiological study.” Behavioral Brain Research, 29 Sept. 2017.

10. Justice, Nicholas J., et al. “Posttraumatic Stress Disorder-Like Induction Elevates β-Amyloid Levels, Which Directly Activates Corticotropin-Releasing Factor Neurons to Exacerbate Stress Responses.” Journal of Neuroscience, Society for Neuroscience, 11 Feb. 2015.

11. Laine, Mikaela A, et al. “Brain Activation Induced by Chronic Psychosocial Stress in Mice.” Advances in Pediatrics., U.S. National Library of Medicine, 2017.


Muscle Weakness Anxiety Symptoms – anxietycentre.com

Muscle weakness anxiety symptoms can affect any muscle or group of muscles in the body, such as arms, legs, back, neck, fingers, toes, etc. Even though weak, tired, and heavy feeling muscles can be unnerving, they are common anxiety disorder symptoms. This article explains how they feel, why anxiety causes them, and what you can do to stop them.

Muscle weakness anxiety symptoms can feel like:

  • A muscle or group of muscles feel unusually weak, tired, heavy, rubbery, or odd.
  • Some people describe this symptom as their muscles feel wobbly, numb, shaky, and tired.
  • A muscle or group of muscles seem difficult or impossible to move, relax, or loosen.
  • It feels like a muscle or group of muscles seem unusually frail, fatigued, and underpowered. No matter what you do, their “weakness” doesn’t change.
  • It feels like a muscle or group of muscles aren’t properly supporting your body or movements due to feeling limp, listless, and worn out.
  • Others describe their muscles as feeling like they won’t work right or too limp to use correctly.
  • Others describe this symptom as feeling like their muscles are unusually heavy or “numb” feeling.
  • Others describe this symptom as that they don’t have confidence in their muscles because they don’t feel as strong as they used to.
  • Others have said that their muscles feel so weak that they are unsure their muscles will support their body.
  • Other descriptions include weak hands, feet, legs, arms, neck, back, head, and face muscles. They can feel so weak that you become concerned you have a serious medical problem, such as MS, ALS, or Parkinson’s Disease.

Anxiety induced muscle weakness can affect any muscle or group of muscles. It can also involve one particular muscle or group of muscles, or can randomly shift from one muscle or group of muscles to another. It can also include several different muscles or groups of muscles at the same time, or feel like your entire body is weak.

Muscle weakness anxiety symptoms can appear for a few moments and then disappear, can last for minutes or hours, or can persist indefinitely. It can also occur or be more noticeable and bothersome when trying to relax, go to sleep, or when waking up. This anxiety symptom can also be more problematic when you are trying to use the affected muscle or group of muscles, such as when walking or lifting.

The degree and intensity of this muscle weakness anxiety symptom can vary from person to person. For example, one or a group of muscles can be only mildly weak for one person, whereas the weak and tiredness can be intensely noticeable and severely restricting for another person.

Muscle weakness can affect ANY muscle or group of muscles in the body. Many of those who experience stress and anxiety comment about weak muscles in the head and face, mouth, back of the head and neck, back and top of the shoulders, chest, arms, legs, hands, stomach, lower back, groin, and feet.

Some people experience significant discomfort due to their muscle weakness anxiety symptoms. Some people also find their muscle weakness so restricting and debilitating that it impedes physical activity and impairs a normal lifestyle. Some people even become bedridden because they feel so weak.

This muscle weakness anxiety symptom can occur when anxious, stressed, or with other panic attack symptoms, or can happen for no apparent reason. It can also be mildly noticeable, moderately bothersome, or exceedingly problematic. It can change from day to day and even moment to moment.

All combinations and variations are common.

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Why does anxiety cause muscle weakness?

Medical Advisory

Anxiety can cause muscle weakness in many ways. It can also cause both a “feeling” of muscle weakness and actual muscle weakness. Here are six of the most common ways anxiety causes muscle weakness symptoms:

1. Stress Response

Anxiety activates the stress response, otherwise known as the fight or flight response. The stress response causes many physiological, psychological, and emotional changes that equip the body for emergency action.[1][2][3]

Some of these changes include:

  • Stimulates the body, including the nervous system.
  • Tightens muscles.
  • Shunts blood away from parts of the body less important for emergency action (such as the digestive system) and to parts that are more important (brain, and muscles).
  • Elevates heart rate.
  • Increases respiration.
  • Increases blood pressure.

To name a few.

These changes can cause “sensations,” such as feeling like your muscles are “weak.” Experiencing weak, tired, or “heavy” muscles is a common stress response experience. Many people notice this type of weakness when afraid. “Weak in the knees” is a common expression heard from people who are anxious, nervous, or afraid.

For a more detailed explanation about the many changes, see our “Stress Response” article.

2. Hyperventilation and Hypoventilation[4]

The fight or flight response also causes the body to change its breathing pattern from a slow, deeper breath to either rapid, deeper breaths (hyperventilation) or rapid, shallow breaths (Tachypnea). When your breathing changes to either of these patterns, carbon dioxide (CO2) levels in the bloodstream decrease. A reduction in CO2 can cause many symptoms, including lightheadedness, feeling faint, and feeling like your muscles are weak, heavy, and tired.

Some people hold their breath or under breathe when they are stressed or anxious, causing Hypoventilation (not enough oxygen). Not enough oxygen increases CO2 in the blood, which can also cause the sensations of feeling lightheaded, faint, and having weak muscles.

3. Low blood sugar[5]

The stress response stresses the body because of the many physiological, psychological, and emotional changes it causes. Stress taxes the body’s energy resources. If you are experiencing an extended episode of anxiety, your body can deplete its energy resources quickly, causing a reduction in blood sugar. Low blood sugar, even if low within the normal range, can cause symptoms, including lightheadedness, fatigue, and weak, tired, and heavy feeling muscles.

4. Fatigue and Sleep deprivation[6][7]

Extended periods of stress or anxiety can cause fatigue. Fatigue can cause a number of symptoms, including lightheadedness, concentration problems, and muscle weakness.

Moreover, stress can cause problems with sleep. Sleep deprivation can also cause symptoms, including feeling dizzy and having weak and tired muscles.

5. Perception of muscle weakness and soreness

Many people with anxiety disorder become inward-focused on it and its symptoms. Sometimes this inward focus can create the “perception” of muscle weakness when there isn’t an actual physical cause.

We explain “Inward Focused Thinking” and how to stop it in chapter 6 in the Recovery Support area.

6. Hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly. When stress responses occur too frequently or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering, which can cause it to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants. Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated. [8][9][10] “Weak muscles” is a common indication of hyperstimulation.

There are several ways hyperstimulation can cause muscle weakness anxiety symptoms, including muscle tension and muscle fatigue, sensory anomalies, and chronic fatigue, to name a few. We explain this in more detail in the “Muscle Weakness and Soreness” symptom in the symptoms section (chapter 9) in the Recovery Support area.

For more information about hyperstimulation and the many ways it can affect the body, visit our “Stress-response Hyperstimulation” article.

How to get rid of muscle weakness anxiety symptoms?

Stress Response

When this symptom is caused by apprehensive behavior and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the active stress response, this anxiety symptom should subside. Keep in mind it can take up to 20 minutes or more for the body to recover from a major stress response. This is normal and shouldn’t be a cause for concern.

Hyper- or Hypoventilation

When this symptom is caused by hyper- or hypoventilation, regulating your breathing will alleviate it as your blood CO2 levels return to normal values and stabilize. As they do, the muscle weakness feeling should subside.

Low blood sugar

When this symptom is caused by low blood sugar, eating a nutritious snack or meal can restore blood sugar to a normal level. As blood sugar returns to a healthy level, this muscle weakness feeling should let up.

Fatigue or sleep deprivation

When muscle weakness is caused by fatigue and sleep deprivation, increasing rest and getting regular good sleep can restore normal energy. As your body recovers from fatigue and sleep loss, weak feeling muscles should disappear.


When this symptom is caused by perception, changing the focus of your attention can eliminate the “perceived” notion of weakness. Distraction is an effective way of changing your focus.

Again, you can learn more about “Inward Focused Thinking” and how to stop it in chapter 6 in the Recovery Support area.


When this anxiety symptom is caused by hyperstimulation, such as from overly apprehensive behavior, it can take much longer for the body to calm down and recover, and to the point where this anxiety symptom subsides.

Reducing your body’s stress and giving it time to recover should eliminate weak feeling muscles. But you have to keep in mind that it can take a long time to recover from hyperstimulation. Reducing the body’s stress overall generally doesn’t happen quickly. You may need to reduce your body’s stress for a few weeks or more before you see this symptom subside.

Nevertheless, when your body has completely recovered from hyperstimulation, it will stop producing symptoms of hyperstimulation, including the muscle weakness anxiety symptoms.

Regular exercise, light weight training, getting fresh air, relaxed breathing, and eating a healthy and balanced diet can also help alleviate this symptom in time. Worrying about the muscle weakness feeling is not helpful since worry stresses the body.

For a more detailed explanation about anxiety symptoms, including the muscle weakness anxiety symptom, why symptoms can persist long after the stress response has ended, common barriers to recovery from hyperstimulation and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

Anxiety muscle weakness frequently asked questions

Can anxiety cause weakness in arms and legs?

Yes! Having weakness in the arms and legs is a common symptom of anxiety disorder. For more information, read why does anxiety cause a weak and heavy legs feeling. You can also read how to get rid of weak and heavy feeling legs.

There are many medical conditions and medications that can cause weakness in arms and legs. You should discuss this symptom with your doctor to rule out a medical cause.

What causes sudden weakness in legs?

Anxiety can cause sudden weakness in legs. Anxiety can cause a sudden weakness in many other parts of the body, as well. For more information, read why anxiety can cause sudden weakness in legs. You can also read how to get rid of sudden weakness in legs.

There are many medical conditions and medications that can cause sudden weakness in legs. You should discuss this symptom with your doctor to rule out a medical cause

Why do my legs feel weak and heavy?

Stress, including anxiety-caused stress, can make your legs feel weak and heavy. Weak and heavy legs is a common symptom of overly apprehensive behavior. For more information, read why anxiety can cause weak and heavy legs. You can also read how to get rid of weak and heavy legs.

There are many medical conditions and medications that can cause legs to feel weak and heavy. You should discuss this symptom with your doctor to rule out a medical cause.

Why do my legs feel weak and tired?

Stress, including anxiety-caused stress, can make your legs feel weak and tired. Many people experience legs that feel weak and tired when they are anxious, stressed, or afraid. For more information, read why anxiety can cause a weak and tired feeling in the legs. You can also read how to get rid of legs that feel weak and tired.

There are many medical conditions and medications that can cause legs to feel weak and tired. You should discuss this symptom with your doctor to rule out a medical cause.

Why do my muscles feel so weak?

There can be many reasons why muscles feel so weak. Stress, including anxiety-caused stress is one reason. For more information, read why anxiety can cause muscles to feel so weak. You can also read how to get rid of muscles that feel so weak.

Since some medical conditions and medications can cause muscles to feel weak, we recommend discussing this symptom with your doctor to rule out a medical cause.

What causes weakness in arms and legs?

Anxiety and chronic stress can cause weakness in the arms and legs. For more information, you can read why anxiety can cause weakness in the arms and legs. You can also read how to get rid of anxiety-caused weakness in the arms and legs.

Since some medical conditions and medications can cause weakness in the arms and legs, we recommend discussing this symptom with your doctor to rule out a medical cause.

Can anxiety cause long term muscle weakness?

Yes! Anxiety stresses the body, and a body that becomes chronically stressed can exhibit long-lasting symptoms, including long-term muscle weakness. For more information, you can read why anxiety can cause long term muscle weakness. You can also read how to get rid of long term muscle weakness.

There are also some medical conditions and medications that can cause long term muscle weakness. We recommend discussing this symptom with your doctor to rule out a medical cause.

Can anxiety cause muscle weakness and twitching?

Yes! Just as anxiety can cause weak feeling muscles, it can also cause muscle twitching. Consequently, anxiety can cause both muscle weakness and twitching at the same time. For more information, you can read more about the anxiety muscle twitching symptom.

There are also some medical conditions and medications that can cause muscle weakness and twitching. We recommend discussing this symptom with your doctor to rule out a medical cause.

Can anxiety cause muscle weakness on one side of body?

Yes! Anxiety-caused muscle weakness can affect any muscle or group of muscles. It can also cause muscle weakness on one side of the body. Anxiety-caused muscle weakness can also affect one side of the body, and then migrate to the other side, and involve both sides. All combinations and variations are common.

There are also some medical conditions and medications that can cause muscle weakness on one side of the body. We recommend discussing this symptom with your doctor to rule out a medical cause.

Can health anxiety cause muscle weakness?

Yes! Any type of anxiety, including health anxiety, can cause anxiety symptoms, including muscle weakness. Health anxiety is one of the more common causes of anxiety disorder. Working with an experienced anxiety disorder therapist is the most effective way to overcome health anxiety.

Can general anxiety disorder cause muscle weakness?

Yes! Any type of anxiety, including generalized anxiety disorder, can cause anxiety symptoms, including muscle weakness. Generalized anxiety is one of the more common causes of anxiety disorder. Working with an experienced anxiety disorder therapist is the most effective way to overcome anxiety disorder, including generalized anxiety disorder and its symptoms, including muscle weakness.

Can anxiety cause a feeling of muscle weakness?

Yes! Anxiety can cause both a feeling of muscle weakness and actual muscle weakness. For more information, you can read why anxiety can cause a feeling of muscle weakness. You can also read how to get rid of a feeling of muscle weakness.

Since there are many medical conditions and medications that can cause a feeling of muscle weakness, we recommend discussing this symptom with your doctor to rule out a medical cause.

Anxiety Therapy

If you are having difficulty with anxiety, its symptoms, and troublesome worry, you might want to connect with one of our recommended anxiety disorder therapists. Working with an experienced anxiety disorder therapist is the most effective way to overcome problematic anxiety.

All of our recommended therapists have experienced anxiety disorder, have successfully overcome it, and are medication-free. Their years of personal and professional experience make them an excellent choice to work with on your road to recovery.

Visit our “Why Therapy” and “What Makes Our Therapists Unique” articles for more information.



The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed – the underlying factors that motivate apprehensive behavior – a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety’s underlying factors is the best way to overcome problematic anxiety.

Available Therapists Make Appointment

Return to Anxiety Disorders Signs and Symptoms section.

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including muscle weakness anxiety symptoms.


1. Selye, Hans. “Results Of The Dissection. ” The Stress of Life. New York: McGraw-Hill Book, 1956. N. pag. Print

2. Folk, Jim and Folk, Marilyn. “Stress Response.” anxietycentre.com, Nov. 2019.

3. “The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis.” DUJS Online. N.p., 03 Feb. 2011. Web. 19 May 2016.

4. Meuret, Alicia E., and Thomas Ritz. “Hyperventilation in Panic Disorder and Asthma: Empirical Evidence and Clinical Strategies.” NCBI PubMed, U.S. National Library of Medicine, Oct. 2010.

5. “Dizziness.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Sept. 2018.

6. ePainAssist, Team. “Sleep Deprivation Dizziness|Causes|Symptoms|Treatment|Prevention|Risks.” EPainAssist, Painassist Inc, 21 Apr. 2018.

7. Kim, Sung Kyun, et al. “Relationship between Sleep Quality and Dizziness.” PLOS ONE, Public Library of Science, 2018.

8. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

9. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

10. Bear,Connors, Paradiso (2016). Neuroscience: Exploring the brain – Fourth Edition. In Neurons And Glia (pp. 29-53). New York, NY: Wolters Kluwer

How Anxiety Can Make Your Legs Feel Like Jelly

Anxiety, despite what many think, actually does have a “useful” purpose. While anxiety comes with many difficult symptoms, it also signals to your body when you should be afraid (when your “fight/flight” response should be activated). This physiological reaction occurs when a harmful event, attack, or threat is perceived.

Unfortunately, many people experience life with their fight or flight system constantly activated. For these individuals, the physiological reaction occurs regardless of whether something actually triggers it or not. This is hard, as the fight or flight response is quite strenuous on the body. One of the symptoms that many complain about is weak legs, or “jelly legs.”

With jelly legs, standing can feel unusual and may be accompanied by dizziness or balance issues. The dizziness and/or balance problems may be related to the inherent leg weakness, or be an additional symptom of the overall anxiety. 

What Creates the Jelly Leg Feeling?

There are several factors that may contribute to the feeling of jelly legs. One of the most common is a result of the adrenaline produced in response to the physiological response of “fight or flight.”

When adrenaline rushes through the body, blood goes to the places that your body feels need it most. That means that your blood is rushing to your heart, your brain, and possibly various muscles, and to do that it rushes out of your legs and makes them feel more like jelly.

Other Causes of Jelly Leg

The sensation of “jelly legs” may also be attributed to the muscle weakness that occurs when the body is flooded with adrenaline. Adrenaline causes the muscles to be in a constant state of tension, and eventually, they will become weak. Also, anxiety can cause changes to one’s breathing that can result in weakened muscles and changes in blood pressure.

How to Tell the Difference Between Anxiety Weak Legs and Something More Serious?

Many people suffering from jelly legs worry they are experiencing a more serious physical problem. While weak legs can be a scary feeling (in that it may feel difficult to stand), jelly legs are fairly common. Nonetheless, it is always appropriate to speak to a medical professional if there is a concern. A doctor can diagnose or rule out any potential underlying health issues. Yet, certain factors may help in determining if the jelly legs are a result of anxiety, or a more significant, underlying condition: 

  • Temporary – Generally, the sensation of jelly legs associated with anxiety is temporary.  Weak legs tend to regain some of their strength when the anxiety dissipates. They may recur often as you go through anxiety, but they won’t be a constant symptom.
  • Strength – Usually weak legs due to anxiety will regain most of their strength. This is not entirely the case as dizziness and hyperventilation can genuinely cause legs to be a bit weaker than normal (as can adrenaline rushes), but leg strength is usually not affected – especially in the long term.
  • Other Symptoms – Weak legs from anxiety are usually accompanied by other anxiety symptoms. Jelly legs from anxiety usually come with anxious thoughts, rapid heartbeat, and other signs of anxiety.

The problem with anxiety and jelly legs (along with the other difficult symptoms of anxiety) is in the difficulty determining the cause of the symptoms. Nevertheless, there are some general differences between anxiety and a more serious, underlying health condition that could help one recognize whether or not his or her experience is anxiety related.

How to Cure and Prevent Jelly Legs

Anxiety, while at times overwhelming, is treatable. There are ways to manage anxiety in the moment as well as long term treatment options.

Some tools and skills to help manage anxiety in the moment include:

  • Go Walking – If you’re not feeling too dizzy (a common symptom of anxiety), try going for a walk. Walking gets the blood flowing and it takes your mind off of your legs. It’s also a reminder that you have leg strength.
  • Close Your Eyes – If you do have a bit of dizziness leading to your weak leg feeling, close your eyes for a while as long it’s safe to do so. Your weak legs are generally the result of feeling dizzy, so with your eyes closed that dizziness will affect you less.
  • Mantra Meditation – There is some debate in the medical community about whether or not mantra meditation is beneficial for anxiety in the long term. However, in the short term, it can help calm you down because it acts as a breathing distraction. The mantras focus your mental energy away from your anxiety, while the meditation gets your breathing under control so that you experience less over-breathing.

These aren’t long term solutions, but in the moment, using these skills may help decrease the intensity of the anxiety and alleviate some of the challenging symptoms, including weak legs. 

Long-term treatment options may include:

There are various approaches to managing anxiety long-term. Some of these approaches may help decrease one’s vulnerability to anxiety altogether, or lessen the intensity of the anxiety when it is experienced. 

  • Herbal Solutions Several natural herbs are effective for controlling anxiety.
  • Anxiety Medications Many medications can reduce anxiety, although they may come with side effects.
  • Therapy Therapy can also be effective at reducing anxiety.

Generally, the best place to start is by thoroughly researching anxiety and getting an idea of which symptoms are affecting you and how.


The “jelly legs” feeling, which typically refers to feelings of weakness, dizziness, or loss of control in the legs, is often caused by a rush of adrenaline taking blood away from the legs, though there may be other causes. It is temporary, but can be distressing, and requires long term anxiety treatments to stop from recurring.

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How to Control Muscle Weakness Associated with Anxiety

Muscle weakness is a potentially frightening anxiety symptom. The experience can be really distressing, leading to severe tension and worry, which only serve to make the anxiety worse. Ultimately, feeling that you don’t have the physical strength to live a normal life can really make things difficult. In this article, we explore the link between anxiety and feelings of muscular weakness, suggesting several coping techniques that you can use. Read on to learn more.

Anxiety Causes Muscle Weakness

Anxiety problems are known to cause feelings of muscle weakness. However, you should visit a doctor if you’re experiencing this, in order to make sure that there isn’t another medical or physical explanation. Most often, however, the muscle weakness that you feel is likely to be linked to your anxiety. While it can be distressing and irritating, these feelings of muscular fatigue, tingling or numbness are not harmful in and of themselves. 

However, is this really a case of your muscles being temporarily weakened, or is this just your anxiety playing tricks on your mind? Muscle weakness is generally subjective. While some people do have problems standing or sitting, few are “testing” the muscle to see if the muscle is actually weaker. There are several different issues that lead to this perceived feeling of weakness. They include:

  • Hyperventilation When you breathe too quickly, or take in too much air, this is known as hyperventilation. Hyperventilation is extremely common for those with anxiety, potentially causing muscle weakness by reducing blood flow to the extremities. It’s not dangerous, but it can cause your muscles to feel weak, tingly, or light, along with many other symptoms.
  • Fight or Flight During the fight or flight response, anxiety causes several changes in the body. These include an increased heart rate, higher blood pressure, faster breathing, and changes in blood flow. One of the effects of these changes is the sensation that the muscles are weakened. They may not actually be weaker, but the complex bodily and hormonal changes may cause your muscles to feel that way.  
  • Muscle Tension and Fatigue Anxiety also leads to both muscle fatigue, due to the way that stress causes your muscles to tense and your body to tire. This can tire your muscles to such a degree that it feels as though they have less strength than they did previously.
  • Perceived Weakness Finally, anxiety tends to make you over-sensitive to what’s happening in your body. This means that you may interpret a feeling of muscle weakness as being worse than it is, which in turn can further fuel your anxiety. In reality, however, you may find that the muscle weakness is just a matter of perception – “all in your mind”, in other words. 

These are some of the potential causes of muscle weakness linked to anxiety. There may be other links as well – anxiety can affect many different aspects of your body. Some people may feel more lightheaded, as though they’re going to faint and this can cause a feeling of muscle weakness as well. Others may not eat or drink enough as a result of their anxiety, causing actual muscle weakness and fatigue. 

The Best Ways to Control Anxiety Related Muscle Weakness

Muscle weakness is a tricky issue. On the one hand, when it’s caused by anxiety it’s not dangerous; and in some cases, it’s just a matter of perception and your muscles are not really weakened. On the other hand, living with muscle weakness can be stressful, often increasing the level of anxiety that you feel.

There are several strategies you can use to decrease the feeling of having weak muscles. These include:

  • Walking Often your muscles aren’t actually weak. They’re simply feeling that way. So go for a walk, and show your brain that your muscles are fine. Walking is good for blood flow and keeps your muscles active, which – while it won’t cure muscle weakness altogether – is useful for overcoming some of the stress. If you prefer to do other forms of physical activity, including stretching and/or yoga exercises, that ought to help as well.  
  • Breathing Slow, concentrated breaths will reduce the effects of hyperventilation. Make sure that you’re not breathing too quickly or in a shallow manner. Breathe slowly, deep into your belly. Each breath should take as long as 15 seconds from the time you start breathing in until the time you finish exhaling. Try to hold your breath for a few seconds between the inhale and the exhale. 
  • Mental Distractions Remember, part of the goal is simply not to focus on your muscles as much because that level of focus can make them feel weaker than they are. Distracting yourself through mental exercises, phone calls, time in nature, music or meditation can help. The exact distraction that you employ doesn’t matter all that much – what’s important is that you find an enjoyable activity that you can use to temporarily take your mind off of what’s happening in your body. 

These strategies aren’t going to reduce your muscle weakness every time. Sometimes, for example, you’re genuinely tired and your there’s a good reason for why your body is feeling that way. Sometimes the anxiety that you feel may seem so overwhelming that you believe these exercises won’t have much of an impact. 

At times, there is no quick fix available. Nonetheless, the techniques that we have discussed today can prove helpful in managing sensations of muscle weakness and reducing your overall anxiety levels. If you want to take things one step further, think more broadly about your anxiety and ways that you can address this. For example:

  • Cognitive Behavioral Therapy
  • Anxiety Reducing Medications (when prescribed by a doctor or psychiatrist) 
  • Self-Help for Anxiety

You can read more about these types of treatments on our anxiety treatment page. By tackling the underlying problem – i.e. the anxiety – at its root, you stand the best chance of overcoming your muscle weakness.


Muscle weakness is typically caused by muscle tension, fatigue, hyperventilation, and changes in blood flow during periods of intense and chronic anxiety. It is helpful to try to determine what may be causing this weakness when possible. Preventing muscle weakness from anxiety requires commitment to an anxiety treatment. 

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Weakness and Fatigue | Michigan Medicine


Weakness and fatigue are terms that are often used as if they mean the same thing. But in fact they describe two different sensations. It is important to know exactly what you mean when you say “I feel weak” or “I am fatigued” because it can help you and your doctor narrow down the possible causes of your symptoms.

  • Weakness is a lack of physical or muscle strength and the feeling that extra effort is required to move your arms, legs, or other muscles. If muscle weakness is the result of pain, the person may be able to make muscles work, but it will hurt.
  • Fatigue is a feeling of tiredness or exhaustion or a need to rest because of lack of energy or strength. Fatigue may result from overwork, poor sleep, worry, boredom, or lack of exercise. It is a symptom that may be caused by illness, medicine, or medical treatment such as chemotherapy. Anxiety or depression can also cause fatigue.

Both weakness and fatigue are symptoms, not diseases. Because these symptoms can be caused by many other health problems, the importance of weakness and fatigue can be determined only when other symptoms are evaluated.


General weakness often occurs after you have done too much activity at one time, such as by taking an extra-long hike. You may feel weak and tired, or your muscles may be sore. These sensations usually go away within a few days.

In rare cases, generalized muscle weakness may be caused by another health problem, such as:

  • A problem with the minerals (electrolytes) found naturally in the body, such as low levels of potassium or sodium.
  • Infections, such as a urinary tract infection or a respiratory infection.
  • Problems with the thyroid gland, which regulates the way the body uses energy.
    • A low thyroid level (hypothyroidism) can cause fatigue, weakness, lethargy, weight gain, depression, memory problems, constipation, dry skin, intolerance to cold, coarse and thinning hair, brittle nails, or a yellowish tint to the skin.
    • A high thyroid level (hyperthyroidism) can cause fatigue, weight loss, increased heart rate, intolerance to heat, sweating, irritability, anxiety, muscle weakness, and thyroid enlargement.
  • Guillain-Barré syndrome, a rare nerve disorder that causes weakness in the legs, arms, and other muscles and that can progress to complete paralysis.
  • Myasthenia gravis, a rare, chronic disorder that causes weakness and rapid muscle fatigue.

Muscle weakness that is slowly getting worse requires a visit to a doctor.

Sudden muscle weakness and loss of function in one area of the body can indicate a serious problem within the brain (such as a stroke or transient ischemic attack) or spinal cord or with a specific nerve in the body.


Fatigue is a feeling of tiredness, exhaustion, or lack of energy. You may feel mildly fatigued because of overwork, poor sleep, worry, boredom, or lack of exercise. Any illness, such as a cold or the flu, may cause fatigue, which usually goes away as the illness clears up. Most of the time, mild fatigue occurs with a health problem that will improve with home treatment and does not require a visit to a doctor.

A stressful emotional situation may also cause fatigue. This type of fatigue usually clears up when the stress is relieved.

Many prescription and nonprescription medicines can cause weakness or fatigue. The use of alcohol, caffeine, or illegal drugs can cause fatigue.

A visit to a doctor usually is needed when fatigue occurs along with more serious symptoms, such as increased breathing problems, signs of a serious illness, abnormal bleeding, or unexplained weight loss or gain.

Fatigue that lasts longer than 2 weeks usually requires a visit to a doctor. This type of fatigue may be caused by a more serious health problem, such as:

  • A decrease in the amount of oxygen-carrying substance (hemoglobin) found in red blood cells (anemia).
  • Problems with the heart, such as coronary artery disease or heart failure, that limit the supply of oxygen-rich blood to the heart muscle or the rest of the body.
  • Metabolic disorders, such as diabetes, in which sugar (glucose) remains in the blood rather than entering the body’s cells to be used for energy.
  • Problems with the thyroid gland, which regulates the way the body uses energy.
    • A low thyroid level (hypothyroidism) can cause fatigue, weakness, lethargy, weight gain, depression, memory problems, constipation, dry skin, intolerance to cold, coarse and thinning hair, brittle nails, or a yellowish tint to the skin.
    • A high thyroid level (hyperthyroidism) can cause fatigue, weight loss, increased heart rate, intolerance to heat, sweating, irritability, anxiety, muscle weakness, and thyroid enlargement.
  • Kidney disease and liver disease, which cause fatigue when the concentration of certain chemicals in the blood builds up to toxic levels.

Myalgic encephalomyelitis/chronic fatigue syndrome is an uncommon cause of severe, persistent fatigue.

If fatigue occurs without an obvious cause, it is important to evaluate your mental health. Fatigue is a common symptom of mental health problems, such as anxiety or depression. Fatigue and depression may become so severe that you may consider suicide as a way to end your pain. If you think your fatigue may be caused by a mental health problem, see your doctor.

4 Ways Stress & Anxiety Are Causing Your Neuropathy

Neuropathy can be caused by a number of different things. Certain medical conditions, injuries, and excessive alcohol consumption can all cause the nerve damage behind neuropathy. But what about stress and anxiety? Can stress actually cause neuropathy? If so, how, and what can be done to treat it? If you’re suffering from symptoms of neuropathy, you will want to seek out Broomfield neuropathy treatment to determine the exact cause of your condition. Once you know if it’s related to stress, you can begin addressing the problem.

Can Anxiety Damage Your Nerves?

While anxiety and stress can play into neuropathy, they can’t actually damage your nerves. This means that stress isn’t a root cause of neuropathy. Even if you’re incredibly stressed every day for months, that by itself won’t cause damage to your nerves. However, that doesn’t mean stress won’t play a part in the symptoms of your neuropathy.

Anxiety Can Cause Neuropathy-Like Symptoms

Anxiety and stress do affect the body in many different ways. A few of the most obvious symptoms of stress include numbness, burning, tingling, and pain or discomfort when moving. These symptoms are very similar to what you might feel with neuropathy. That’s why it’s very easy to think you have neuropathy when you actually don’t. If you assume that’s what you’re dealing with and never confirm it with your doctor, you won’t be able to address the actual problem (your stress).

Your Nerves May Be Over-Firing

Studies have also provided evidence that anxiety and nerve firings are related. Specifically, researchers believe that high anxiety may cause nerve firing to occur more often. This can make you feel tingling, burning, and other sensations that are also associated with nerve damage and neuropathy. Anxiety may also cause muscles to cramp up, which can also be related to nerve damage.

Hyperventilating Is Another Concern

Anxiety can make you hyperventilate. When you do, it makes the blood vessels in your body constrict. This reduces the amount of blood flow to your lower legs and arms. That, in turn, can cause burning, tingling, and other sensations similar to what you would experience with neuropathy.

Being Too Aware of Your Body Can Actually Cause Problems

When you’re dealing with anxiety and believe you may have peripheral neuropathy, you may be more aware of your body. You’re always checking for signs of neuropathy, and every odd muscle twinge or odd sensation is noticeable. This over-awareness can actually make it more difficult to move naturally. You’re always taking stock of your body, so you notice more oddities. You also pay more attention to things you’d normally do without thinking, such as walking or reaching out for something. This can make those movements more difficult or more awkward. This, in turn, spikes your anxiety because the movement feels off. The worse your anxiety gets, the more you’ll experience symptoms similar to neuropathy.

You Need to Get a Diagnosis

If you believe you have neuropathy, don’t try to treat it on your own. Instead, you need to get a diagnosis. There are several conclusive methods that will tell you if you truly do have neuropathy or if the symptoms you’re feeling are caused by something like anxiety.

An electromyograph uses electric stimulation that will show if there’s something affecting the nerves. If you haven’t had any injuries that could have caused nerve damage, this test can be used to determine if there’s another medical condition affecting your body that you don’t know about.

A CT or MRI can be used to look for physical damage. These scans can determine if your nerves are under pressure from misaligned bones or have been crushed from pressure. Often, surgery is required to relieve this pressure.

Ready to Get to the Bottom of Your Nerve Pain?

If you believe you’re dealing with neuropathy, but aren’t sure what’s causing it, contact Fox Integrated Healthcare today. We will determine the cause of your neuropathy and help you treat it, whether that means physical therapy, other forms of treatment, or working to address your anxiety.

90,000 Weakness in the legs is one of the symptoms of many diseases

The feeling of weakness in the legs is familiar to many, if not all, people. Weakness in the legs can be caused by a variety of disorders in the human body, and also be one of the manifestations of quite serious diseases. Therefore, it is especially important to note other symptoms accompanying this phenomenon (for example, dizziness, nausea, other pain) for a timely diagnosis and subsequent treatment.

Symptoms most commonly associated with leg weakness:

  • Dizziness
  • Headache
  • Faintness, light-headedness
  • Nausea
  • Increased fatigue
  • Increased body temperature
  • Trembling legs
  • Numbness of limbs
  • Swelling
  • Pallor or blue discoloration of the skin on the legs
  • Weakness in the back
  • Low back pain
  • Convulsions

Since the causes of weakness in the legs can be a variety of diseases, it is advisable to first consult a physician.A specialist, taking into account all the available symptoms, may consider it necessary to carry out such diagnostic procedures as: general blood and urine analysis, ECG, ultrasound of the heart, angiography of the vessels of the legs, X-ray of bones.

Weakness in the legs is quite often a manifestation of circulatory problems. Including it can be one of the symptoms of such dangerous diseases as stroke and heart attack. An early warning of the risk of stroke can be severe weakness in one or more limbs. At the same time, weakness in the legs lasts no more than an hour, but can occur several times a day.The obvious signs of a stroke develop later, so it is important to pay attention to possible symptoms on time.

Sudden weakness in the legs combined with even a slight heartache, dizziness and lightheadedness can speak of another deadly disease – a heart attack. In this case, you should immediately seek emergency medical help.

In old age, one of the most common causes of weakness in the legs is a decrease and blockage of blood vessels with cholesterol plaques – atherosclerosis.In this case, directly weakness in the legs can cause not only atherosclerosis of the vessels of the legs, but also atherosclerosis of the cerebral or coronary arteries. In addition to problems with blood circulation, a sharp change in blood pressure – hypotension can lead to weakness in the legs.

Another dangerous disease manifests itself in weakness in the legs, this is diabetes. With prolonged development of diabetes, neuropathy of the feet may occur. A high level of glucose in the body leads to a malnutrition of the nerves, their oxygen starvation.Diabetic neuropathy manifests itself in numbness of the feet, loss of their sensitivity, heaviness when walking.

Weakness in the legs can be one of the symptoms of diseases of the central nervous system, as well as concussion. This is usually accompanied by headaches, nausea, and general weakness. If, with weakness in the legs, visual impairment is also noted, then this may serve as a signal of the development of multiple sclerosis. In this case, a timely appeal to a neurologist is necessary.

If weakness of the legs is combined with a feeling of numbness, tingling, and pain in the extremities is also added, then spinal lesion can cause such a symptom.The most common causes of these symptoms are: osteochondrosis, arthritis, spondylitis, trauma or swelling of the spine.

Feeling weak in the legs can signal bone problems, including closed foot injury, osteoporosis, and bone tumors.

Weakness in the legs is very often the result of an increase in body temperature. The reason for the increased temperature, in turn, can be: a cold or SARS, viral, bacterial or fungal infection, food poisoning, overheating or sunstroke.

Psychological problems and stress can be a serious factor in the development of weakness in the legs, especially in old age. Panic attacks, neurosis, depression can be behind the general weakness in a person, and in particular for the frequently occurring weakness in the legs. Contacting a specialist psychologist, and in some cases, a psychiatrist will provide timely necessary assistance.

90,000 Restless legs syndrome

Restless legs syndrome (RLS) is a neurological disease manifested by paresthesias in the lower extremities and their excessive motor activity, mainly at rest or during sleep.

Restless Legs Syndrome was first described by Thomas Willis in 1672: “Some people, when they are going to sleep and go to bed, immediately after that there is a movement of tendons, arms and legs, accompanied by colic and such anxiety that the patient cannot sleep, as if he is under torture. ” The modern definition of this syndrome was proposed by the Swedish scientist K. Ekbom in 1945:

Restless legs syndrome can be primary (idiopathic) and secondary.

One of the most probable causes of the development of primary restless legs syndrome is considered to be the insufficiency of the dopaminergic systems in the subcortical structures of the brain involved in inhibitory processes.

Secondary restless legs syndrome can develop during pregnancy and various pathological conditions.

The main causes of secondary restless legs syndrome are:

  1. Iron deficiency. Iron deficiency disrupts the production of dopamine in the brain, which in turn provokes the development of secondary RLS.A patient’s iron stores may be depleted even without clinically significant anemia. Studies have shown that a decrease in iron stores, as measured by a decrease in ferritin levels below 50 mcg / L, can cause or worsen RLS symptoms.
  2. Neurological disorders. Secondary RLS is often observed in spinal cord and peripheral nervous system injuries, as well as peripheral neuropathies of various origins (diabetic, alcoholic, toxic).
  3. Pregnancy.RLS occurs in 15-20% of women during pregnancy. Symptoms can be severe, but usually resolve completely within a few weeks after delivery. It is assumed that the causes of RLS during pregnancy can be iron deficiency anemia, folate deficiency, hormonal changes and venous congestion in the lower extremities.
  4. Uremia. Up to 50% of patients with end-stage renal disease have RLS. RLS incidence was shown to correlate with blood urea levels, anemia, peripheral neuropathy, and a decrease in parathyroid hormone levels in this category of patients.Particularly severe symptoms are noted directly during dialysis, when the patient is forced to lie still for several hours. RLS symptoms have been shown to decrease or disappear after kidney transplantation.
  5. The use of medicines. RLS symptoms can develop or worsen with the use of various medications, such as tricyclic antidepressants (amitriptyline, azafen, etc.), selective serotonin reuptake inhibitors (trazodone, Prozac), lithium preparations, metoclopramide (raglan), calcium channel blockers (corinfen finoptin).Caffeine also makes RLS symptoms worse.

Clinical manifestations of RLS can be grouped into several main symptom complexes:

Unpleasant sensations in the legs. These are commonly described as creeping, shivering, tingling, burning, twitching, electric shock, wiggling under the skin, etc. About 30% of patients describe these sensations as painful. Sometimes patients cannot accurately describe the nature of the sensations, but they are always extremely unpleasant.These sensations are localized in the thighs, legs, feet and arise in waves every 5-30 seconds. There are significant fluctuations in the severity of these symptoms. In some patients, symptoms may occur only at the beginning of the night, in others, they may be disturbed continuously throughout the day.

Symptoms are worse at rest. The most common and unusual manifestation of RLS is an increase in sensory or motor symptoms at rest. Patients usually report worsening while sitting or lying down, and especially when falling asleep.It usually takes from a few minutes to an hour before symptoms appear when the patient is calm.

Symptoms are better with motion. Symptoms greatly improve or disappear with movement. Walking is most often the case. Stretching, bending over, exercise on a stationary bike, or just standing up can help in some cases.

Symptoms are circadian in nature. Symptoms are significantly worse in the evening and in the first half of the night (between 6 pm and 4 am).Symptoms subside before dawn and may disappear altogether in the first half of the day.

It should be noted, however, that sometimes there may be diagnostic difficulties in the differential diagnosis of primary and secondary restless legs syndrome. Since there are no precise biochemical markers for primary RLS, it is not possible to say with certainty whether the above condition is the cause of secondary RLS, or whether it only triggered the clinical manifestations of primary RLS.

Valuable diagnostic information to confirm the presence of restless legs syndrome can be obtained from polysomnography, a method of long-term recording of various physiological parameters during sleep.

If you or your relatives want to fully rest during sleep, we are waiting for you in the sleep department of the Medical Diagnostic Center of the International Institute of Biological Systems named after S.M. Berezina.

Give yourself a healthy sleep!

90,000 All shades of neurosis

Natalia Voitovich


24 October 2017

With complaints of poor sleep or unexpected weakness, we usually go to the therapist.If the doctor, after conducting an examination, does not find any changes in the body, he prescribes vitamins or sedatives, advises to walk more and lets go. Inspired, we return home, but … a couple of weeks pass and our condition does not improve.

Illustration pixabay.com

We turn to another doctor, then another one … We pass tests, consult, but this does not give a result. Anxiety is growing, the thought “I feel very bad, and the doctors are powerless” causes panic.Maybe we are not just seriously, but even terminally ill? This assumption plunges into depression … Until, finally, another doctor informs us of the diagnosis – “neurosis” – and sends us to a psychotherapist.

So what kind of illness is this – neurosis? What are its causes and, most importantly, how to get rid of it?

Neurosis is a disorder that is caused by various traumatic circumstances. And there are many of them around us. Conflicts, stress, psychological trauma, which occurred in childhood or even yesterday, upset our inner balance and can seriously damage our personality.In such cases, a defense mechanism is provided in the human psyche: neurosis is a state that occupies our attention and in this way protects our personality, helps to come to terms with circumstances and live on.

It is important to know: although the symptoms of neurosis are similar to many well-known diseases, it itself does not cause any damage to the body. Does not cause disease, is not a mental disorder. And even if it lasts for many years, it is always reversible.

At the heart of the formation of any neurosis, there are many reasons: it is heredity, and past diseases, and character traits, and even upbringing with education.And its most important feature is the presence of the so-called intrapersonal conflict, broken relationships or an important unmet need.

For example, a person wants to perform on stage, but he has to work as an accountant … Or he is forced to lead a team, not wanting to be a boss at all and not having the necessary qualities for this … Because of a difficult relationship with her husband, a woman wants to divorce, but her the mother, whom she cannot object to, insists on preserving the marriage…

The difficulty is that the person himself is not aware of such problems. Headache, insomnia, stomach pains are troubling, but not what was the real reason for their appearance. That is why it is more difficult to cure a neurosis than a cold or appendicitis. It is not enough to remove the headache or obsessive thoughts. It is necessary to find out why these symptoms are “needed” by the patient. A neurosis always has a “secondary benefit” – no matter how difficult its manifestations are, they are always useful in some way.

What manifestations of neurosis do we most often encounter in life?

Asthenia, or exhaustion, is increased fatigue, lack of strength, a state of weakness, primarily physical. Working capacity decreases, attention and memory deteriorate. All this can be accompanied by increased excitability, irritability, and mood instability. It becomes difficult to wait, perceive loud sounds, noise, bright light.

Sleep disorders. A person has difficulty falling asleep, wakes up in the middle of the night and does not feel cheerful in the morning.

Obsessive thoughts and lack of confidence in the correctness or completeness of actions. The desire to re-check many times – whether the gas or light is turned off. Constant fear of dangerous or ridiculous actions – cutting yourself with sharp objects, jumping from the balcony. Repeated hand washing, endless medical examinations.

Phobias. For example, hypochondria is an excessive fear for one’s health, a tendency to ascribe to oneself diseases that do not exist.

Depression. The main symptom is melancholy, bad mood. Lack of strength and desire to do something. Emotional instability.

Autonomic disorders. They are called differently: vegetative-vascular dystonia, or VSD, neurocirculatory dystonia, vegetosis, angioneurosis, heart neurosis. Vegetative disorders are very diverse: palpitations, increased blood pressure, skin pallor or redness, “goose bumps”, fever, chilliness of the extremities, increased intestinal motility.

Panic attacks or vegetative crises: pain, “freezing” in the region of the heart, sensation of “interruptions”, a feeling of pressure in the chest, dizziness, choking. Unpleasant sensations in the abdomen, nausea, increased salivation, fever, sweating. At the same time, anxiety joins, panic develops. With the recurrence of vegetative crises, various phobias can form, for example, fear of death, cardiac arrest, stroke.

However, all the manifestations of neurosis cannot be enumerated! It can be a disorder of any of the systems of the human body – cardiovascular, respiratory, gastrointestinal, urogenital.Symptoms that bother a person may get worse or better from time to time. Sometimes they even completely disappear, and then they resume again. A characteristic feature of all neurotic states is the variability of symptoms. For example, fear of getting AIDS over time can transform into compulsive hand washing.

How long can this state last? Differently. From several weeks to several years. Depends on the duration of a person’s stay in a difficult situation, on how timely he turned to medical help.Finally, on his ability to adequately solve his problems.

I repeat: with neurosis, there is no damage to organs or systems of the body. The changes concern only the sphere of the psyche. Therefore, the desire of the person himself to change, to try to somehow correct the effective reactions is, perhaps, the most important condition in the treatment of neurosis.

So I can say: healthy is not the one who does not have any problems, but the one who knows how to solve them.

From case histories

Doctor, help me, I am constantly tired, I explode for any reason, I do not sleep well, I had to start a diary because I forget everything, I find it difficult to concentrate (Anton, 43 years old).

Suddenly I am covered with such weakness, my legs are cotton, I cannot budge. And at night I wake up in a cold sweat, my heart is beating and I am very scared (Alexandra, 39 years old).

I do not want to do anything, I have absolutely no strength and energy.It seems she would sleep all day. Maybe this is old age? (Elena, 28 years old).

I go back five times to check if I closed the door. Or maybe I forgot to turn off the light? I’m going crazy? (Alexey, 36 years old).

It seems to me that I am sick with some kind of terrible disease. Examined everything and everyone. And, of course, the doctors don’t find anything. I am as healthy as an astronaut. And as soon as I calm down that I do not have cancer or AIDS, I begin to be afraid of tuberculosis or hepatitis.And so on ad infinitum. I’m tired (Yaroslav, 52).

Category materials

90,000 Meteosensitivity: causes, symptoms and treatment

Category: Health from “A” to “Z”.

Meteosensitivity: Causes, Symptoms and Treatment

Meteosensitivity (meteorological dependence) is the reaction of your body to the effects of weather (meteorological) factors.It can be snow, rain or just cloudy weather, magnetic storms, flares in the sun, etc.

A person is too susceptible to weather fluctuations due to weakened immunity or chronic diseases. Most often, a problem with the cardiovascular system is accompanied by meteosensitivity. Studies have shown that the body does not react to the weather itself, but to its sudden change. And the malaise can last for 4 days. Everything depends on the human body, his age, equipment and the presence of chronic diseases, even character plays a role in this situation.

Disease symptoms

There are many symptoms. Everything is pretty individual. And in each person, the disease can manifest itself in different ways. It depends on your immunity. Most common symptoms of weather sensitivity:

Feels a slight discomfort;

  • Loss of appetite;
  • Fatigue;
  • Joint pain
  • Migraine;
  • Dizziness;
  • Tinnitus and eye pain;
  • Pressure surges;
  • Exacerbation of chronic diseases;
  • Palpitations.

Sometimes there may be pain in the heart due to sudden changes in the weather, there is a possibility that the disease will lead to a heart attack. During solar flares and magnetic storms, many people go to the emergency room. They noted that on such days there are more accidents on the roads and aggravated neuroses and other mental disorders.

Types of meteosensitivity in humans

It should be said that there are several types of meteosensitivity, which are accompanied by different symptoms and consequences.The first degree of the disease is meteosensitivity. It is characterized by a deterioration in the general condition of the body. The person may feel mildly unwell. The deterioration of the condition is not confirmed in any way by general analyzes. So it is simply not possible to determine what is with a person. The next degree of the disease is meteorological dependence. In this case, a person can observe a violation of the rhythm of the heart, even painful sensations are possible. Blood pressure will change. It can either go down or rise sharply.The person is in a state of anxiety. The last degree and the most severe is meteopathy. It, in turn, is divided into five more types of meteosensitivity.

Brain type. A person can describe such a state with meteosensitivity as follows: there is a noise in the head and ears, dizziness, headaches. This prevents them from working or studying normally. The state is simply unsettling.

Asthenoneurotic type. A change in blood pressure is noted in a person.Sleep disturbances and persistent irritability can be observed. He has increased excitability, which can lead to various disorders.

Undefined type. With this type, a person cannot accurately describe his condition. He feels bad, feels pain in the joints, malaise, absent-mindedness, a kind of weakness, muscle pain. His whole body can ache.

Reasons for meteosensitivity

Everyone is eager to know why some people are so sensitive to the weather.Man is a part of nature, we are closely connected with the external environment. Weather is not only clear or cloudy weather. We sense pressure, humidity, magnetic and electric fields. And all this affects our condition. What changes in nature at a given time affects our body. We feel it with every cell of the body. Meteosensitivity depends on the initial state of the body. The disease is noted most often in people who rarely visit the fresh air, lead a sedentary lifestyle and are engaged in mental work.Their microclimatic comfort zones are too narrow. With a sharp change in the weather, a person may feel scattered, and he is more inclined to various viruses (flu, tonsillitis, etc.)

Strong winds can cause overstimulation of the nervous system, while irritating skin receptors. In recent years, the study of weather conditions on the human body has received the name – syndromic metepatology. For some people, bad rainy weather leaves an imprint on their appearance.The face becomes pale and looks very tired.

Treatment and prevention of meteosensitivity

If a person has chronic diseases, then first of all, drug prophylaxis is required during unfavorable weather conditions.

It is recommended to take sun and air baths. Spend more time outdoors. This will help your body deal with the problem. It is worth doing physical therapy.

It should be noted that a healthy lifestyle will help get rid of meteosensitivity. It is necessary to strengthen your immunity and the protective functions of the body. Proper nutrition and exercise will play a big role in this situation. It helps with meteosensitivity walking, jogging, contrast shower, breathing exercises, cold wraps.

If you feel low blood pressure, then it is worth drinking multivitamins and preparing herbal infusions (lemongrass, eleutherococcus, etc.)or strong tea.

During bad weather, try to eat foods that contain iron, potassium, calcium, and ascorbic acid. Limit your salt intake.

It is worth noting that meteosensitivity cannot be completely eliminated, but its course can be facilitated.

Hypoglycemia – Dibikor

Blood sugar levels can fluctuate significantly during the day. A condition in which blood sugar drops below 3.5 mmol / L is called hypoglycemia .In some children, symptoms of hypoglycemia develop with a blood sugar of 4-4.5 mmol / L.

If the blood sugar level drops sharply from high numbers to quite normal, for example, from 20.0 mmol / L to 10.0 mmol / L, then symptoms of false hypoglycemia may occur.

Types of hypoglycemia:

  • Mild hypoglycemia – in this case, self-medication is possible and glucose levels are easily restored.
  • In the case of moderate hypoglycemia the body reacts with autonomous hypoglycemic symptoms and you can take the necessary action.Self-medication is possible.
  • There are asymptomatic hypoglycemia when the patient himself is not able to recognize that he has hypoglycemia.
  • Severe hypoglycemia – a situation where the symptoms of hypoglycemia render the patient incapacitated, when the help of other people is required in eating or administering glucagon. Severe hypoglycemia can cause unconsciousness or seizures.
  • Allocate another nocturnal hypoglycemia , which occurs during nocturnal sleep.Symptoms of nocturnal hypoglycemia can include nightmares, sweating (wet sheets), headache in the morning, fatigue upon waking.

The main symptoms of hypoglycemia on the part of the body:

  • Irritability;
  • Feeling hungry;
  • Trembling in the body;
  • Anxiety, feeling of fear;
  • Pale skin;
  • Cold sweat;
  • Rapid heartbeat.

The main symptoms of hypoglycemia from the brain:

  • Weakness, dizziness;
  • Double vision, blurred vision;
  • Headache;
  • Drowsiness;
  • Confusion of consciousness;
  • Blurred speech;
  • Hearing problems;
  • Convulsions.

In young children, hypoglycemia can manifest itself differently. Kids begin to be capricious for no reason or, conversely, become quiet, lethargic, can fall asleep at an unusual time for themselves. Often, instead of feeling hungry, the child stubbornly refuses food and even sweets. For any unusual behavior of a young child, blood sugar should be checked immediately.

What could have caused hypoglycemia:

  • Skipping, delaying or eating too little.
  • Unusually intense and / or prolonged physical activity.
  • Insulin dose too high.
  • New injection site (for example, instead of the thigh into the abdomen, or injection into a place free of fatty seals – lipohypertrophy).
  • Previous hypoglycemia:

– Depletion of glucose stores in the liver.

– Less predictive symptoms of hypoglycemia (asymptomatic hypoglycemia).

  • Drinking alcohol.
  • Diseases accompanied by vomiting and loose stools.
  • Introducing the wrong type of insulin (short insulin instead of extended insulin).

Practical advice:

  • You need to check your glycemic level. Feeling hypoglycemic does not necessarily mean that your blood sugar is actually low. If the symptoms are so severe that it is difficult to measure blood sugar, it is necessary to eat foods containing easily digestible carbohydrates as soon as possible. If blood sugar is high, taking excess glucose is acceptable, given the risk of severe hypoglycemia, unless it is eliminated immediately.
  • In case of confirmed hypoglycemia (blood glucose less than 3.5 mmol / l), it is necessary to eat foods containing easily digestible carbohydrates. If after 15-20 minutes the state of health has not improved, and the blood sugar level has not increased, you need to repeat the intake of easily digestible carbohydrates.

What products can be used to relieve hypoglycemia:

  • 1-3 glucose tablets.
  • 2-4 lumps of sugar.
  • 1 glass of fruit juice or sweet tea.
  • 1-2 teaspoons of honey.
  • 1 glass of regular sweet soda water.

Do not eat chocolate, cookies, waffles, ice cream, apples, sandwiches, drink milk or kefir. These products are absorbed into the blood for a long time, slowly increasing the sugar level, and cannot contribute to a quick exit from hypoglycemia.

A blood sugar level of 3.5-4.5 mmol / l gives you the right to choose what to do – eat some carbohydrates, postpone exercise, or change the next dose of insulin. In such a situation, any fruit will do.

In case of severe hypoglycemia: ineffectiveness of repeated oral intake of carbohydrates, loss of consciousness and / or the occurrence of seizures, an injection of glucagon is necessary. The injection is done subcutaneously or intramuscularly. Food or drink should never be given to an unconscious person, as it can enter the respiratory tract, leading then to suffocation or pneumonia.

90,000 Treatment of generalized anxiety disorders and panic disorders (with and without agarophobia) by family physicians

This patient guide is based on the Estonian guidelines “Treatment of generalized anxiety disorders and panic disorders (with and without agarophobia) by family doctors”, approved in 2014 by the Treatment Guidelines Council, and the topics covered there along with recommendations.The recommendations for the management were drawn up on the basis of an analysis of the evidence-based medicine literature, and taking into account the needs in Estonia and the health care possibilities, especially at the primary health care level. With early diagnosis of anxiety disorders at the primary care level and with adequate treatment, the health of the patient with excessive anxiety can be improved as well as the ability to cope with daily activities can be improved. A patient guide helps to cope with the illness, to understand the nature of the anxiety disorder, the different risk factors, gives recommendations on lifestyle and self-care that can help alleviate the illness, stimulates seeking medical help from a family doctor, explains the treatment of anxiety disorders, the effect of different groups of drugs, and psychotherapy; and the importance of ongoing treatment.The aim is also to ensure that the patient is informed about their diseases and, if possible, productive cooperation with the family doctor. These guidelines are good to use as material for individual advice and as a written source of information for both the patient and those close to him. The Patient Guidelines are written by practicing nurses who advise and treat patients with anxiety disorders every day. The guide was reviewed by psychiatrists and family physicians who participated in the development of the guide for health care professionals, as well as by patient representatives who made recommendations to this guide.

  • If, without any reason, you have severe, long-term symptoms of anxiety that are uncontrollable and interfere with daily activities, including communication with other people, you should contact your family doctor or nurse.
  • Read self-help advice for anxiety disorders, or ask your family doctor or nurse to explain the nature of the anxiety disorder, the factors that slow down or alleviate it, treatment options, the course of the illness, recovery options, flare-ups and self-help techniques.
  • In case of tension or anxiety, use self-help exercises.
  • Use self-help techniques and if they don’t work, talk to your doctor and try psychotherapy and / or medications. Both of these treatments are equally effective for treatment.
  • Cognitive Behavioral Therapy is the most widely used effective evidence-based therapy, which lasts 12-20 sessions and has fewer side effects compared to drugs.
  • If your doctor recommends treatment with antidepressants, then taking them is necessary for six months or a year, regardless of whether your condition has improved.
  • If you are prescribed sleeping pills in addition to antidepressants, use it for a short time (more than one month) to avoid dependence.
  • If you are prescribed a sedative (benzodiazepine) in addition to antidepressants to relieve severe anxiety, use it for a short time to avoid dependence (no more than six weeks from the moment you feel significant relief from your condition).

What is anxiety?

Anxiety is an integral part of modern life. In everyday life, situations often arise when the feeling of anxiety is justified. It would be abnormal if the person did not feel anxious about any situation that could actually be dangerous or could fail (such as an exam).

From an evolutionary point of view, anxiety has an important role to play – to get a person to pull himself together in order to prepare for escape.This helped to stay alive, since all not the most ongoing processes stopped, and attention was concentrated around finding a way out of a dangerous situation. The body was activated to escape, freeze and prepare for the fight. All people can feel anxiety as a reaction to stress. In some periods of life, situations or places, anxiety is felt on a different scale. For example, a little anxiety before an exam, sports competition, a trip, or a birthday is more or less familiar to everyone.

Feelings of anxiety can be manifested by different sensations – for example, tingling in the abdomen, a feeling of tension in some parts of the body or head, nausea, increased heart rate, restless thoughts, fear of losing control, fear of death. Anxiety turns into anxiety disorder when it begins to disrupt everyday life. Anxiety disorder differs from ordinary, normal anxiety in that the accompanying feeling of anxiety is very strong or lasts longer than (several months, does not decrease after the stressful situation has passed) and can lead to phobias that disrupt a person’s life.For example, a person is unable to fall asleep normally due to disturbed thoughts or begins to completely avoid normal situations (going to school or work, eating) that make him feel anxious. A person begins to assess the situation as dangerous when it is not such (for example, for another person).

The main symptoms of anxiety disorder are:

  • Mental symptoms: strong, unreasonable fear of a situation or object.
  • Physical symptoms: rapid breathing or heartbeat, increased blood pressure, shivering or jerking, sweating, choking, nausea, abdominal discomfort, dizziness, numbness, hot flashes.
  • Fear of death, fear of losing control of a situation or loss of mind, disorder of the sense of reality or a sense of detachment.

Figure 1. Most common physical symptoms

What is panic disorder?

A panic attack is characterized by sudden attacks of fear, which are often accompanied by a rapid heartbeat, sweating, weakness, impotence, fainting, dizziness, and increased blood pressure.During a panic attack, a person may feel hot flashes or flushes, and they may feel itching, burning, or numbness in their hands. Also, a person may feel nausea, chest pain, and suffocate. One of the signs of panic disorder is fear of unexplained physical symptoms. A panic attack can often manifest itself as a feeling of unreality, fear of death, or fear of losing control. Often times, people experiencing a panic attack believe that they may suffer a heart attack, loss of mind, or it will put them in a state between life and death.They are not able to predict where and when a panic attack may start, in between them they are very worried and are afraid of the onset of a new attack. A panic attack can occur at any time, even during sleep. The attack reaches its peak within 10 minutes, but some symptoms may last longer.

A panic attack can be an unpleasant experience, but it is not life threatening.

Panic attacks most often begin at the border of adolescence and early adulthood.Not all people experiencing panic attacks develop panic disorder. Many have a single seizure that never recurs. The tendency for the appearance / development of panic attacks is associated with heredity. Repeated panic attacks can render people incapacitated and must find the right treatment before they start avoiding the place and situation where they once had a panic attack. For example, if the panic attack was in an elevator, some people with panic disorder may develop a fear of elevators.This can affect the choice of work or place of residence and limit his opportunities for entertainment. Fear of elevators can also limit how you can access health care if you need to use an elevator en route to where you can get help.

Some people may become so limited in their lives that they begin to avoid normal activities such as grocery shopping or driving. About a third of these people become domestic recluses or may only come into contact with unwanted frightening situations when they are accompanied by a spouse or other confidants.If the condition develops this far, then this condition is called agoraphobia or fear of public places.

Panic disorder is a disease that can be successfully treated.

What is agoraphobia?

The word agoraphobia comes from the Greek language and means fear of openness or squares. In psychology, the main character of agoraphobia is the fear of panic attacks (Bourne 2007: 26). A person with agoraphobia fears (and avoids) situations where exit may be difficult or in the event of a panic attack it is impossible to get help. Agoraphobia is the most common of the anxiety disorders (about 5% of the population). Agoraphobia affects people from all social strata and spheres of life (mostly women). The most common places where agoraphobia occurs are:

  • Crowded places, e.g. grocery stores, shopping malls, restaurants
  • Enclosed or restricted areas, e.g. bridges, tunnels
  • Public transport (bus, train, plane) • Being at home alone
  • Leaving home alone

It is important to note that people are afraid of these places not because of their signs, but because they are places where, in the event of a panic attack, it is difficult to exit or it can create an embarrassing situation.A person with agoraphobia is not only afraid of having a panic attack, but may be afraid of what other people will think when they see their panic attack.

The most common sign of agoraphobia is fear that there is no quick way out of a situation that creates an attack, as well as fear of parting with home or a trusted trusted person (spouse, roommate, parent). In the most severe cases, a person cannot move further than a meter from the house by himself or cannot leave the house at all.A person with agoraphobia is in anxiety most of the time: he is afraid not only of possible dangerous situations, but the very knowledge that he may get into such a situation. Often agoraphobia in such people is accompanied by depression, since he feels that he does not control the situation and is not able to change it in any way.

What is generalized or generalized anxiety disorder?

Generalized anxiety disorder is characterized by persistent , chronic anxiety, restlessness and tension.It usually lasts six months, but it is not accompanied by panic attacks, phobias, or obsessive thoughts. Anxiety and anxiety usually focus on several circumstances (for example, financial situation, relationships, academic / work success, etc.). It is inherent in the disorder that a person has many reasons for anxiety, he spends most of his time in anxiety and cannot take control of the situation. The scale of the experience is usually greater than the real likelihood that the anticipated events might actually happen.After constant anxiety, other additional symptoms generally appear. For example, restlessness, easy fatigue, inability to concentrate, muscle tension, sleep disorders, irritability. Generalized anxiety disorder can occur at any age and the exact cause is unknown. Most likely, its occurrence is influenced by heredity and experiences transferred in childhood (too high expectations, rejection, rejection by the parents), contributing to the onset of anxiety disorder.

If you notice a change in your mental state to such an extent that it interferes with your daily life or your loved ones have noticed it, you should contact your family doctor or nurse. If you are uncomfortable walking alone, you can take a loved one with you. The family doctor has the knowledge and ability to initiate appropriate treatment for anxiety disorder. Contact your family doctor if:

  • Anxiety symptoms last too long, for example, they persist even when the stressful situation is already in the past.
  • the symptoms of anxiety are too strong for you to be controlled.
  • along with anxiety, physical symptoms (for example, complaints of heart problems) arise, and it is necessary to monitor your overall health.
  • alarm occurs for no particular reason.
  • All of the above began to interfere with your daily life, work, hobbies and relationship problems.
  • You want to seek help from a psychologist or psychiatrist, but do not know where, how and to whom to contact.

Clinical interviews or questionnaires are used to diagnose anxiety disorders. Various questionnaires (for example, the Emotional Well-Being Questionnaire) can be used to help clarify the different degrees of disorders.

Self-Assessment Questionnaire Anxiety

The use of an anxiety self-assessment questionnaire in the diagnosis of anxiety disorders can be of assistance to the family doctor for the initial detection of the disease.Most often, the questionnaire is completed by the patients themselves. Such questionnaires are suitable for use in patients who have subjective complaints (mood disorders, anxiety disorders). In most cases, it is easy for the patients to fill them in and it does not take much time. In addition, the questionnaire is filled out several times, after certain periods of time (for example, once a week, or once every two weeks, once a month), this makes it possible to get an overview of the change in your condition. A simple example of using a questionnaire is the Emotional Well-Being Questionnaire.An Anxiety Self-Assessment Questionnaire can be found in Appendix 1 of this Patient Guide.

Treatment for anxiety disorders begins with talking to your family doctor or nurse. During the conversation, the nature of anxiety disorders and the factors that exacerbate and alleviate the disease are clarified. Also, methods of self-help are recommended, information is given about the possibilities of treatment and recovery, the course of the disease and signs of exacerbation.

Anxiety Disorder Treatment Options

Self-help for patients Psychotherapy Medicines
In the case of self-help, you are introduced to written or electronic self-help materials.You can work on them both independently and under the guidance of a specialist (doctor, nurse, psychologist). Self-help resources provide information on anxiety disorders and self-help techniques from which you can choose the one that suits you best. Psychotherapy is a treatment that uses psychological therapies to help create the changes in your thoughts, feelings, and behaviors that are necessary for recovery. For anxiety disorders, cognitive behavioral therapy is considered an effective form of psychotherapy. Antidepressants are used in the treatment of anxiety disorders and sedatives and / or hypnotics are added to the regimen as needed.

Treatment goals

In the case of panic disorder, the main goal of treatment is to reduce the incidence and severity of panic attacks. In the case of agoraphobia, it is important to reduce the tendency to avoid places and situations that stimulate the development of severe anxiety.For generalized anxiety disorders, treatment can help reduce anxiety and feelings of tension.

Choice of treatment methods

During a discussion with your doctor, you should find out the most suitable treatment for you. The choice is influenced by the severity of your condition, the appropriate treatment proposed, and your preferences and options. It is advisable to use self-help techniques immediately after starting treatment. If they don’t work and your anxiety symptoms persist, your doctor may advise you to use either psychotherapy or medications that are equally effective treatments.If each of the methods of treatment separately did not give results, they can be combined.

Tolerability of treatment

Good cooperation between the doctor and the patient is a prerequisite for successful treatment Trust is the basis for this – The patient should not be afraid to tell the doctor about the symptoms of the disorder and, if necessary, other problems in his life. For good treatment results, it is important that you are motivated to receive treatment and agree to follow the treatment plan prescribed by your doctor .It will be easier to agree to treatment if you know about the nature of the disorder, the methods of treatment, the duration of the course of treatment, the treating effects and side effects of your prescribed medications, and the possible risks of addiction. Awareness of the positive results that you will receive from treatment will help motivation. Because treatment for anxiety disorders can sometimes take a long time, patience and continuity of treatment are essential.

Problems with treatment tolerance

Side effects of drugs. If, while taking medication, you begin to feel strong side effects, do not interrupt the treatment on your own, but be sure to inform your doctor about this, who will find ways to continue the treatment or change it. Continuity of medication. If the symptoms of the disorder begin to disappear quickly with the use of drugs, the patient may want to prematurely interrupt the course of treatment. But after that, the symptoms of the disorder return again. Problems can also arise when the prescribed drugs remain unbought, if you take them in more or less than it was prescribed, or if you take them irregularly.You need to inform your doctor about all this and on the basis of this data the doctor will be able to evaluate the results of treatment, your consent to treatment and the side effects of the medication during each visit.

Do not interrupt the started treatment yourself, be sure to inform your doctor about the side effects.

Doctor visits

Your doctor will be able to schedule appointments for you with an interval of one week to four weeks until your condition improves.In most cases, initial improvement occurs four to eight weeks after starting treatment. Further visits to the doctor may be less frequent, depending on the severity of the condition.

Knowing the physical and mental symptoms of anxiety will help you better deal with it. In case of anxiety, unfortunately, they often underestimate their capabilities and overestimate the possible danger. Self-help techniques are techniques that can help you cope with physical and mental symptoms and effectively solve your problems.All the self-help exercises in this manual can always be used when tension and anxiety arise.

  • Eat regularly and balanced
  • Reduce your intake of excess caffeine. Caffeine is found in coffee, tea, and energy drinks. Caffeine primarily affects the physical symptoms of anxiety (such as increased heart rate), which can lead to increased anxiety and panic attacks.
  • Avoid excessive alcohol consumption.
  • Smoking is recommended to quit.
  • Be physically active. Physical activity can help relieve stress and tension. Find a suitable type of aerobic activity (for example, walking, swimming, cycling, hiking, soccer, aerobics, jogging in the forest). Moderate physical activity should be at least 2.5 hours per week.
  • Take time to do what you love and pause from time to time in your daily work.

Cognitive Behavioral Therapy is the most commonly used treatment for anxiety disorders and has been scientifically proven to be effective.Cognitive Behavioral Therapy is delivered by qualified clinical psychologists and psychiatrists.
The core of cognitive therapy is the idea that thoughts have an important influence on our feelings and behavior. The events themselves have little effect on well-being, more important is what you notice during the events, what you think about them and how important you think they are. The therapist will help you recognize and understand thoughts and ideas that can be analyzed to help you.These thoughts and ideas influence how you feel – for example, make you feel anxious. The goal of treatment is to shift your thoughts into a realistic and helpful area. You will also learn during your treatment to find and change persistent thought patterns or beliefs that bring you back to anxious thoughts over and over again. For example, in the case of a panic attack, cognitive therapy helps identify the thoughts that precede the onset of a panic attack, and helps to change beliefs about the danger of physical symptoms, and how to respond to these symptoms.Behavioral therapy helps change the hitherto persistent patterns of behavior that support anxiety disorders. For example, if you are afraid to be in public places and avoid them, it starts to disrupt your daily life. With therapy, you will learn not to adhere to avoidance tactics in the face of fearful situations. Anxiety may build up at first during therapy, but the therapist will teach you how to control your anxiety using breathing and relaxation techniques.

Cognitive Behavioral Therapy is a combination of both cognitive and behavioral therapy.

What happens during the course of cognitive behavioral therapy and how long does it last?

In the first session, the therapist tries with you to find a common understanding of the problem. With the help of a therapist, you will learn to see how your thoughts, beliefs, feelings, attitudes and behavior affect your daily life. You are given information about the nature of the disorder and trained to recognize the symptoms and what kind of anxiety is normal.

After that, a treatment plan and goals that you want to achieve during treatment, as well as the number of sessions required, are discussed with you. Each session lasts 50-60 minutes. Usually, therapy is carried out once a week, especially at the beginning of treatment, and less often by the end of the course of treatment. Most often, therapy lasts 12-20 sessions.

Remember that you are expected to actively participate in therapy. This means that you will be given homework assignments between sessions. For example, the therapist may ask you to fill out a diary about your thoughts during situations in which you feel anxious so that they can be analyzed later.

During therapy, you will be taught practical skills to help you keep your anxiety under control. These techniques include breathing and relaxation exercises.

Cognitive behavioral therapy is used both individually and in a group. Group therapy is also conducted under the guidance of a suitably qualified person to identify the nature of the anxiety and teach how to deal with it.

Benefits of Cognitive Behavioral Therapy

  • An advantage of using cognitive-behavioral therapy over drugs is that there is less risk of side effects.
  • Therapy is practical by its type, with it focusing on the current problems that exist today and on the factors that support them.
  • The therapy can have a long-term positive effect, as the skills learned can be used later in life. Therefore, it is important that you use them after your well-being has improved – they will help you to cope with the normal feeling of anxiety, control the symptoms of anxiety and prevent their excessive expansion.It will also help reduce the likelihood that anxiety will return to its original level in the future.
  • Questions about therapy can be addressed to your family doctor
More information on cognitive behavioral therapy can be found here: Estonian Association for Cognitive Behavioral Therapy (www.ekka.ee) Peaasjad MTÜ (http://peaasi.ee/ru)

Antidepressants are mainly used in the treatment of anxiety disorders, and sedatives and / or hypnotics are also used when necessary.


In general, treatment begins with antidepressants. Antidepressants are medications used to treat depression, but they are also used successfully to treat anxiety disorders.

The brain consists of many nerve cells that exchange information. This exchange of information in the brain occurs with the help of chemicals, including special messenger substances. For anxiety disorders, antidepressants are used that affect serotonin and norepinephrine levels.It has been found that messenger substances are involved in anxiety, fear and stress.

Selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SSRIs)

These antidepressants are usually prescribed by a doctor first, that is, they are the drugs of first choice. All antidepressants used were found to be more or less equally effective. Therefore, when choosing a medicine, first of all, the doctor makes a choice, taking into account the number of side effects and its price.The drug does not appear immediately, in most cases within four to eight weeks after starting treatment. Side effects can occur after the first dose of the medication, so treatment is usually started with doses less than the usual amount of medication required for treatment. The doctor increases the dose of the medicine gradually according to how you tolerate the medicine.

The group of SSRIs includes citalopram, etsitalopram, paroxetine, sertalin. The SSRIs group includes duloxetine and venlafaxine.

Antidepressants are not addictive. The duration of the course of treatment depends on your condition and, in addition, the frequency of side effects and withdrawal symptoms is very individual.

Most common side effects Duration of treatment End of treatment, possible withdrawal symptoms
• Nausea
• Headache
If during the course of treatment you feel a significant improvement in your well-being, then the medication should be continued for a period of six months to a year.Treatment too short increases the risk that the disorder may return. Because anxiety disorders can recur throughout life, a new course of treatment may be needed. At the end of the course of treatment, the doctor gradually reduces the dose of the medication, as withdrawal symptoms (nausea, headache, dizziness, anxiety) may occur. In most cases, these side effects are mild and go away on their own. With a sudden interruption of medication, the incidence of side effects increases.

Tips for antidepressant treatment:

  • Take your medicine every day, at the exact prescribed dose and at the same time.
  • If you forget to take your medication, do so as soon as possible, but do not take a double dose.
  • If you feel any side effects of the medication, do not interrupt the treatment yourself. Some side effects disappear within a few days. If the side effects become more severe, contact your doctor.
  • Alcohol should not be taken during antidepressant treatment. This can contribute to the appearance of side effects.

Sedatives or benzodiazepines

Anxiety drugs belong to a group of drugs that reduce feelings of fear and anxiety. Medicines used to treat anxiety disorders are called benzodiazepines. In the brain, they potentiate the action of gamma-aminobutyric acid (GABA). GABA has an inhibitory effect on brain cells and therefore has a sedative effect.The sedatives include diazepam, alprazolam, lorazepam, oxazepam, bromazepam. In addition to its calming effects, sedatives relax the muscles, thus helping to reduce physical stress.

Unlike antidepressants, sedatives act faster. The incidence of possible side effects, dependence and withdrawal symptoms can be very individual.

Most common side effects Duration of treatment End of treatment, possible withdrawal symptoms
• Clouding of consciousness
• Feeling weak
• Long-term use may lead to tolerance or dependence (see pages 20 – 21).
i • Feeling weak • Long term use may cause tolerance or dependence (see pages 20 – 21). During an exacerbation (severe anxiety and anxiety), sedatives should be used for a short time (no more than a period of four to six weeks), unless the doctor has prescribed otherwise. The doctor may prescribe you a sedative even when you start antidepressant treatment, but the feeling of anxiety still seems too strong and difficult for you to bear.In this case, taking sedatives should continue no longer than six weeks after you feel significant relief in your well-being. You should stop taking sedatives by gradually reducing the dose to reduce the likelihood and severity of withdrawal symptoms. The dose reduction scheme must be prescribed by a doctor. Possible withdrawal symptoms (headache, muscle pain, anxiety, feeling of tension) usually occur within 48 hours after the dose is reduced or the drug is stopped.They can be mild and go away on their own, but they can cause more severe conditions, depending on how much and how long the medication is taken.

Sleeping medicines

Anxiety disorders are often accompanied by insomnia. The treatment of insomnia must first of all be psychological. If this method does not help relieve the symptoms of insomnia, your doctor may prescribe sleeping pills for a short time. Zopiclone and zolpidem are used as sleeping pills.These medications are similar to sedatives, which also affect the activity of the gamma-aminobutyric acid system in the brain. Sleeping medications have sedative and hypnotic effects. They speed up falling asleep and prolong sleep. The effect usually appears within 15-20 minutes after taking the medication. It is advisable to take medications immediately before bedtime and you need to ensure yourself the opportunity for restful sleep for the next 7-8 hours. Possible side effects and withdrawal symptoms are individual.

Most common side effects Duration of treatment End of treatment, possible withdrawal symptoms
• Bitter feeling in the mouth • Blurred consciousness the day after ingestion • Long-term use results in tolerance or dependence (see pages 20-21).

Sleeping pills are not recommended for longer than four weeks.

With a sharp interruption in the course of treatment, withdrawal symptoms (insomnia, headache, muscle pain, anxiety, feeling of tension) may appear. For this reason, taking sleeping pills should be stopped gradually according to the schedule prescribed by the doctor.

Long-term use of sleeping pills can lead to problems with drug abuse and dependence, since such drugs very quickly relieve anxiety and insomnia and restore well-being.There is no dependence when using antidepressants (see pages 17 – 18).


Abuse refers to the use of drugs when it begins to harm health, but despite this, a person continues to take these drugs. The harm to health can be both physical (for example, liver damage) and mental (for example, mood disorders). This happens when the medicine has been taken for at least a month or there have been repeated courses for 12 months.


With repeated use, the drugs have less effect on the body than at the beginning of the course of treatment. Tolerance or a condition arises when the body gets used to and adapts to the drug. The body gets used to the use of sedatives and sleeping pills very quickly.

The joint use of sedatives with alcohol and other addictive substances contributes to the development of tolerance. If a person has previously abused alcohol, he may develop a tolerance for sedatives.A person who misuses alcohol needs large doses of sedatives to achieve the same effect as someone who has no alcohol problem.

The most important sign of addiction is a strong desire or urge to use the drug. Taking medicine becomes the most important thing in life, all other things remain secondary. Such a person can no longer control when he starts and stops taking the medicine and in what volumes he takes it. Tolerance to medication is also growing – in order to achieve the same effect, the dose must be constantly increased.Although the user of the medication may be aware of their addiction, they continue to take the medication regardless of health problems, communication and social problems.

Addiction affects both the body and the psyche

Psychological dependence means a state when the drug user becomes obligatory for the drug user, and he cannot imagine his life without it.

Physical dependence is manifested by withdrawal symptoms (eg, headache, muscle pain, anxiety, feeling of tension) when the drug is stopped.This means that the body is accustomed to taking the medicine, and in the absence of it must get used to the new conditions.

Therefore, it is important that you monitor your condition during the course of treatment, and be sure to adhere to the medication prescribed by your doctor.

Information on all prescriptions issued and purchased by you can be checked in the prescription center, the state portal www.eesti.ee → Services → For a citizen → Health and healthcare → Prescriptions.

Alcohol and anxiety disorders

Alcohol and anxiety disorders have different points of contact.Statistics show that anxiety disorders are most likely to occur in alcohol abusers and vice versa. Alcohol dependence is about 2-3 times more common in people with anxiety disorders than in the general population. Alcohol abuse is also higher than the average (Kushner, et al. 2011). Johnston et al (1999), based on various studies, state that people with anxiety disorders make up a significant proportion of the total number of people suffering from alcoholism.It is not known exactly which of these problems (anxiety disorders or alcoholism) appears first and why, but one thing is for sure that several types of disorders are present at the same time (that is, they are comorbid) or originate from each other. Comorbid anxiety disorder was present in 22–69% of alcoholic patients (Roberts 1999).

In stressful situations, people often turn to alcohol, although in fact alcohol is considered a poor aid in recuperation, as well as in getting rid of anxiety.About one fifth of patients with anxiety disorders report using alcohol to relieve anxiety. In addition, alcohol abuse impairs the ability to perform daily activities, including the ability to use other methods to correct the situation.

Does alcohol abuse cause anxiety?

  • Based on data from various studies (Johnston et al. 1991; Kushner et al. 2011), this question can be answered with confidence in the affirmative.In most cases, this is due to withdrawal symptoms. There are several reasons for this.
  • Alcohol withdrawal symptoms or fear of them already lead to anxiety in advance.
  • Physical stress: Feeling unwell leads to mental imbalance and associated anxiety.
  • The work of the nervous system: if the human brain is used to alcohol, then a sharp interruption of its intake changes the work of the brain (the balance of chemical compounds), the brain is under stress and this leads to increased anxiety.

What happens if you use alcohol to recuperate?

With regard to alcohol and anxiety, one thing is certain: using alcohol to reduce anxiety does not really solve your problem. Using alcohol to control anxiety is the best example of a solution to avoid. Typically, the cycle begins with the first glass and continues in a vicious circle: in the beginning, the use of alcohol reduces the manifestations of symptoms, but when alcohol disappears from the body, a person can find solutions how to deal with anxiety now.As a result, the person returns to alcohol again. Finding: People with anxiety disorders often have problems with alcohol or drug abuse and thus increase their risk of worsening the anxiety disorder.

Marijuana use and anxiety disorders

Although considered a sedative and anxiety-reducing drug among marijuana proponents, its use still carries the risk of anxiety and panic attacks.The endogenous (human-derived) cannabinoids in the amygdala (the nucleus in the brain that governs emotion) do indeed control anxiety and escape responses, and controlled cannabinoid intake could theoretically help slow the development of anxiety. However, chronic and heavy use leads to overreacting of cannabinoid receptors and triggering the opposite response: increased anxiety and panic attack, and in some cases, addiction (Ramikie et al.2014). Although marijuana does not appear to be physically addictive, tolerance (need for dose escalation) can still develop and a stress response similar to alcohol withdrawal can occur when the drug is discontinued (Ahtee 2000). Patients with pre-existing anxiety disorder are particularly at risk of experiencing increased anxiety or panic attacks while using marijuana (Szuster et al. 1988).

After smoking marijuana, the first effect appears after seven to eight minutes, the sensations reach their peak in about 30 minutes and last from two to three hours.In the first stage, a person most often becomes talkative, active and cheerful. Physical symptoms include reddening of the whites of the eyes, dry mouth and when swallowing, dizziness, coughing, and increased sensitivity of the eyes to light. The individual response varies according to the volume of consumption. A person under the influence of marijuana after 1.5-3 hours may seem withdrawn, but there are many images and associations, different senses are exacerbated: the colors seem brighter, the smells are more intense, they pay more attention to details.

Long-term use of marijuana leads to mental changes and behavioral disorders: learning ability decreases, short-term memory is weakened, associations become impractical, and the ability to assess the situation is weakened. Disorders in assessing time, place and distance arise, reaction time increases and coordination deteriorates. Abundant use leads to personality changes, passivity, apathy. Reception in large doses can cause anxiety and hallucinations, in the worst cases and panic attacks.One third of regular marijuana users develop irritability and feelings of fear and depression (Fabritius et al. 2000).

Due to the lack of evidence, it is difficult to argue that marijuana has a therapeutic effect for people suffering from anxiety, since the response to it is very individual. By no means is the use of marijuana a solution to health problems associated with profound mental problems that can be effectively treated with behavioral therapy (Bushak 2014).

Used literature

Ahtee, L. (2000). Opioidid ja kannabinoidid. Kogumikus: Salaspuro, M., Kiianmaa, K.,

Seppä, K. (Toim) Narkoloogia. (lk 132-154). Tallinn: Medicina.
Alcocholrehab.com (2008–2015). Alcochol induced anxiety. Alcohol Withdrawal Causes Severe Anxiety Symptoms.
Barlow, D. H., Craske, M. G. (2007) Mastery of Your Anxiety and Panic. Workbook. Oxford University Press.
Bourne, E.J. (2011). The Anxiety & Phobia Workbook 5th ed.New Harbinger Publications.
Bushak, L. (2014). How Marijuana Relieves (Or Exacerbates) Anxiety. (2009–2014).
Craske, M. G., Barlow, D. H. (2007) Mastery of Your Anxiety and Panic. Therapist Guide. Oxford University Press.
Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (1994). Washington D.C .: American Psychiatric Association.
Fabritius, C., Salaspuro, M. (2000). Kanep mõnuainena. Kogumikus: Salaspuro, M.,
Kiianmaa, K., Seppä, K. (Toim) Narkoloogia.(lk 419-422). Tallinn: Medicina.
Generaliseerunud ärevushäire ja paanikahäire käsitlus perearstiabis, RJ-F / 2.1–2014. Ravijuhendite nõukoda. 2014.
Harro, J. (2006). Uimastite ajastu. Tartu: Tartu Ülikooli Kirjastus.
Hawton, K., Salkovskis, P. M., Kirk, J., Clark, O. M. (1993) Psühhiaatriliste probleemide kognitiivne käitumisravi. Praktiline käsiraamat. Fontes PMP.
Johnston, A.L., Thevos, A.K., Randall, C.L., Anton, R.F. (1991). Increased severity of alcohol withdrawal in in-patient alcoholics with a co-existing anxiety diagnosis.British journal of addiction 86.6: 719-725.
Kiianmaa, K. (2000). Alkohol. Kogumikus: Salaspuro, M., Kiianmaa, K., Seppä, K. (Toim) Narkoloogia. (lk 102-113). Tallinn: Medicina.
Kushner, M. G., Specker, S. M., Maurer, E. (2011). Substance Use Disorders in Patients With Anxiety Disorders.
Lönnqvist, J., Heikkinen, M., Henriksson, M., Marttunen, M., Partonen, T. (2006). Psühhiaatria. Kirjastus Medicina. Meditsiinisõnastik. (2004). 2., uuendatud trükk. Kirjastus Medicina.
National Institute of Mental Health (2014a).What is Generalized Anxiety Disorder?
National Institute of Mental Health (2014b). Introduction.
NHS (2014). Panic Disorder – Symptoms.
Pippo, S., Salo, U. (2007). Meelte ja tunnete taimed. Tallinn: Varrak.
Ramikie, T.S., Nyilas, R., Bluett, R.J., Gamble-George, J.C., Hartley, N.D., Mackie, K., Watanabe, M., Katona, I., Patel, S. (2014). Multiple Mechanistically Distinct Modes of Endocannabinoid Mobilization at Central Amygdala Glutamatergic Synapses. Neuron, 2014; 81 (5): 1111.
Psüühika- ja käitumishäirete klassifikatsioon RHK-10. Kliinilised kirjeldused ja diagnostilized juhised. (1995) Tartu Ülikool.
Salaspuro, M., Kiianmaa, K., Seppä, K. (2000). Narkoloogia. Kirjastus Medicina.
Stein, D.J. (2004). Clinical Manual of Anxiety Disorders. American Psychiatric Press.
Szuster, R.R., Pontius, E.B., Campos, P.E. (1988) Marijuana sensitivity and panic anxiety. Journal of Clinical Psyhiatry, 49 (11): 427-429.
Stahl, S. M. (2011) Stahl’s Essential Psychopharmacology.The Prescriber’s Guide. 4th ed. Cambridge University Press.
Stahl, S. M. (2013) Stahl’s Essential Psyhcopharmacology Online. 4th ed. (07.02.2016)
Williams, M., Penman, D. (2013). Ärksus. Tee rahuni pöörases maailmas. Tallinn: Pegasus.

Further reading

Selection of literature for self-help for patients

E. J. Bourne (2007) “Ärevushäirete ja foobiate käsiraamat”
M. Davis, E. Robbins Eshelman, M. McKay (2008) Lõõgastumise ja stressist
vabanemise käsiraamat “
A.Ellis (2000) “Kuidas saada jagu oma ärevusest”
D. Greenberger, C. A. Padesky (2007) “Mõistus juhib tundeid”
M. Williams, D. Penman (2013) Ärksus. Tee rahuni pöörases maailmas. “

Thematic web pages

Estonian Association for Cognitive and Behavioral Therapy

MTÜ Peaasjad

The patient can complete this questionnaire on his own at home, at a visit to the family doctor or nurse, it can be completed again (for example, once a month, after two weeks, etc.).etc.). When filling out, you need to circle the option that best describes HOW THIS PROBLEM HAS BEEN CONCERNING YOU DURING THE LAST MONTHS. The sum of the received points in the test must be analyzed together with the family doctor or nurse, if in response you several times noted “sometimes”, “often” or “constantly”.

Never Rarely Sometimes Often Permanent
1. Sad mood 1 2 3 4 5
2. Loss of interests 1 2 3 4 5
3. Inferiority complex 1 2 3 4 5
4. Blaming yourself 1 2 3 4 5
5. Recurring thoughts of death and suicide 1 2 3 4 5
6. Feelings of loneliness 1 2 3 4 5
7. Feeling hopeless about the future 1 2 3 4 5
8. Inability to feel joy 1 2 3 4 5
9. Rapid irritation and resentment 1 2 3 4 5
10. Feeling anxious or helpless 1 2 3 4 5
11. Feeling tense and unable to relax 1 2 3 4 5
12. Excessive experiences for various reasons 1 2 3 4 5
13. Anxiety or impatience, but it is difficult to sit still 1 2 3 4 5
14. You get scared easily 1 2 3 4 5
15. Sudden panic attacks, which are accompanied by a rapid heartbeat, shortness of breath, a sense of loss of consciousness and other similar physical manifestations 1 2 3 4 5
16. Fear of being alone away from home 1 2 3 4 5
17. Feelings of fear in public and on the street 1 2 3 4 5
18. Fear of loss of consciousness in a crowd of people 1 2 3 4 5
19. Fear of traveling by bus, tram, train or car 1 2 3 4 5
20. Fear of being in the spotlight 1 2 3 4 5
21. Fear of communication with strangers 1 2 3 4 5
22. Feeling sluggish and tired 1 2 3 4 5
23. Impaired attention and ability to concentrate 1 2 3 4 5
24. Rest does not help to restore strength 1 2 3 4 5
25. You get tired quickly 1 2 3 4 5
26. Trouble falling asleep 1 2 3 4 5
27. Restless and intermittent sleep 1 2 3 4 5
28. Waking up from sleep too early 1 2 3 4 5

Breathing control

When inhaled, two types of muscles are used: the connective muscles (or diaphragm) and the external intercostal muscles. If inhalation uses more intercostal muscles, then this breathing is called chest breathing. At the same time, as air enters the lungs, the chest expands and the shoulders rise.Chest breathing is often shallow, irregular, and rapid, and accompanies feelings of anxiety and stress responses.

If a diaphragm is used for inhalation, then this is called diaphragm breathing or abdominal breathing, since the stomach is mainly involved in breathing. Abdominal breathing is deeper and slower than chest breathing and therefore more rhythmic and relaxing.

Abdominal breathing

Controlling your breathing and slowing it down soothes both your mind and body.For this, the use of abdominal breathing is recommended.

You need to lie on your back and put one hand on your stomach, the other on your chest. Watch your breathing.

Exercise using meditation

  1. Use abdominal breathing. Inhaling, say to yourself mentally “one” and exhaling – “relax.”
  2. During the next inhalation, say to yourself mentally “two” and exhaling – “relax.”
  3. Repeat counting in this way with an inhalation to “ten” and then begin to return to “one”.
  4. Focus only on breath and words. It may not be easy and it is normal for you to start thinking about something else. Do not worry about this, but turn your attention back to breathing, numbers and words.

Exercise twice a day for about ten minutes (Barlow jt 2007).

About 10-14 cycles of inhalation-exhalation per minute will help you return to your natural rhythm of breathing. Exercise at first in a calm state so that later you can use this exercise in a situation that contributes to the occurrence of stress and anxiety.In the case of panic disorder, the purpose of the above exercise is to regulate your breathing, and in addition, you learn to accept and tolerate the symptoms of anxiety. This, in turn, will help you to alleviate cases of increased anxiety (Craske jt 2007).

Gradual muscle relaxation

Gradual muscle relaxation relies on the body responding to anxiety-stimulating thoughts and events by increasing muscle tension. This, in turn, can worsen anxiety and other related symptoms.It is impossible to be both energized and physically relaxed at the same time. Muscle tension and relaxation will help to recognize two different states – tension and relaxation. Relaxation helps to release both physical tension and relieve arousal.

  1. Find a quiet place and time for the exercise.
  2. Leave all your problems aside and feel comfortable. Relax your muscles.
  3. The exercises can be done while sitting, for example in a comfortable chair.
  4. Use abdominal breathing.

Tighten and relax the muscles described below. In each muscle group, tense the muscles for about 5 seconds and then relax them for about 10-15 seconds. Focus on reducing stress.

Hands. Make a fist with your right hand, feel the tension in the fist and in the forearm. Make a fist with your left hand, feel the tension in the fist and in the forearm.

Forearm. Bend your forearm at the elbow and contract the biceps muscle of the shoulder while keeping the hand relaxed.Straighten your forearms outward and contract the triceps muscle of the shoulder, resting your forearms on a chair, keeping your hands relaxed.

Face . Raise your eyebrows and furrow your forehead. Bring your eyebrows closer to each other (as if frowning). Squinting your eyes by contracting the muscles around your eyes. Clench your teeth and tighten your chin muscles. Without opening your lips, press your tongue firmly and firmly against the upper palate, pay attention to the tension in the abdomen. Press your lips together tightly, as if “pouting” when offended.

Neck. Tilt your head back as much as possible, and press with maximum force against the back of the chair. Place your chin against your chest.

Shoulders. Raise your shoulders to your ears, make circles with your shoulders.

Chest. Breathe with your abdominal muscles in a normal and regular rhythm. Inhale deeply so that the lungs fill completely, hold your breath for a couple of seconds and then exhale passively.

Belly. Tighten your abdominal muscles.Pull in your stomach.

Back. Fold the bottom out away from the chair.

Buttocks and legs. Place your heels on the floor, keep your legs straight and tighten your glutes and calves. Raise the soles of your feet and toes and contract the front calf muscles. Breathe with your abdominal muscles in a normal and regular rhythm (Hawton jt 1993).

It is recommended to train relaxation first in a normal calm state and every day. Exercise twice a day for about 15-20 minutes.If during the day you find that a muscle is tense, try relaxing it (Hawton jt 1993).

Exercise is also recommended when you feel tension or anxiety during the day.

Alertness or Alertness

Mindfulness exercise can be used to deal with anxiety and tension. Mindfulness means being able to understand your thoughts, feelings, physical sensations, and your environment.At the same time, they put themselves in the position of an observer, without assessing what is happening in themselves and around, and without a desire to change the situation in any way.

One Minute Meditation Exercise

  1. Sit in a straight-backed chair. If possible, leave some space between your back and the back of the chair so that your back does not rest on the back. Place the soles of your feet on the floor. Close your eyes and lower your head.
  2. Concentrate on inhaling and exhaling. Note the sensations that accompany each inhalation and exhalation.Track your breathing, but don’t expect anything special. Don’t change your breathing rhythm.
  3. After a while, thoughts may start to scatter. If you notice this, then again focus on breathing. Do not be annoyed with yourself – the goal of the exercise is to understand that thoughts can go their own way. It is important to return your attention to breathing and avoid self-criticism.
  4. You can feel relaxed and experience other sensations, but it is also important to feel that all feelings pass over time.Whatever happens, don’t get involved.
  5. After a minute, open your eyes and look around the room (Williams 2013).

Dealing with thoughts that create anxiety and fear

Our thoughts influence both feelings, physical reactions and behavior. If we learn to better feel our thoughts and see them in a more realistic light than when we feel bad, then we can change how we feel. Think of a situation that has happened lately when you felt intense anxiety.Try to analyze the situation using the questions below.

Recognizing thoughts that create anxiety and fear

When you feel anxious, think of the following:

  1. What thoughts were in your head? Was there any image in front of your eyes?
  2. What’s the worst thing that can happen to you?
  3. What does this really mean for you?

Weighted Reflection


  1. What is behind thoughts of fear?
  2. What other ways of interpreting the situation could be?
  3. Are you belittling your ability to solve a problem?
  4. Do you overestimate the seriousness of what is happening? Think carefully about how you have dealt with these situations in the past and practice how you might handle the challenges ahead (Hawton jt 1993).


If you have become more anxious and feel that unresolved problems are beginning to accumulate in your life, and instead of solving them you are pushing the work with them further and further, then help can be obtained with the help of problem-solving techniques. Instead of experiencing problems, start solving them, and thus your anxiety will decrease. First, consider what your problems are and how you can solve them. If you are anxious about problems that you cannot solve, or about still unclear problems that may happen in the future, then try to leave thoughts about them, and direct your attention to something else.

Problem solving steps:

  1. What is the problem and what is the task that you want to achieve? Describe your problem as accurately as possible and think about what you want to achieve by solving it.
  2. Think of all the resolution options and write them down. It doesn’t matter if they are realistic or not.
  3. Review all possible solutions and weigh the pros and cons.
  4. Choose the most realistic solution options or those that get the most benefits.
  5. Plan to implement solutions. Think about what is needed for this and what obstacles need to be overcome. Practice overcoming these obstacles. Consider what you can do right away and what you can save for the future.
  6. If you have solved the problem, think about what you have been able to achieve and what you have learned. Celebrate your progress and congratulate yourself (Hawton jt 1993).

Moving away from avoidance tactics

If you feel too restless in certain situations or places and therefore try to avoid them, you will never be able to experience a successful solution to the problem.The next time in the same situation or place, you need to try to be calmer and you can cope with the problem. To move away from avoidance tactics, you need to get back in touch with the situation and get used to it. From the beginning, this approach can increase your anxiety and addiction requires persistence and courage from you.

  1. List situations and places that cause anxiety. Prioritize them according to the strength of anxiety, starting with the situations that cause the least anxiety.
  2. To begin with, try to spend some time in situations that cause the least anxiety. For example, if you are afraid to leave the house, take a short walk around the house with people close to you. Try to do this before you feel the anxiety begins to fade.
  3. Next, take a more difficult step, such as a walk alone, and repeat until the anxiety disappears.
  4. Continue these steps for more severe anxiety situations until you can handle the anxiety in those situations as well (Hawton jt 1993).

How to deal with panic attacks?

  • A panic attack can be unpleasant, but it is not life threatening.
  • If possible, stay in a situation where the feeling of panic has arisen. Keep yourself and others safe, such as when driving, park it in a safe place.
  • Remind yourself that fearful thoughts and physical sensations will pass. Focus on the things around you, such as the items on the shelves.See how big they are, what color and shape. This will help you to be distracted for a short time, in the case of long periods, the fear of panic symptoms may persist.
  • Focus on your breathing. Try to breathe slowly and deeply for a count of three as you inhale and exhale.
  • Try to resist your fearful thoughts. Try to find out what specifically triggers your fear and resist that cause. Repeat to yourself that what you are afraid of is actually unrealistic and will go away on its own after a few minutes.
  • Creative imagination or visualization. During a panic attack, thoughts of disaster or death may arise. Instead of focusing on negative thoughts and images, try focusing on the positive. Think of a place or situation where you feel calm and relaxed and try to focus on them. This should help you distract yourself and reduce the severity of the unpleasant symptoms. Visualization, of course, requires prior training.
  • Don’t fight a panic attack. Fighting it can make the attack more severe, as admitting that you are unable to do so can increase the feeling of anxiety. Instead, tell yourself again that the attack will go away, it does not threaten your life, and you are doing everything to cope with it.
  • Relax. To do this, first learn to relax your muscles.
  • Use cards with different ways of getting out of the situation. Use slips of paper, but which you can write text to help you cope with fearful thoughts, such as “this won’t last long.”You can keep the cards in your wallet or notebook.

Find yourself the most memorable, memorable ways to help you cope with anxiety, and try using in the event of a panic attack.

90,000 How to recover from COVID-19 | Articles of the clinic Medservice

COVID-19 is a new disease that humanity faced just a few months ago. The virus mutates and grows stronger, the disease “gains momentum”, relatives, colleagues, friends get sick.For some, the disease is mild, with almost no symptoms. And someone is sick for a long time and hard. But in any case, the question arises of how to return to the usual way of life, physical activity.

Weakness, distracted attention, apathy or even panic – this is not a complete list of what you have to deal with. Sometimes the complications that the virus leaves behind can lead to more serious consequences.

By the end of October 2020, according to official data, more than 8,000 people had been ill in Udmurtia.For many of those officially COVID-negative, the fight against the new infection is not over yet. People don’t feel healthy. Let’s figure out why this is happening and how to regain the former quality of life.

Why does weakness last for a long time after coronavirus and shortness of breath appears

Our life, whether we like it or not, is divided into “before” and “after”. The symptoms of coronavirus are known to everyone today, as well as the methods of examination and treatment.They talk and write a lot about this. Everyone knows that two or three weeks have to go through, and the virus disappears from the analyzes, which means that a long-awaited recovery should come.

But many patients are “stuck” at the same level of well-being that he had during the illness. All muscles hurt, fatigue persists, the head does not understand, physical exertion, even minor ones, is especially difficult. A person left for work from sick leave, and in the evening he comes home, falls exhausted and even eating becomes a problem.Or, it turns out that the habitual washing of dishes has turned into physical activity. It would seem that the treatment lasted almost a month, everything should be in order, but the state of health is bad, even very bad.

Such complaints are more and more often encountered at the doctor’s appointment at the Medservice clinic, Izhevsk. And now doctors know exactly what it is connected with. People who have had COVID-19 inevitably face deterioration in lung function after suffering pneumonia. This entails a violation of oxygen metabolism in the tissues of the body, which affects the internal organs and structures, in particular, the heart and the musculoskeletal system, the endocrine and nervous systems.

As a result:

  • weakness increases throughout the body, the patient quickly feels overwork;
  • even moderate physical activity is difficult
  • efficiency decreases;
  • shortness of breath appears;
  • it is difficult to breathe deeply.

Threat to the cardiovascular system

We all have already understood that coronavirus is a serious disease that harms not only the respiratory organs.The cardiovascular system is also seriously affected. One of the most formidable and common complications of COVID-19 is vasculitis, an inflammation of small vessels.

This disease is especially dangerous because it may not develop immediately, but some time after the onset of the disease. The virus infects the inner lining of the vessels – the endothelium. This inflammation is accompanied by an increase in blood viscosity and blockage of small vessels, formed by clots or blood clots. And the vessels permeate the whole body, which means that such inflammation can appear in any organ, and there will be violations.

The brain, intestines, kidneys can suffer. One of the most vulnerable places is the myocardium or heart muscle. The heart requires good blood supply and nutrition to function properly. The resulting inflammation, myocarditis, causes:

  • weakness, decreased performance, increased fatigue;
  • rapid heartbeat, heart rhythm disturbance;
  • chest pain.

If you are worried about your condition after a viral infection, and it complicates your usual life, see your doctor.It is important to know that the earlier you start rehabilitation, the less the virus will have on the body.

Diagnostics and rehabilitation after coronavirus

The doctors of the Medservice clinic, Izhevsk, have sufficient qualifications and experience to help restore the impaired body functions. You need to seek help from a therapist, cardiologist or neurologist. Believe me, it is only at first glance that fatigue and poor health are exclusively personal feelings. They can be signs of serious complications that arise after the transferred viral diseases.

After coronavirus pneumonia, as after any other, X-ray control is necessary one, three and 12 months after the end of treatment. Our clinic employs a modern X-ray computed tomograph, which allows us to detect even the smallest changes in the lungs and bronchi.

With shortness of breath, persistent coughing, dyspnea and other similar complaints, control over the function of external respiration is necessary.