Can extreme anxiety cause neurological symptoms?

Anxiety is a common mental health condition that involves feelings of worry, nervousness, or fear. While mild to moderate anxiety is a normal part of life, some people experience more intense, excessive, and persistent anxiety that can interfere with daily activities. This is known as an anxiety disorder.

When anxiety becomes excessive or uncontrollable, it can cause both psychological and physical symptoms. Extreme anxiety is often accompanied by neurological symptoms – those involving the nervous system. Let’s explore the link between anxiety and neurological symptoms and see how excessive anxiety can affect the brain and nervous system.

Table of Contents

What are the common neurological symptoms of anxiety?

Anxiety can cause a wide range of neurological symptoms. Here are some of the most common:

Headaches – Studies show up to 90% of people with anxiety experience tension headaches related to muscle tightness and pain.
Dizziness – Feeling lightheaded or dizzy is common with anxiety due to rapid breathing and changes in blood flow.
Numbness and tingling – Anxiety can cause pins and needles sensations, numbness, and burning due to its effects on breathing and hyperventilation.

Tremors – Shakiness in the hands or body tremors can occur with elevated anxiety levels and panic attacks.
Muscle weakness – Extreme anxiety can make muscles feel temporarily weak or shaky due to reactive muscle tension.
Impaired coordination – Anxiety can affect coordination skills, balance, and motor control.

Speech difficulties – Excessive anxiety may cause stuttering, slurred speech, or difficulty finding words.

Neurological symptoms can also include exaggerated startle reflex, hypersensitivity to light or sounds, seizures (rarely), and fainting spells during panic attacks. The severity of symptoms tends to correlate with the intensity of anxiety.

How does anxiety affect the nervous system and brain?

Anxiety involves activation of the “fight-or-flight” nervous system response. When faced with danger, real or perceived, your body is flooded with stress hormones like adrenaline and cortisol. This triggers a cascade of neurological and physiological reactions, including:

Increased heart rate, blood pressure, sweating as your body prepares to respond to threat.
Rapid, shallow breathing or hyperventilation as your lungs take in more oxygen.
Diversion of blood flow away from digestive system and towards muscles.

Release of glucose for instant energy.
Dilation of pupils to improve vision.
Activation of the limbic system, the emotional center of the brain.

While this response is normally protective, chronic activation due to anxiety can cause neurological symptoms in several ways:

Brain inflammation – Stress hormones and immune chemicals released during anxiety can cause inflammation in the brain, leading to symptoms like headaches, brain fog, and dizziness.
Imbalance of brain chemicals – Anxiety disrupts regulation of neurotransmitters like serotonin, dopamine, and GABA that control mood, cognition, and nerve signaling.

Changes in blood flow – Hyperventilation and blood vessel constriction during anxiety reduces blood flow to the brain, triggering temporary oxygen deprivation, lightheadedness, and tingling.
Chronic muscle tension – This causes pain, tension headaches, muscle spasms and can compress nerves causing numbness and tingling.
Overactivity of the nervous system – Anxiety puts the sympathetic nervous system into overdrive, causing neurological symptoms like tremors, twitching, and poor coordination.

In essence, the flood of stress chemicals, inflammation, and neural hyperactivity generated by anxiety disrupts normal functioning of the nervous system. This manifests in a variety of neurological symptoms.

What are the most common anxiety disorders that cause neurological symptoms?

Any chronic anxiety disorder can eventually cause neurological symptoms due to prolonged activation of the nervous system. However, the most common diagnoses associated with neurological symptoms include:

Generalized anxiety disorder (GAD) – This involves persistent, excessive anxiety and worry about many areas of life. Physical symptoms are very common.

Panic disorder – Recurrent panic attacks marked by intense physical symptoms like heart racing, dizziness, numbness/tingling, and feeling loss of control.
Social anxiety disorder – Extreme fear around social situations that provokes physical anxiety symptoms like blushing, trembling, and speech difficulties.
Specific phobias – Phobias of specific things like heights or needles reliably trigger neurological symptoms like dizziness and shaking.

Obsessive compulsive disorder (OCD) – Repetitive obsessive thoughts combined with physical anxiety symptoms like muscle tension, headaches, and tingling extremities.
Post-traumatic stress disorder (PTSD) – Following trauma, symptoms like hyperarousal, flashbacks, nightmares, and hypervigilance promote anxiety and neurological manifestations.

Severe anxiety from any source can generate neurological symptoms, but anxiety disorders tend to produce the highest symptom burden over time due to their chronic nature.

What tests help diagnose anxiety-related neurological symptoms?

If anxiety appears to be causing neurological symptoms, a doctor may recommend tests to rule out underlying medical conditions and assess nervous system function. Typical diagnostic tests include:

Physical exam – Checks reflexes, muscle strength, balance, coordination, and signs of muscle tension.
Neurological exam – Assesses senses, speech, cognition to detect any deficits.

Blood tests – Measure hormone, vitamin, and electrolyte levels to uncover any abnormalities.
Brain imaging – CT or MRI scans help detect unusual brain structure and rule out conditions like tumors.
EEG – Records electrical activity in the brain, useful for detecting seizure disorders.

EMG – Measures electrical signals in muscles to identify any nerve damage.

Doctors may also check thyroid and vitamin B12 levels since deficiencies in these can cause neurological symptoms that mimic anxiety.
In many cases, test results are normal, confirming anxiety as the cause of symptoms.

How is anxiety treated to alleviate neurological symptoms?

Treating the underlying anxiety is key to reducing both the mental and physical symptoms. Typical treatment approaches include:

Therapy – Cognitive behavioral therapy (CBT) helps patients recognize and change distorted anxious thinking patterns.
Medications – Antidepressants and anti-anxiety drugs like SSRIs, SNRIs, and benzodiazepines can be highly effective in controlling anxiety levels.
Relaxation techniques – Deep breathing, meditation, yoga, and progressive muscle relaxation counter the neurological effects of anxiety.

Exercise – Promotes neurochemical balance and emotional well-being to reduce anxiety and symptoms.
Diet/lifestyle changes – Limiting caffeine, improving sleep habits, eating a balanced diet, and quitting smoking can minimize anxiety.

For some patients, a combination approach yields the best relief. Even after anxiety is treated, it may take time for neurological symptoms to fully resolve as the nervous system calms down.

When should you seek emergency treatment for neurological symptoms?

Most neurological symptoms caused by anxiety are not immediately dangerous. However, emergency medical care is needed if you experience:

Loss of consciousness or fainting
Numbness/weakness on one side of the body

Slurred speech or confusion
Severe head trauma
Uncontrollable movements or convulsions

Rapid vision changes

Since these can indicate stroke, seizure, or other serious conditions, it is better not to wait if these symptoms develop.

Can anxiety cause permanent neurological damage?

In most cases, anxiety does not directly cause permanent damage to the brain or nervous system. The neurological symptoms stem from overactivity and disruption in normal nerve signaling patterns rather than structural damage or cell death. Once the anxiety is controlled, symptoms generally resolve.

However, a few caveats exist:

Untreated severe anxiety may indirectly harm the brain over time due to chronically elevated stress hormones, inflammation, and oxygen deprivation from hyperventilation.
Recurring panic attacks have been hypothesized to damage the locus coeruleus, an area involved in regulating anxiety levels, possibly leading to more frequent attacks.

In rare cases, severe B12 deficiency from long-term anxiety and malnutrition can progress to permanent nerve damage if untreated.
Benzodiazepine medications used to treat anxiety carry risks of dependency, may impair memory and coordination, and can worsen anxiety if stopped abruptly.

For most people, getting prompt treatment for anxiety prevents progression down a path towards permanent impairment. But uncontrolled, extreme anxiety does have the potential to cause lasting neurological changes in some individuals.

When should you consider seeing a neurologist for anxiety symptoms?

Seeing a neurologist may be warranted if you experience:

Worsening or new neurological symptoms that are severe or not relieved by standard anxiety treatment
Symptoms that involve loss of motor control, vision changes, loss of consciousness

Headaches that are excruciating, debilitating, or occur with neurological deficits
Symptoms that significantly impair daily functioning and quality of life
Unusual neurological symptoms not clearly linked to anxiety

Persistent pins-and-needles, weakness, or numbness in limbs
Fainting spells, seizures, or repetitive uncontrolled movements

A neurologist can run specialized diagnostic tests to identify any underlying conditions that standard exams may have missed. They can also determine if your symptoms stem from actual nervous system dysfunction versus purely anxious perceptions.

Can you develop neurological symptoms from anxiety years after onset?

For most people, neurological symptoms emerge early on if anxiety is significant enough. But it is possible for symptoms to develop well after anxiety onset in some cases:

Symptoms may appear years later as untreated mild anxiety worsens over time.
Initial anxiety may manifest as mainly mental symptoms, with physical symptoms developing years later as chronic stress increasingly disrupts nervous system functioning.

Delayed symptoms can stem from substance abuse (alcohol, drugs) used to cope with long-term anxiety.
In older adults, mild cognitive impairment can become exacerbated by escalating anxiety.
Major life stressors can trigger relapse and new neurological symptoms in anxiety disorders considered resolved.

Worsening depression alongside anxiety can provoke symptoms like headaches, concentration problems, and fatigue.

It’s possible for long-standing anxiety to eventually catch up with the nervous system. This demonstrates the importance of actively treating anxiety rather than waiting for symptoms to dissipate on their own.

Can you have neurological symptoms from anxiety without mental symptoms?

It’s rare, but some people can experience physical anxiety symptoms without significant conscious feelings of worry, fear, or distress. Reasons this may happen include:

Unconscious anxiety – People may repress worrisome thoughts.
Non-mental triggers – Caffeine, drugs, and medicines can provoke anxiety physiology.
Somatic manifestations – Some focus anxiety solely in physical symptoms.

Differing symptom thresholds – Physical symptoms may appear at lower anxiety levels.
Misreading body signals – Normal bodily sensations are perceived as neurological symptoms.
Comorbid conditions – Other disorders like depression or chronic pain exacerbate symptoms.

However, absence of mental anxiety symptoms is unusual. A doctor will still evaluate for any underlying anxiety or medical issues that could explain neurological symptoms that seem disconnected from worried thoughts.

Can neurological symptoms stem from post-acute withdrawal after stopping anxiety medication?

Yes, anxiety medications like benzodiazepines or SNRIs/SSRIs have potential for dependence and withdrawal side effects. Stopping them abruptly can trigger rebounds in anxiety along with neurological symptoms such as:

Headaches

Dizziness
Tremors
Brain zaps – shock-like sensations

Tingling and numbness
Insomnia
Nausea

These post-acute withdrawal symptoms result from the brain and body adjusting to the absence of medications that suppress nervous system excitability. Symptoms may persist for weeks to months after stopping but gradually dissipate as new balance is achieved. Slow medication tapers under a doctor’s supervision can help minimize discomfort.

Can extreme anxiety cause pseudoseizures and non-epileptic seizures?

Yes, high anxiety is a known trigger for psychogenic non-epileptic seizures (PNES), also called pseudoseizures. These are events that may outwardly resemble epileptic seizures but without abnormal electrical brain activity seen on EEG.

Extreme anxiety can cause PNES through:

Altered limbic system functioning
Chronic hyperventilation leading to oxygen deprivation
Severe muscle tension triggering muscle spasms

Dissociation and loss of emotional control

During PNES, people remain fully or partially conscious, in contrast to true epileptic seizures. High anxiety, borderline personality disorder, and trauma history are risk factors. Treatment involves therapy and reducing anxiety to gain seizure control.

Can anxiety cause neurological symptoms like weakness and numbness?

Yes, anxiety frequently causes sensations of numbness, tingling, and perceived weakness in the limbs or face. Mechanisms include:

Hyperventilation and reduced blood flow to extremities
Chronic muscle tension resulting in nerve compression
Magnesium and calcium deficiencies from stress

Altered sodium and potassium levels
Inflammation affecting sensory nerves
Increased neural excitability

The weakness is not true motor weakness but rather results from poor coordination, fatigue, and perceived inability to fully exert normal force – although true clinical weakness can result from extended vitamin deficiencies.

Addressing the root anxiety along with diet and lifestyle changes helps resolve sensations of numbness and weakness.

Can anxiety cause headaches like migraines?

Yes, research indicates anxiety frequently contributes to migraine and headache disorders. Mechanisms include:

Chronic muscle tension in neck and shoulders
Neural excitability and inflammation
Sensitization of pain pathways

Imbalance of brain chemicals like serotonin
Fluctuating estrogen levels in women

Stress and inadequate sleep also provoke headaches by reducing pain thresholds. Migraines involve more neurological dysfunction than regular tension headaches. Relaxation techniques, anxiety treatment, and trigger avoidance can help prevent headache symptoms.

Conclusion

In summary, persistent excessive anxiety is capable of producing diverse neurological symptoms that affect many areas of mental and physical health. The root cause stems from the biochemical changes and nervous system overactivity generated by anxiety disorders and chronic stress response activation. Effective treatment of anxiety is key to alleviating both the mental distress and physical neurological manifestations.

While anxiety-related neurological symptoms can be scary and disruptive to quality of life, most are temporary and not indicative of serious medical illness once other conditions have been medically ruled out. However, it is important not to overlook real neurological disease if red flags appear. Working closely with mental health professionals and neurologists helps ensure appropriate diagnosis and treatment to resolve neurological symptoms linked to severe anxiety.