Is it possible? Could it be? (Symptoms)

Among the most frequent questions and concerns on this forum are those having to do with the association of various symptoms with anxiety or the meds we take. The list is long; everything from burning sensations to twitches and itches to brain fog and all in between. Dozens and dozens of symptoms.

But there is a special emphasis on physical sensations, as opposed to mental states like fear or anger or doubt. This is an understandable concern, because it is logically difficult to associate something like a tingling in the legs with an anxiety diagnosis, or a burning in the lower back with a medication. Sometimes, the association of a physical symptom with anxiety seems so far-fetched that we question the anxiety diagnosis itself: we may think we have something "else" instead of anxiety, or else that, yes, we have anxiety, but the symptom relates to yet another problem. Likewise, if we have started on a new medication, is it a likely suspect as the cause of an odd feeling

Sound familiar? You bet.

The fact of the matter is that the physical symptom may, indeed, relate to a different problem entirely. You certainly COULD have developed adult on-set diabetes in addition to the anxiety you know you already have. Or that sense of numbness in your lower legs could relate to the anxiety. The fact that anxiety frequently presents a symptom such as difficulty swallowing does NOT mean that swallowing problems ONLY come from anxiety. For the person who has panic and anxiety, this situation of "maybe, maybe not" only adds to the discomfort.

For many panic and anxiety sufferers, there is a diagnostic phase in which many tests are done to rule out the various disorders that might present in the symptoms we have. Once enough of these tests are done, our medical providers and we accept anxiety or panic as the working diagnosis. While this is not always welcome news (we would rather have something like acid reflux, perhaps) we at least get some comfort from knowing WHAT we have because now we can treat it. But this comfort level is based on a snap-shot of us at a particular time, and things can change over time. Sure, we checked out good last month -but what about NOW?

And so, we see all those posts that say something like, "Could this be..." and a new symptom. What to do?

Obviously, it is not practical to run a battery of tests with the appearance of every new sensation or symptom. At the same time, if the condition persists or gets worse, we will eventually be driven to pin it down. Those who are in regular therapy have a distinct advantage, here, because the schedule of visits allow them to give their therapists frequent updates on what they are feeling. The therapist can then track these observations and order new or more tests if any seem indicated. But, what do you do if you are NOT in regular contact?

Well, one thing is to come to the forum and ask, "Is this...?" as so many do. The motive here is not so much to get a diagnosis as it is to get reassurance that if other people say,"me too!" then you can accept the new symptom as something "normal" for your condition. But as many will note, the problem with such reassurances is that they may NOT be appropriate, or correct, in YOUR case. And that is why many respondents wisely advise to check with your doctor, as well.

Here is a framework for dealing with this situation that might be helpful. Adapt it to your situation is you think it is useful and if your medical provider is OK with it. Basically, the idea is to keep a log of symptoms that you update over time. If you ARE in regular therapy, it gives you a body of data to presebt at a session. If you are NOT in regular therapy, then at least arrange with your doctor for a regulat brief check-in every 2 weeks, or each month or whatever seems appropriate.

Your log:

Take a piece of paper (or your word processor or spreadsheet or some other means of record keeping) and make X columns across the top. The first column is going to be a list of your symptoms by whatever name you choose for them: "Trouble swallowing," "burning in fingers," "fullness in chest," etc. The next column is, "First Occurred." List the date or month when you FIRST had the symptom. Next is four columns to record how often symptoms have occurred over the past week. These columns will carry dates, each of which is a week apart. The four are all under a master column called, "Frequency." For example, you might set your log up so that you update it every Friday. The first week might carry an initial entry like, "2-3 X day" which would mean you noted the symptom 2 or 3 times a day over the prior week. In the next week you might note more or fewer occurrences. The final column will be "Notes." Here you enter anything that seems important. For example, if there was a spike in a particular symptom during a particular week, perhaps you were in social situations or a bad encounter at work that week, so your note might say "Had to speak at church meeting" or some such. Supposing you have no idea why the spike, maybe a simple ? will remind you that you have no clue. Did you start a new med, or change dosage? Add a note and date it.

You may be advised -and correctly, I think- not to get too overboard in keeping your log, because it can become a focus of anxiety itself if you do. So perhaps a weekly update is better than daily. And the over-all design and layout should be easy and quick for you to use. A benefit of using weekly or twice monthly updates is that there is a built-in passage of time that allows for some symptoms to just go away. You will only post the ones you remember. And, you will also see the evidence of positive changes -symptoms that dwindle over time. Good news. But mostly, you will have a way of managing those new things that happen from time to time and developing an accurate record. That's not to say you stop asking about them on the forum. In fact, what others say may even go on your notes: "3 A/F membs said they had."  And you certainly should not put off action for any new occurrence which is especially frightening or possibly dangerous in any way.

The idea here is to build a bridge between the onset of something new, changes in what is familiar, and the development of a professional opinion about it. Your log gives you a convenient way to do so. Thus, even though you can't get a test or call the doctor with each new wrinkle, you CAN show your provider a plot of data over time. Finally, it gives you something you can actually DO about the symptom pending medical advice. Discuss the idea with your therapist or doctor -and see what they say.

No doubt some folks here are already doing this, or something like it. I welcome and encourage commenst which may make this idea useful.