Many people live with racing hearts, dizziness, or fatigue and assume it’s just anxiety. But what if it isn’t? Several medical conditions share the same symptoms as anxiety disorders, which can lead to misdiagnosis, delayed treatment, and unnecessary suffering. Understanding these look-alike conditions is the first step toward getting the right help.
Understanding the difference between true anxiety disorders and medical conditions that resemble them is essential for getting the right care.
What is Anxiety?
Anxiety is a natural response to stress, a feeling everyone experiences from time to time. It becomes a disorder when symptoms are severe, persistent, and interfere with daily life.
Common anxiety disorders include:
Generalized Anxiety Disorder (GAD): This is an excessive and uncontrollable worrying.
Panic Disorder: This is a recurring panic attack and ongoing fear of more attacks.
Social Anxiety Disorder:This is an intense fear of social situations or performance.
Phobias: These are irrational fear of specific objects or situations.
Although no longer classified as anxiety disorders in the DSM-5, OCD (obsessive-compulsive disorder) and PTSD (post-traumatic stress disorder) can present with anxiety-like symptoms.
Typical anxiety symptoms include:
- Restlessness and irritability
- Excessive worry or dread
- Muscle tension
- Sleep disturbances
- Palpitations and rapid breathing
- Stomach discomfort
- Shaking, chills, or hot flashes
Because these symptoms also occur in several physical illnesses, the line between anxiety and other conditions can easily blur.
Medical Conditions Confused With Anxiety
1. Adrenal Insufficiency
Adrenal insufficiency, including Addison’s disease, occurs when the adrenal glands fail to produce enough hormones—especially cortisol. Cortisol plays a key role in regulating stress, blood pressure, and metabolism.
Symptoms resembling anxiety: Fatigue, weakness, dizziness, and low blood pressure can feel similar to anxiety or panic attacks.
How to differentiate: People with adrenal insufficiency may experience salt cravings, weight loss, and darkening of the skin (hyperpigmentation). The diagnosis becomes complete when it involves blood tests that measure cortisol and ACTH levels.
2. Fibromyalgia
Fibromyalgia is a chronic disorder that causes widespread musculoskeletal pain, fatigue, and increased sensitivity to touch. It may develop after physical trauma, infections, or long-term stress.
Symptoms resembling anxiety: Constant fatigue, poor sleep, and brain fog can resemble anxiety symptoms. Anxiety and depression are also common in people with fibromyalgia.
How to differentiate: However, unlike anxiety, fibromyalgia is characterized by tenderness in specific body points, disrupted sleep, and cognitive difficulties. Doctors diagnose it by ruling out other causes and assessing pain patterns.
3. Inflammatory Bowel Disease (IBD)
IBD, which includes Crohn’s disease and ulcerative colitis, is a chronic condition that causes ongoing inflammation in the digestive tract.
Symptoms resembling anxiety: Abdominal pain, cramping, diarrhea, and fatigue can overlap with anxiety symptoms. Stress may worsen flare-ups, making it harder to tell the difference.
How to differentiate: IBM is marked by persistent diarrhea, blood in the stool, and weight loss. The diagnosis is always confirmed by undergoing colonoscopy, other imaging scans such as ultrasound, and supportive lab tests.
4. Endometriosis
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, often affecting the ovaries, fallopian tubes, or pelvic lining.
Symptoms resembling anxiety: Chronic pain, fatigue, and mood changes linked to hormonal fluctuations can feel like anxiety.
How to differentiate: Endometriosis is marked by severe menstrual cramps, pelvic pain, pain during intercourse, and fertility challenges. The diagnosis is often confirmed by imaging tests or laparoscopy.
5. Heart Problems
Heart rhythm disorders—such as arrhythmias, inappropriate sinus tachycardia (IST), or structural heart issues—can often be mistaken for anxiety.
Symptoms resembling anxiety: Palpitations, chest pain, dizziness, and shortness of breath occur in both heart conditions and panic attacks.
How to differentiate: Heart problems may appear during rest or physical exertion, not only in stressful situations. The heart-related causes are determined by tests like ECGs, Holter monitoring, or echocardiograms.
6. Hyperthyroidism
Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone, leading to an accelerated metabolism.
Symptoms resembling anxiety: Nervousness, sweating, rapid heartbeat, and irritability can strongly resemble anxiety.
How to differentiate: The strong indicators of hyperthyroidism are tremors, unexplained weight loss, heat intolerance, and thyroid enlargement (goiter). The diagnosis is often confirmed with blood tests that measure thyroid hormone levels.
7. Polycystic Ovary Syndrome (PCOS)
PCOS is a hormonal disorder in which the ovaries become enlarged and develop small cysts. It can affect reproductive health, metabolism, and emotional well-being.
Symptoms resembling anxiety: Hormonal imbalances can cause mood swings, irritability, and fatigue, all resembling anxiety.
How to differentiate: PCOS often includes irregular periods, excess hair growth, acne, and weight gain. The diagnosis is supported by elevated testosterone levels in blood tests.
8. Irritable Bowel Syndrome (IBS)
IBS is a functional gastrointestinal disorder that leads to abdominal pain, bloating, and changes in bowel habits.
Symptoms resembling anxiety: Stomach pain, diarrhea, constipation, and nausea can overlap with anxiety symptoms, especially during stressful periods.
How to differentiate: Unlike IBD, IBS does not cause inflammation, bleeding, or weight loss. Diagnosis is based on symptoms and ruling out other digestive diseases.
9. Neurological Conditions
Neurological disorders—such as brain tumors, traumatic brain injury, dementia, or infections—can impact mood and behavior.
Symptoms resembling anxiety: Irritability, fatigue, poor concentration, and sleep disturbances may appear as anxiety-like symptoms.
How to differentiate: Unlike anxiety, neurological conditions often present with additional signs such as seizures, memory loss, or motor impairments. Diagnosis is confirmed through imaging tests like MRI or CT scans.
10. Ankylosing Spondylitis (AS)
Ankylosing Spondylitis is a form of arthritis that primarily affects the spine, causing chronic inflammation, stiffness, and reduced mobility. Over time, it can also affect other joints and organs, including the eyes and heart.
Symptoms resembling anxiety: Persistent back pain, fatigue, and discomfort can increase stress levels and mimic anxiety symptoms.
How to differentiate: Unlike anxiety, AS-related pain and stiffness often improve with physical activity but worsen with prolonged rest. Diagnosis is confirmed through genetic testing for HLA-B27 and imaging studies such as X-rays or MRI, which can reveal inflammation and structural changes in the spine.
11. Postural Orthostatic Tachycardia Syndrome (POTS)
POTS is a condition in which standing up causes an abnormally rapid increase in heart rate, often leading to dizziness, lightheadedness, or fainting. It is a type of autonomic nervous system dysfunction that can significantly impact daily life.
Symptoms resembling anxiety: Palpitations, rapid heartbeat, lightheadedness, and fatigue can easily be mistaken for panic attacks or generalized anxiety.
How to differentiate: Unlike anxiety, POTS symptoms are triggered by changes in posture rather than emotional stress. Other signs may include exercise intolerance, brain fog, and headaches. Diagnosis is typically confirmed using a tilt table test, which measures heart rate and blood pressure responses to changes in position.
12. Lyme Disease
Lyme disease is an infection caused by the bite of infected ticks, which can lead to multi-system complications if left untreated, affecting the skin, joints, heart, and nervous system.
Symptoms resembling anxiety: Fatigue, brain fog, headaches, and irritability can closely mimic anxiety or depression, making early recognition challenging.
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How to differentiate: Unlike anxiety, Lyme disease often presents with a characteristic “bull’s-eye” rash at the bite site, flu-like symptoms, and joint pain or swelling. Diagnosis is confirmed through blood tests that detect antibodies against the bacteria. Early treatment with antibiotics is crucial to prevent long-term complications such as neurological or cardiac
Getting the Right Diagnosis
If you’re experiencing symptoms of anxiety, it’s important not to assume it’s only psychological. Anxiety disorders are real and treatable, but so are the medical conditions that mimic them.
A doctor may:
- Review your full medical history
- Order blood tests, imaging, or monitoring (such as ECGs)
- Assess medication, caffeine, or substance use
- Consider both mental and physical health together
Treatment depends on the root cause. Anxiety disorders often respond well to therapy (like cognitive behavioral therapy), medication, and lifestyle changes. But if another condition is present, treating that underlying issue can significantly reduce anxiety-like symptoms
While anxiety is a real and serious condition, it’s not always the root cause of symptoms like palpitations, dizziness, or fatigue. If you’re experiencing these signs, consult a healthcare professional to rule out underlying medical issues. Getting the right diagnosis is the first step toward effective treatment and peace of mind.
