Anxiety can be caused by a physical disorder or the use or discontinuation (withdrawal) of a drug. Physical disorders that can cause anxiety include the following:

• Heart disorders, such as heart failure and abnormal heart rhythms (arrhythmias)
• Hormonal (endocrine) disorders, such as an overactive adrenal or thyroid gland or a hormone-secreting tumor called a pheochromocytoma
• Lung (respiratory) disorders, such as asthma and chronic obstructive pulmonary disease (COPD)

Even fever can cause anxiety.

Drugs that can induce anxiety include the following:

• Alcohol
• Stimulants
• Caffeine
• Cocaine
• Many prescription drugs, such as corticosteroids
• Some over-the-counter weight-loss products, such as those containing the herbal product guarana, caffeine, or both

Withdrawal from alcohol or sedatives, such as benzodiazepines (used to treat anxiety disorders), can cause anxiety and other symptoms, such as insomnia and restlessness.

Anxiety may occur in dying people as a result of fear of death, pain, and difficulty breathing (see Death and Dying: Depression and Anxiety).

Treatment

A doctor aims to correct the cause rather than treat the symptoms of anxiety. Anxiety should subside after the physical disorder is treated or the drug has been stopped long enough for any withdrawal symptoms to abate.

If anxiety remains, antianxiety drugs or psychotherapy (such as behavioral therapy) is used. For people who are dying, strong pain relievers (analgesics) with potent antianxiety effects, such as morphineSome Trade Names
MS CONTIN ORAMORPH
, are often appropriate. No dying person should have to experience intense anxiety.

Last full review/revision September 2012 by John H. Greist, MD