Part 3
Part 3: “It’s All Anxiety”—When Doctors Miss the Real Diagnosis
The Intersection of Medical and Mental Health Diagnoses: When Doctors Don’t Listen
“Anxiety became the explanation for everything—even when my body was screaming something else.”
It’s a story far too many people can tell: persistent pain, fatigue, nausea, shortness of breath—and yet, after bloodwork or a quick listen to the lungs, a doctor leans back and says the word that changes everything: “It’s probably anxiety.”
Sometimes they’re right. But too often, they’re catastrophically wrong.
In this part of the series, we explore how real, often serious physical conditions are dismissed as “just anxiety”—a misdiagnosis with life-altering consequences.
The Overlap Between Anxiety and Physical Illness
Anxiety can mimic many physical conditions. It can cause:
Heart palpitations
Shortness of breath
Chest pain
Dizziness
Digestive issues
The problem isn’t recognizing these symptoms as possible signs of anxiety—the problem is stopping there.
Physicians under pressure—whether from time constraints or cognitive bias—often default to anxiety as the diagnosis, especially if the patient has a mental health history or falls into a demographic they unconsciously associate with overreacting.
Real Stories, Real Consequences
Amy, a 29-year-old woman with a history of panic attacks, visited urgent care multiple times for chest pain. Each time, she was sent home with no further testing. Two months later, she was diagnosed with pericarditis—an inflammation of the sac around the heart that can mimic anxiety but requires urgent treatment.
Carlos, a 41-year-old Latino man, reported numbness in his hands, muscle weakness, and fatigue. Told repeatedly it was “stress,” he later found out he had multiple sclerosis—diagnosed over a year after initial symptoms.
Jasmine, a Black woman in her 30s, described joint pain and extreme fatigue. Her symptoms were attributed to depression. After months of being dismissed, she was diagnosed with lupus.
These aren't rare exceptions. They represent a widespread failure of diagnostic curiosity—where once “anxiety” enters the room, all other possibilities leave it.
The Science of Misdiagnosis
Doctors aren’t just guessing. They’re operating under a kind of mental shortcut called anchoring bias—fixating on one explanation (like anxiety) and failing to adjust their thinking when new evidence appears.
A 2016 study in BMJ Quality & Safety found that cognitive errors—especially premature closure and failure to consider alternatives—accounted for more than 75% of diagnostic mistakes.
Another issue is gendered expectations. A 2018 review in Academic Emergency Medicine found that women are significantly more likely than men to have their symptoms of heart disease dismissed as emotional or stress-related.
And for people with a psychiatric history? The chances of misattribution skyrocket.
Conditions Commonly Misdiagnosed as Anxiety
Heart Conditions – arrhythmias, pericarditis, or even early signs of heart attacks, especially in women
Thyroid Disorders – hyperthyroidism can mimic panic symptoms
Autoimmune Diseases – like lupus, fibromyalgia, or multiple sclerosis
Endometriosis – often dismissed as menstrual anxiety or stress
POTS (Postural Orthostatic Tachycardia Syndrome) – causes racing heart and dizziness, frequently written off as anxiety
Seizure Disorders (especially focal seizures) – sometimes confused with panic attacks
Why “Just Anxiety” Hurts Everyone—Including Those With Anxiety
The irony is that even people who do have anxiety deserve thorough medical evaluations. Anxiety disorders don’t protect someone from other health conditions—they complicate them. Dismissing physical symptoms as psychological can delay the diagnosis of treatable illnesses in all patients.
Additionally, when true anxiety is misdiagnosed due to poor communication, patients may never get the targeted mental health treatment they actually need.
Being told you’re anxious when your body is telling a different story doesn’t just hurt—it erodes trust in the entire medical system.
What Patients Can Say Instead of Accepting “It’s Just Anxiety”
If you feel your concerns are being brushed off, here are some assertive—but respectful—ways to respond:
“I understand that anxiety is a possibility, but can we rule out physical causes first?”
“I’ve had anxiety before, and this doesn’t feel the same. I’d like a full workup.”
“Can you help me understand why further tests aren’t necessary?”
“Could this be something else that mimics anxiety?”
Bringing a symptom journal to your appointment—detailing what you experience, when, and how it affects you—can also support your case for deeper investigation.
How Clinicians Can Do Better
Recognize bias: Acknowledge when diagnostic shortcuts are based on assumptions, not evidence.
Practice shared decision-making: Involve patients in the reasoning process behind a diagnosis.
Follow the “diagnostic pause” method: Before confirming anxiety as the cause, ask: “What else could this be?”
Avoid labeling behaviors as pathology: Being firm, anxious, or emotional in a stressful situation doesn’t mean a person isn’t also physically ill.
📚 References
Graber, M. L., et al. (2012). The incidence of diagnostic error in medicine. BMJ Quality & Safety.
Samulowitz, A., et al. (2018). “Brave men” and “emotional women”: A theory-guided literature review on gender bias in health care and pain. Journal of Pain Research.
Drossman, D. A. (2016). Functional GI disorders and the Rome IV criteria. Gastroenterology.