The Difference Between Anxiety and a Stroke

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated October 10, 2020

The Difference Between Anxiety and a Stroke

One of the most frightening aspects of living with anxiety attacks is the way they mimic very serious health problems - problems that can be deadly if left untreated. Thousands of people with severe or unexpected panic attacks become hospitalized because the physical symptoms are nearly identical to other serious conditions, despite having a mental health cause. One such condition is a stroke.

For anyone that suffers from one of these attacks, you need to find a way to tell the difference between anxiety and a stroke, and you need to also know how to avoid letting your fear of stroke increase the frequency and severity of your anxiety attack symptoms.

Anxiety is Not Always Mental

The most important thing to understand is that anxiety is not just a problem with the way you think. It also affects the way you feel. It can cause chain reactions that lead to symptoms so pronounced they feel like you are suffering from a stroke.

The key thing to understand is that the symptoms can be so similar that you should still strongly consider seeing a doctor. Only a doctor can provide you with a diagnosis, and when it comes to your health there is nothing you should leave to chance.

But the symptoms of anxiety are very real, and many of them resemble a stroke-like experience, for example:

  • Difficulty thinking or formulating thoughts.
  • Feeling like limbs or muscles cannot move.
  • Blurry vision or dizziness.
  • Feeling faint.
  • Sudden feeling of doom.

Those are "brain symptoms" that could occur in a stroke. There are also “heart symptoms” (such as chest pains and rapid heartbeat) that may cause someone to feel like they are having a heart attack. Heart attacks and strokes are very different, but moments of pure fear it may feel like they're one in the same.

These symptoms are very scary, especially for those that have never had an anxiety attack before. In some cases for a while after the problem occurs it may feel like the symptoms don't recover right away, leading many to convince themselves they've had a stroke.

Transient Ischemic Attack (Mini-stroke) and Anxiety

Strokes themselves are life threatening and immediate, with symptoms that require immediate medical attention. Generally if you have a full blown stroke, there is no question as to whether it's a stroke or anxiety. Strokes are deadly, sudden dangers, and if you have a full blown stroke, you'll almost certainly know.

The worry is that you may have suffered from a transient ischemic attack, or "mini-stroke." These are strokes that occur instantly, have effects for less than an hour, and then fade. They are often the precursors to a full blown stroke but are less likely to cause significant impairment. They may be confused with an anxiety attack.

How to Tell the Difference Between Anxiety and a Mini Stroke

Only a doctor can tell you with 100% certainty if what you've experienced is stroke-like symptoms from an anxiety attack or an actual stroke. But generally there are several ways to tell the difference between the two, including:

  • Rapid/Gradual Both panic attacks and strokes can come on somewhat rapidly, but strokes are almost always instant, while a panic attack generally peaks around 10 minutes in and then slowly fades. With a mini-stroke, the symptoms occur almost immediately. Any anxiety tends to come after. Also, transient ischemic attacks usually last a shorter amount of time.
  • Other Anxiety Symptoms Strokes are a loss of brain function. Though they can cause anxiety, they do not generally occur concurrently with other anxiety symptoms. If you have many other symptoms of anxiety, like shaking, a rapid heartbeat, and more - especially if these occur before the stroke-like sensations, then anxiety is far more likely.
  • Paralysis One thing that anxiety rarely causes is paralysis. Anxiety can make it harder to move certain muscles, especially if you are feeling weak and hyperventilating, but in a stroke it's not uncommon to have absolutely no ability to move a muscle at all. Facial paralysis, where your face starts to "fall" and you drool or choke because you cannot move is a stroke symptom. With anxiety, even though those sensations can still occur, the ability to move or act is still generally present. Not all strokes cause paralysis, however.
  • Family History Strokes are not very common in those under 55, those without a family history, and those without high blood pressure or high cholesterol. That's why seeing a doctor is still valuable even if you are positive it's anxiety.

As you can see, the differences are subtle. But they are definitely there, and if you are willing to think about the attack logically you'll often find that it's clear what occurred. However, it is critical to rule out a cerebrovascular event (stroke, TIA) first.

How to Avoid Health Anxiety From Panic Attacks

Once a stroke has been ruled out, you'll need to control not just your anxiety, but also the health anxiety that often occurs when someone suffers from panic attacks that cause stroke-like symptoms.

Those with severe anxiety are rarely satisfied with a panic attack diagnosis. Because the symptoms are so similar and can have so much in common, it becomes too hard to believe that they are caused by something non-physical. There is a tendency to want to believe that the worst case scenario is possible, because if it was possible something could be done about it.

The best way to ensure that you do not start to experience severe health anxiety as a result of your attacks is to address panic attacks anyway, even if you aren't completely convinced that's the problem. If you learn to control your panic attacks, and the techniques that you attempt work, you'll find that the symptoms that were causing you such health anxiety start to fade and you are left feeling more comfortable and confident in your health.

Questions? Comments?

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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