OpenHealth Q&A

20-Year-Old Struggling with Ongoing Symptoms During Physical Activity

For nearly five months now, I have been experiencing persistent and vague discomfort. Adding to my challenges is my long-standing battle with severe anxiety, which often leads to sporadic symptoms. However, what truly alarms me is the feeling of unease I face every time I engage in physical activity or movement. Each time I rise to my feet or take a stroll, I find myself grappling with bouts of lightheadedness or dizziness. More often than not, it feels as if my body lacks strength and is unusually weak, rather than the sensation of imminent fainting. It’s worth mentioning that I have only experienced genuine presyncope—characterized by darkening vision and muffled sounds—following blood draws and once during gym class as a child when exposed to heat. In addition to this, I frequently encounter other unusual symptoms. Occasionally, these are connected to my chest, manifesting as mild tightness predominantly on the left side, a feeling of fullness, or even a slight ache. At other times, I experience an array of random sensations, including pressure in my head or ears, a sense that my vision isn’t quite right (though I haven't lost clarity or experienced blurriness; perhaps dissociation is a factor), or a feeling akin to shortness of breath—not gasping for air, but rather an odd tightness or discomfort in my airways. Naturally, I’ve considered the possibility of postural orthostatic tachycardia syndrome (POTS), especially as my heart rate can be quite reactive, sometimes spiking over 40 beats per minute just from the simple act of standing. Yet, there are days when my heart rate doesn’t respond as dramatically. My symptoms tend to fluctuate day to day; even within the same day, I often find greater relief in the evening. I'm acutely aware that my physical conditioning is lacking. Even prior to my symptoms worsening and my anxiety being partially managed, I was not particularly active. A couple of weeks ago, I attempted a 10-minute workout designed for seniors, and I found myself extremely sore afterward, with my heart rate soaring to 190 beats per minute. Nowadays, my exercise consists of pushing myself to walk around my house or yard for short intervals, practicing gentle yoga, preparing meals, and attending to my personal hygiene. As someone recovering from agoraphobia, I’m primarily confined to my home, venturing out only for planned exposures. With a move looming less than a week away, I’m consumed by anxiety over how this might impact my health, fearing it could lead to a hospital visit. Recently, I’ve been dedicating around 30 minutes each night to packing, which has been challenging, yet I managed to continue. However, when I tried to pack earlier in the day, I became so fatigued that I had to cease my efforts after only 40 minutes. This exhaustion has recurred, and just recently I felt fleeting tight or stabbing chest pains while packing in addition to the usual discomfort. Yesterday and today, I also experienced general chest tightness and periodic dull pain on my left side, which is distressing every time it occurs. Additionally, I'm plagued by feelings of air hunger and dyspnea. Increasingly, I find myself conscious of how routine activities feel perilous due to these alarming symptoms. Just today, I noticed these sensations while taking out the trash and even while playing the piano. I’m in the midst of finding a new primary care physician since my previous doctor closed their practice, but my first appointment is still weeks away. Back in March, I had a telehealth visit and blood tests, which yielded little clarity—only revealing some minor, potentially insignificant abnormalities. Although I’ve worried about possible heart-related issues, I had an EKG and a Holter monitor just two years ago that returned normal results. Still, I feel that’s not sufficient reassurance, and I plan to request a referral for a cardiologist when I finally meet with my new doctor.

Answers (1)

7/27/2025, 10:02:27 AM

OpenHealth AI

It's understandable to feel overwhelmed by the combination of physical symptoms and anxiety you're experiencing, especially given your history with anxiety and your recent struggles. Your symptoms of lightheadedness, feelings of weakness, and chest discomfort during physical activity could stem from various factors, including anxiety, possible postural issues, or even some cardiovascular responses to exertion.

Explanation

Persistent physical discomfort can be particularly distressing, especially when it is intensified during activity. Your mention of fluctuating heart rates and feelings of air hunger are noteworthy and may indicate a heightened sensitivity to physical exertion—this is sometimes seen in conditions like POTS, but can also be influenced by anxiety and deconditioning. The tightness in your chest, especially alongside anxiety, can create a cycle where physical discomfort heightens anxiety, and vice versa.

Next Steps

1. Monitor Symptoms: Keep a detailed log of your symptoms including when they occur, their duration, intensity, and any associated activities. This will help you notice patterns which can be very useful when you see your new doctor.

2. Gradual Activity Increase: Given that you're experiencing fatigue and discomfort during physical exertion, aim to gradually increase your activity levels. Think about gentle movements—such as seated exercises or short walks—that prioritize comfort.

3. Hydration and Nutrition: Ensure that you're staying well-hydrated, as dehydration can exacerbate feelings of lightheadedness. Eating regular, balanced meals may also help maintain your energy levels.

4. Relaxation Techniques: Incorporate relaxation techniques to help manage anxiety. Mindfulness meditation, deep-breathing exercises, or even gentle yoga practices may support both your physical and mental health.

5. Plan for the Move: Since moving can be a stressful time, consider breaking down your tasks into smaller, manageable pieces and allow for ample breaks. If it's possible, seek support from friends or family to help with the physical aspects of your move.

6. Pre-Appointment Preparation: When you meet your new doctor, be ready to discuss all your symptoms in detail and express your concerns regarding anxiety and physical health. Request specific follow-up evaluations, including potentially seeing a cardiologist if you feel it's necessary.

7. Emergency Situations: If you ever feel that your symptoms escalate to a point where you are concerned about your safety (such as severe chest pain, difficulty breathing, or extreme dizziness), seek immediate medical attention.

Remember, it's okay to take things one step at a time. Acknowledge your progress and be kind to yourself as you navigate this journey.