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Restlessness as a Symptom of Underlying Conditions

Feeling restless, agitated, or unable to sit still can be frustrating and uncomfortable. While occasional restlessness is normal, when it becomes an ongoing issue it can negatively impact daily life and point to an underlying physical or mental health condition. Understanding potential causes of restlessness and working with a doctor to find relief are important.

What Causes Restlessness?

There are many possible explanations for chronic restlessness including:

  • Anxiety disorders – Conditions like generalized anxiety disorder, panic disorder, phobias, OCD, and PTSD can all cause feelings of chronic restlessness along with other symptoms like excessive worry, muscle tension, fatigue, irritability, difficulty concentrating, and sleep disturbances. Restlessness may be most prominent during anxiety attacks.
  • Depression – Agitation and inability to relax are common symptoms of major depressive disorder. Restlessness may occur along with low mood, loss of interest in activities, changes in appetite and sleep, feelings of worthlessness or guilt, suicidal thoughts, and lack of motivation and energy.
  • ADHD – Attention deficit hyperactivity disorder is characterized by difficulty concentrating, impulsiveness, hyperactivity, and restless behavior. Adults with ADHD often feel restless, fidgety, and impatient.
  • Medication side effects – Certain prescription medications including asthma drugs like albuterol, antidepressants, drugs for nausea and motion sickness, stimulants for ADHD, and some cholesterol and blood pressure medications may cause jitteriness, agitation, and restlessness as side effects.
  • Drug withdrawal – Withdrawing from drugs like caffeine, nicotine, cocaine, opioids, and marijuana can spark restlessness along with other physical and emotional symptoms. The severity depends on the drug and level of dependence.
  • Sleep disorders – Conditions like restless leg syndrome, periodic limb movement disorder, and sleep apnea inhibit restful sleep. Tossing, turning, and constantly waking up through the night often lead to feeling restless during the day.
  • Chronic stress – When the body’s stress response is continuously activated for long periods of time, it can cause feelings of anxiety, nervousness, and chronic restlessness. Stress has many health consequences that may also contribute to restlessness.
  • Underlying medical conditions – Restlessness can accompany issues like Parkinson’s disease, diabetes, thyroid disorders, kidney failure, dementia, and problems with iron deficiency, electrolytes, or calcium. It’s important to rule out any underlying condition.
  • Menopause – The hormonal fluctuations of perimenopause and menopause can trigger restlessness along with hot flashes, sleep disruption, and mood changes like anxiety and irritability. Restlessness tends to improve as hormone levels stabilize.

Getting to the Root of the Problem

Since restlessness has many potential causes, getting an accurate diagnosis is key. Keeping a symptom journal and tracking when restlessness occurs, what makes it better or worse, and associated symptoms can help identify patterns.

A physician will perform a physical exam, take a detailed history, order blood work or other tests if appropriate, and assess for any underlying conditions. Providing information about prescription and recreational drugs along with diet, lifestyle, stress levels, and family medical history is helpful.

Based on the symptoms and evaluation, a doctor may refer a patient to a specialist like a psychiatrist, neurologist, or sleep medicine specialist for further assessment and diagnosis. Ongoing restlessness should not be ignored.

Finding the Right Treatment

The appropriate solutions differ based on the reason behind restless feelings. Treatment options may include:

  • Medications – Anti-anxiety meds, antidepressants, antipsychotics, mood stabilizers, muscle relaxers, Parkinson’s drugs, or other medications can reduce restlessness in some cases.
  • Therapy – Cognitive behavioral therapy, psychotherapy, and support groups help manage contributing issues like anxiety, depression, stress, and addiction.
  • Lifestyle changes – Getting regular exercise, sticking to a sleep routine, limiting caffeine, doing relaxing activities, and having a healthy diet can help minimize restless tendencies.
  • Treating underlying conditions – Diagnosing and properly managing any medical conditions causing restlessness is essential.
  • Alternative approaches – Massage, acupuncture, meditation, yoga, and hypnosis may complement other treatment. But they should not replace medical care.

A combination approach focused on the root cause and utilizing healthy lifestyle strategies is often most effective for managing troublesome restlessness. While it may take some trial and error, finding the right treatment helps restore a sense of calm and tranquility.