Unexplained fatigue and panic-like symptoms despite normal tests — physical or anxiety?
TL;DR:
35-year-old man, generally healthy lifestyle, experiencing unexplained episodes for ~10 years: fatigue, shortness of breath, lightheadedness, and panic-like sensations (especially at night with feelings of imminent death). Extensive medical tests (cardiac, brain, sleep, etc.) all normal. Symptoms started after father’s death from leukemia and a history of family health trauma. Has explored psychological causes without clear results. Unsure whether the issue is physical or anxiety-related; looking for similar experiences or explanations.
Hello, I need help diagnosing myself. It’s going to be quite long to explain all the context, sorry in advance.
To start, I am a 35-year-old man, 1m83 tall and 82 kg, trying to stay fairly active physically, although have been working a desk job for ten years now. My main physical activity is a few fitness sessions per week and walking. I have a little abdominal fat, but overall I'd say I'm in good shape. I have a quite full life, with a friends, family, girlfriend, cats, traveling and more projects for the future.
For about ten years now, I’ve been experiencing situations where my body seems to give out on me or puts me in unpleasant and not always easily explainable states. Up until I was 25, I always felt quite physically fortunate — I could always rely on my body, I was fairly athletic and in shape, I was always running around and climbing several flights of stairs with very little effort.
At 25, my father fell ill with leukemia and passed away within a year. Around that time, I started waking up at night in a panic with a feeling of imminent death and strange sensations around my heart — like an overload, a surge, a kind of nervousness, as if a big wave was coming and I was about to die, or that something was about to happen. After that, this phenomenon happened many times sporadically, and sometimes nothing for months. But many other symptoms also appeared since then, quite varied, but often involving feelings of weakness in the heart area or in the body in general; a feeling of not having enough energy even to speak, shortness of breath, intense fatigue while walking, even a kind of lightheadedness after eating. A sort of fatigue could sometimes overwhelm me after moderate physical activity like cycling — but sometimes not, even with the same activity. My lifestyle is quite healthy: diet, hydration, sleep, etc. I don’t consume alcohol, drugs, or take any regular medication.
All of this gradually started to complicate my life and affect my choices, even though I am still trying to live it fully and I'm quite happy overall. I began avoiding certain activities or going on vacation with certain people because I didn’t want to be a burden — suddenly tired “for no reason” and needing to rest for three days straight. I find it hard to talk about because it feels strange, not very rational, and difficult to explain. I even oriented my professional life toward an office job because at least it limits physical effort and reduces the risk of drawing attention when I experience these states of fatigue or lightheadedness.
Over the past ten years, I’ve consulted many professionals across different fields: medicine, psychotherapy/psychology, hypnotherapy, alternative medicine, and spirituality. I’ve undergone quite a few tests such as: brain MRI, several complete cardiac evaluations over the years, a sleep apnea test, gastroscopy and colonoscopy, common allergy tests, general check-ups, and blood tests. None of these examinations have revealed any dysfunction, abnormality, or weakness. Over the years, I have also followed several therapies with different psychologists and psychotherapists to explore the anxiety/psychosomatic angle, but so far I don’t feel it has been very conclusive.
What might support the anxiety hypothesis is that I have seen several people in my family suffer from illnesses, in addition to my father. At 16, I saw my mother collapse and scream due to a recurrence of a brain tumor, for which she was successfully operated on, but which still physically weakened her. During my teenage years, I also witnessed my sister having epileptic seizures several times. It was quite traumatic for me, and I think that along with my father’s death, it made mortality very real — and since then I feel quite hypochondriac.
What I cannot clearly determine is whether all of this is mental/psychological in nature or purely physical. Has anyone experienced something similar and been able to find causes and/or solutions ?
I know my post must lack a lot of information to be able to make a clear assessment, even more trying to do so over the internet. And of course the best thing to do will be to keep exploring all this with professionals, but I thought it could maybe help to have some insights by people who might recognize themselves in my post.
Thank you in advance for your help.
