Is it anxiety? Is it a heart attack?
Your heart begins to race, you start sweating, and your chest begins to tighten. You find yourself petrified that you might be having a heart attack. How do you know for sure? Could it be anxiety? This is a terrifying experience to find yourself in, one that is much more common than you might expect.
The National Institute of Mental Health (NIMH), estimates 31.1% of US adults will experience an anxiety disorder in their lifetimes. The Cleveland Clinic shared that every year 11% of Americans experience a panic attack and around 2-3% of that population will go on to develop a panic disorder. On the other hand, according to the CDC, around 805,000 people in the US have a heart attack each year. So it makes sense that you could feel quite confused and afraid. Heart attack symptoms have a great deal of overlap with symptoms of anxiety and panic. Some examples of overlapping symptoms are: tightness in your chest, shooting pain in your body, blurred vision, difficulty breathing, dizziness, tingling sensations, fatigue, heartburn, and nausea.
As a mental health clinician, I would like to first acknowledge that I am not a medical doctor and cannot tell you whether or not you are having a heart attack. I always recommend if you are uncertain whether you are having a medical or a mental health related emergency, to err on the side of being evaluated by a medical doctor first. For me, this is always the first step I recommend to rule out medical related concerns before I begin diagnosis of Generalized Anxiety Disorder or Panic Disorder and treatment of these conditions.
So if you have been evaluated by a medical professional and rule out that you are not in fact having a heart attack and are in good heart health, it is likely you will be told you were experiencing anxiety or a panic attack. This is where us clinicians come in. So next time you are experiencing tightness in your chest, difficulty breathing, pain in your arm, blurred vision, sweating, and intense fear that you are having a heart attack what do you do?
Signs it is anxiety and not a heart attack
1. You have experienced panic attacks before
2. You are diagnosed with an anxiety or panic disorder
3. The symptoms come and go with stress or triggers
4. The symptoms get better when you use calming strategies and coping skills
5. You have been seen by a medical professional and been told you are in good heart health
6. You do not have a family history of heart attacks or heart disease
7. You have a family history of anxiety and/or panic disorders
If it is anxiety… How to Cope
The voice of anxiety can be very loud when you are experiencing physical symptoms of anxiety. It can be so convincing in telling you that something is very wrong and that you might be dying. This can be quite a frightening experience. It is important to prepare and think through strategies to cope with panic attacks and episodes of anxiety before you are feeling anxious so that you are ready when you need these resources.
Strategies
1. Talk yourself through
Remind yourself that you have experienced these sensations before and they passed with time. Remind yourself that you are safe and that you have what you need within you to get through this episode.
2. Breathe
When experiencing anxiety, it is common to hold your breath. This can be where symptoms like tightness of chest, difficulty breathing, and light-headedness can come from. When experiencing an episode of anxiety or a panic attack, engaging in breathing strategies like Box Breathing can be very helpful.
3. Grounding
When experiencing anxiety or panic, our bodies are often living in the past or the future, concerned about what might happen or something that has already taken place, both being times outside of our control. Grounding into the present moment can remind our body where we are, in the present, where we have control and are safe. One great grounding skill is the 5,4,3,2,1 Method.
Some common misconceptions about panic disorder and anxiety disorders
For those suffering with anxiety and panic disorder as well as society as a whole there can be the misconception that anxiety is “all in your head.” For those suffering with these disorders it can be then very alarming when these symptoms manifest in a physical way, leading to confusing one’s symptoms for other medical conditions like a heart attack. For society, this can lead to harmful claims that those suffering with anxiety are “just making up” these physical symptoms and are not actually experiencing them. This contributes to the overall stigma of mental illness and can prevent folks struggling from receiving the help they need and deserve.
Another common misconception of anxiety and panic disorder is that the person experiencing them will always struggle with anxiety and panic and that these conditions cannot be treated. This too is false. In fact, Anxiety is one of the most treatable mental health conditions that mental health clinicians can treat. Modalities like Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), and Exposure and Response Prevention (ERP) have been found to be very effective for treating anxiety disorders.
If you are experiencing symptoms of a heart attack, please always seek medical attention first. If you have received medical attention and have ruled out heart disease and heart attacks, reach out to a mental health clinician who specializes in anxiety and panic disorder to learn how to cope with the episodes you are experiencing and to treat the overarching condition of anxiety.
References:
https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
https://www.healthline.com/health/box-breathing#slowly-exhale