Anxiety, Heart, Panic: A Fearful Circle

Anxiety, heart, and panic … have you noticed how people always refer to these three conditions as if they were all the same thing?

You must have heard sufferers say, “I’m having an anxiety episode. I’m panicking. My heart’s racing towards an attack!”j

That’s natural because these three conditions are indeed interconnected. But there are also fine differences between them.

It helps to know how to tell one type of attack from another … without confusing the signals.

It also helps to know that the whole fear-driven vicious circle is possible to calm down and manage.

1. What is an anxiety attack and how is it caused?

Anxiety is the most natural response of the body to danger. Our bodies are naturally made to show us signals when we are presented with imminent threats.

For example, our hearts beat faster, our breathing gets heavier, our muscles tighten, our nerves are on sharp alert, and our minds are overactive. This, according to the expert psychiatrists is called the “fight or flight response”. In the face of lurking alarm, our bodies get ready to either stay and fight the hazard – or flee from it.

In olden times, when people faced life in the wild amidst real danger, these signals of anxiety alerted them to save themselves from wild animals or other natural perils. But the modern world has no such dangers, right? So why do we then have anxiety symptoms?

That’s because many of us see ordinary life challenges as “perceived threats”. Our bodies then create the same “fight or flight response” signals even for sillier things like work deadline fears, or life changes like relocations. Sometimes, even good life events like an impending wedding or a promotion can create anxieties.

2. What kinds of people get more anxiety in their lives?

Two kinds of people are more prone to anxiety in their lives.

One group, as we saw earlier, is those who see every small challenge or change in life as “dangerous” or “highly negative”. Life, as we know, never goes 100% smoothly at any time. When you take every setback, minor and major, as a threat your anxiety can go sky-high.

The second group of anxiety sufferers is those who have OCD (Obsessive Compulsive Disorder). These are people who are extreme perfectionists, always wanting life to follow a certain pattern. Even a slight change of order can create high levels of anxiety in them to set right the “disorderliness”.

3. How is an anxiety attack different from a panic attack?

A panic attack is a more aggressive kind of anxiety attack. In an ordinary anxiety attack (called Generalized Anxiety Disorder), we would feel tight and stressed, with fast heartbeats and raw nerves. In a panic attack (also called Panic Disorder), things get so stressful that we find it difficult to breathe.

We suffer what doctors call “hyperventilation” – or very short, shallow, and fast breathing that sometimes leads us to faint. Our stomachs begin to churn, our mouths go dry, and we feel as if we are suffocating from lack of oxygen. It’s as if something is tightening our chests unbearably.

Hyperventilation is not a shortness of oxygen, as we think … but because our breathing is shallow and rapid, there’s an over-intake of oxygen and a lack of enough balancing carbon dioxide.

An age-old trick that doctors prescribe is to breathe into a paper bag, held tight to our faces, for a short while. We thus briefly breathe in the carbon dioxide we are breathing out – and we rebalance the carbon dioxide levels in our lungs.

4. How do anxiety or panic attacks affect the heart?

The relationship between anxiety, panic, and heart disease is a vicious cycle, where anxiety and panic affect the heart and vice versa – as demonstrated by this graphic from the Centers for Disease Control and Prevention (CDC).

Click on the image to expand.

Image courtesy: Centers For Disease Control and Prevention

According to CDC, people with depression, anxiety, or stress, over a long period, may experience certain physiologic effects on the body, such as increased heart rate and blood pressure, reduced blood flow to the heart, and heightened levels of cortisol. Over time, this can lead to calcium buildup in the arteries, metabolic disease, and heart disease.

On the other hand, after heart disease sets in, those with anxiety and depression may also increase their smoking, inactive lifestyles, or fail to take prescribed medications, because they may have fewer healthy coping strategies for stressful situations.

One more thing about the heart … if you are a patient with other ailments like hypertension, obesity, diabetes, or cholesterol – or you have a family history of heart disease – the chances of future heart attacks get multiplicative.

5. When is an anxiety or panic attack serious enough to call the doctor?

It’s often wrong to try and evaluate if you are having an anxiety or panic attack, or a heart attack, just by trying to gauge your heart rate. There is no standard anxiety heart rate, panic heart rate, or heart attack heart rate. Your doctor is the best judge because there are so many other variables to consider besides heart rate.

The best thing to do is to monitor the situation. An anxiety attack or panic attack may go away on its own after a while. But if the problem persists for a long duration or recurs too frequently, you may be better off visiting a doctor to see if your heart is involved or impacted.

The signs to take seriously are when you also have shortness of breath, dizziness, chest pain, or a fainting episode, along with excessive sweating. If you have a doubt, it’s always better to get a medical clearance that all is well with your heart. That’s one worry less, and that always helps!

6. How do specialists diagnose and treat anxiety?

If you feel you have an anxiety disorder or a panic disorder, get your doctor’s referral to a good psychotherapist. Your therapist may recommend an approach that combines some anxiety-relieving medications and some behavioral counseling.

You may be encouraged to try Cognitive Behavioral Therapy, where you are taught to identify automatic negative thoughts and replace them with positive ones. One other method is called Exposure Therapy where you are made to face the anxiety-causing problems often – to stop fearing them anymore.

Other treatments could include relaxation exercises, biofeedback, and meditation.

7. How can you calm yourself and prevent anxiety from impacting your heart?

If you’re cleared medically and feel capable of handling your anxiety yourself, there are some excellent self-care ideas you can try to calm your mind and body.

• Get some regular exercise. When you rid your body of excess nervous tension through active physical movement, your mind will stop racing out of control.

• Avoid interactions with those who are argumentative. Don’t let anyone wear you down with too much intellectual squabble.
• Spend lots of time with Nature. The scenes, scents, and sounds of life around will take your mind away from itself, where it tends to wallow in its miseries.
• Focus on sensory pleasures. Savor the taste of food. Inhale the aroma of cooking. Hear the sounds of the street outside. Pet your puppy’s warm fur. Fill your eyes with the beauty of the sunset.
• Learn to take life easy. As wise people say, “Don’t take everything to heart.”
• Don’t always live in your mind overwhelmed by thoughts. Live amongst things outside of yourself.

Free yourself from the old negative anxious or panicky thoughts and greet each new day with a fresh mindset, eager to live. Show your heart some love.