Anxiety, Palpitations and More Anxiety

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated October 10, 2020

Anxiety, Palpitations and More Anxiety

There you are, minding your own business, when suddenly – out of nowhere – your heart starts racing. It feels like it's beating out of your chest. You may even feel a bit lightheaded, and it feels like you’re going to pass out. You're worried you may have a heart attack, and you feel a rising sense of panic, not knowing what to do next.

You may have had a heart palpitation – the term that doctors use to describe a rapidly beating heart. It may feel like your heart’s beat has skipped or doubled-up. Heart palpitations can be terrifying, but what may surprise you is that these palpitations are almost always completely harmless.

What Heart Palpitations Tell You About Your Anxiety

Heart palpitations can affect anyone with anxiety. They're both a symptom and a cause of anxiety, and they are especially common in those that suffer from panic attacks.

Heart palpitations can be caused by anxiety. At other times, however, they may occur for no particular reason and then go on to cause subsequent anxiety. Palpitations are a confusing and potentially distressing event and people may erroneously assume that something is terribly wrong with their heart.

Understanding the Causes of Palpitations

It's well known that anxiety can cause heart palpitations. Being over-aware of your own bodily functions (including your heartbeat), in combination with surges of adrenaline that are often present in people who have anxiety, may lead to heart palpitations. These palpitations may also trigger panic attacks, which in turn may increase the likelihood of more palpitations.

During a panic attack, two things occur that may elevate your heart rate:

  • First, the sympathetic nervous system is on high alert, which may lead to a rapid increase in heart rate. The sympathetic nervous system is the part of the nervous system that creates the fight or flight response. The increase in heart rate is a reaction designed to help improve blood flow so that you can run or fight more effectively.
  • Second, during panic attacks, people often have a tendency to hyperventilate. Hyperventilation also leads to an increase in heart rate.

Yet panic attacks and anxiety themselves do not account for all of the palpitations. That's because palpitations may also occur for other reasons, such as:

  • Caffeine Caffeine is known to cause heart palpitations. It's likely that those with anxiety are either more prone to these palpitations, or more prone to noticing them and thus amplifying their effects.
  • Alcohol and Nicotine Both alcohol and nicotine may also cause heart palpitations. Once again, this affects both those with anxiety and without, but many people with anxiety suffer from "over awareness" of the way their body feels, so the rapid heartbeat is interpreted as something being wrong.
  • Exercise Exercise can also contribute to palpitations. Interestingly, these can occur both before and after exercise, but are less common during. That may be because following exercise, a person’s heart rate reduces naturally despite the continued presence of adrenaline in the body.

It's important to remember that heart palpitations are not just a rapid heartbeat. It's also the awareness of that heartbeat. That's why these issues – which are all very common and affect nearly everyone – do not by themselves cause palpitations or the anxiety that surrounds them. For something to be considered a palpitation, there must be an awareness of the rapid heartbeat taking place - and usually a sense of discomfort relating to this change in rhythm.

There are also some heart issues that are not dangerous that may create palpitations. For example, there is a condition known as mitral valve prolapse that can lead to heart palpitations that isn't by itself dangerous. In some cases heart palpitations are caused indirectly by a heart condition, when having that diagnosis increases your anxiety which then leads to anxiety-related palpitations.

How to Control Your Anxiety During Heart Palpitations

It's always important to first get checked out by a doctor. Heart health issues are nothing to leave to chance. But it's also important to remember that after your doctor has told you that you have a healthy heart, it's common to continue to fear that the doctor missed something (especially if you have anxiety). Anxiety causes worst case scenario thinking, and so doctor's visits may not always be sufficient to calm the mind - but they are necessary and constitute a step in the right direction.

If you're suffering from heart palpitations, consider the following tips to prevent that palpitation developing into a panic attack:

  • Go Walk Around Some palpitations can be so severe that a person feels dizzy or lightheaded and worries they cannot walk. But if you can walk around, get up and take a brief walk in an area where you feel safe. Walking helps with blood flow, and may have a natural calming effect with the added benefit of a lowered resting heart rate.
  • Distract Your Mind Remember that actively thinking about your heartbeat can trigger palpitations and/or make them worse and more pronounced. Once you're thinking about your beating heart, it's often hard to think about anything else, but you can decrease how much you think about it by performing an activity to distract your mind. Try calling a friend, as many people find that talking to a friendly voice is calming and holding a conversation can serve as a helpful momentary distractor. Alternatively, you might want to listen to some calming music, read a book or drink a cup of herbal tea.
  • Control Your Breathing Through controlled breathing, you can reduce the likelihood of palpitations by lowering your overall anxiety levels and reducing the risk of hyperventilation. Take slow, controlled breaths to ensure that you're not breathing too rapidly. Try to maintain a regular breathing pace and pause for a few seconds between your inhalation and exhalation (as long as this pause feels comfortable).
  • Cut Back on Caffeine Caffeine isn't the demon that a lot of anxiety specialists claim it to be. But there is no denying that many people with anxiety attacks experience fear due to some of the symptoms of caffeine. A single cup in the morning is usually acceptable, but too many and you increase the risk of palpitations and anxiety. Because the line between “acceptable” and “too much” is small, it is highly recommended that people eliminate caffeine just to be safe.
  • Drink Water Drinking water is a naturally calming activity. The cool water often has a soothing effect on the body. Since dehydration is also another possible cause of heart palpitations, it's possible that drinking water may also simply reduce the palpitations as well.

One thing to notice, however, is that none of these are going to stop palpitations from occurring if you already have anxiety. Remember that focusing on your heart too much can in fact trigger or exacerbate palpitations. Although palpitations in and of themselves are generally harmless, the best way to address this issue is to commit to a formal anxiety reduction strategy. By lowering your anxiety levels, you’re reducing the overall likelihood of experiencing palpitations.

Questions? Comments?

Do you have a specific question that this article didn’t answered? Send us a message and we’ll answer it for you!

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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