You're walking along, minding your own business, when suddenly – out of nowhere – your heart races. It feels like it's beating out of your chest. You may even feel a bit lightheaded, and it feels like your heart is going to crash. You're worried you may have a heart attack, and your 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. Heart palpitations can be a terrifying problem, but what may surprise you is that these palpitations are almost always completely harmless.
Heart Palpitations = Anxiety?
Sudden, rapid heartbeat could be indicative of a heart health problem. Talk to your doctor, but also make sure that you take my free 7 minute anxiety test to get a complete profile of your anxiety and how to treat it.
What Heart Palpitations Tell You About Your Anxiety
Heart palpitations can affect anyone with anxiety. They're both a symptom and a cause, and are more common in those that suffer from anxiety attacks. Check out your anxiety profile (if you haven't taken my free anxiety test yet, do so first). You'll see information about what type of anxiety you're likely suffering from and what it means.
Heart palpitations may be caused by "skipped beats" or caused by nothing at all. They can be caused by anxiety and they can occur for no reason and actually cause anxiety when they occur. Palpitations are a confusing and often distressing event that many people find causes them to feel as though something is terribly wrong with their heart.
Understanding the Causes of Palpitations
It can be difficult for doctors to find the origin of these palpitations, because often they have no origin. It's well known that anxiety can cause heart palpitations, and it's believed that the main cause may be an over-awareness of one's own heart, combined with surges of adrenaline that may occur at random in those with anxiety. These types of palpitations often trigger panic attacks.
Panic attacks themselves can also cause palpitations. During a panic attack, two things occur that lead to rapid heartbeat:
- First, the sympathetic nervous system is on high alert, which may lead to a rapid increase in heart rate.
- 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 reasons unrelated to anxiety, but still affected by anxiety. For example:
- 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. Most likely this is because the body "understands" why you're experiencing an increased heart rate during exercise, and essentially explains it away, while when it occurs before and after exercise it becomes more distressing.
It's important to remember that heart palpitations are not just 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 acute awareness of the rapid heartbeat taking place.
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, an in most cases is completely harmless. Also, there are heart conditions that can cause heart palpitations, and in some cases diagnosis of a heart condition can cause 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 not uncommon to continue to fear that the doctor missed something. Anxiety causes worst case scenario thinking, and so doctor's visits alone are rarely enough to calm the mind.
If you're suffering from a heart palpitation, consider the following tips to avoid turning that palpitation into a severe panic attack:
- Go Walk Around Some palpitations can be so severe that the 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 that you feel safe. Walking helps with blood flow, and appears to have a natural calming effect on a fast beating heart.
- Distract Your Mind Remember that the awareness of your heartbeat can both cause a palpitations and 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 doing 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 make it difficult to think too much about your heartbeat.
- Control Your Breathing It's not often the palpitations themselves that cause the most anxiety. It's the additional symptoms that mimic those of heart disease. That's why it's very important that you do your best to avoid hyperventilation. Take slow, controlled breaths to ensure that you're not rapid breathing. Fight to urge to yawn or take overly deep breaths as your body may not need that much oxygen, even though it often feels as though you aren't getting enough air.
- 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.
- Drink Water Drinking water is actually a naturally calming activity. The cool water seems to have 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 seems to have the ability to create palpitations, and those with panic attacks may be more prone to them in general. Make sure you also commit to an anxiety reduction strategy.
I've helped thousands of those suffering from heart palpitations learn to control their anxiety and reduce the frequency of these palpitations from occurring. Start with my free 7 minute anxiety test. It'll help you learn more about your anxiety and how to reduce it.
Friedman, Bruce H., and Julian F. Thayer. Autonomic balance revisited: panic anxiety and heart rate variability. Journal of Psychosomatic Research 44.1 (1998): 133-151.
Ley, Ronald. Agoraphobia, the panic attack and the hyperventilation syndrome. Behaviour Research and Therapy 23.1 (1985): 79-81.
Ehlers, Anke, et al. Psychological and perceptual factors associated with arrhythmias and benign palpitations. Psychosomatic Medicine 62.5 (2000): 693-702.
Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.