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Anxiety, Palpitations and More Anxiety

Daniel Sher, MA, Clin Psychology
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:

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: 

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:

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.

Article Resources
  1. 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.
  2. Ley, Ronald. Agoraphobia, the panic attack and the hyperventilation syndrome. Behaviour Research and Therapy 23.1 (1985): 79-81.
  3. Ehlers, Anke, et al. Psychological and perceptual factors associated with arrhythmias and benign palpitations. Psychosomatic Medicine 62.5 (2000): 693-702. 
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