Really struggling with anxiety about heart problem

[damianjmcgrath]

I've probably had health anxiety since I was 15, and I'm 30 now. Up until last year, it was stomach problems that I was worried about and I'm sure I had IBS and a fear of being sick. I only mention that to set the scene that I am naturally anxious person about my health.

Last year, I started getting chest pains, light headedness, dizziness, fast pulse, high blood pressure, hotness in my face, clammy hands. I thought it was a heart problem, and I've had many tests done. I've had a full blood count, multiple ECG's including a stress ECG, an echocardiogram, and a thyroid blood test. I also had a 24 hour urine test to check for an adrenaline problem. Everything has come back fine.

(There was 1 note on the ECG's, which was an inverted T wave in lead 3, which Google tells me is a problem, but all the doctors and cardiologists say it's absolutely normal. This plays on my mind often).

Anyway, the doctor prescribed me proponanol which I haven't taken. I wanted to try other solutions first. I've had a 6-week group CBT course, and I'm currently 8 sessions into a 12-session one-to-one CBT course. I've had 4 hypnotherapy sessions, and I've had 4 chiropractor sessions to try and eliminate a muscle problem for the chest pain. The chiropractor actually makes me feel slightly better but generally, nothing has worked in terms of "curing" me.

All of that has made me realise it's anxiety though. Over the last month, I have come to the 100% realisation that it is anxiety, and I've felt better generally. I've had more good days than bad, and I felt like I was turning a corner.

However, in the last week, I feel like I've gone downhill again.

I've had these symptoms for the last week, pretty much continuously:



Heavy indigestion type feeling in my left side chest and occasionally middle chest.
Feeling like my lungs can't expand properly. I am breathing fine, I'm not hyperventiliating, but it sometimes feels difficult to breathe, like the feeling you get in a sauna.
Occasionally choky throat feeling, similar to that feeling you get before vomiting.
Complete lack of interest in anyone's conversation, watching TV - it's like there's no motivation to do anything. Everything annoys me.
Feeling of wanting to run away from something. It's like I'm trapped or scared of the symptoms, and I feel like I want to burst or explode. This is the time when I feel really panicky and scared.


I know it's anxiety. I'm sure it's not a heart problem. But together with all of those symptoms, there is 1 symptom I have which I want to try and get past.

It's my frame of mind. I'm aware that I'm always worried. I can't go for a jog because my mind is on my heartbeats. I can't relax in the garden because when I'm doing nothing, my mind focuses on the pains and sensations in the chest. Even when I feel fine, I'm sort of waiting for the pain to start again, so I'm always on edge. My little daughter crying or being annoying will stress me out far too much, and that makes me feel worse, because it seems to affect my chest tightness more. It's like my mood creates a heaviness that's always around and makes me not want to do anything. I continually talk to people about how I'm feeling. I continually work myself up to the point where I need to check myself with my blood pressure monitor or home ECG kit.

I'm really really struggling to ignore the symptoms and just get on with things. It's like if you tell someone with a migraine to get up and go to a party. It feels impossible. It feels like I'm not physically able to ignore it. I think if I can distract my mind and ignore things, that will be the key to "curing" myself.

I've tried podcasts, breathing techniques, mindfulness meditation, relaxing by myself, doing something fun like playing computer games, but it doesn't seem to work. It's like half my mind is always on my symptoms.

Can anyone recommend something for me to try - something to help distract my mind?

[ricardo]

I think you have analysed yourself completely and everything IMO points to General Anxiety Disorder. Yoy are completely transfixed on your own body,which is not at all unusual in high anxiety cases,I have done it myself and moved from one part of the body to another.

Did your doctor give you propranol for your BP or for anxiety ,or both, and how much did they prescribe.?

[damianjmcgrath]

When I saw him, I was suffering from my fast heart rate during the anxious moments. He prescribed it to slow that down. He prescribed 10mg - the smallest dose possible - because both of us thought it wasn't that bad.

Since then, the fast heart beats have disappeared, I no longer get those. I just get pain, dull ache, like indigestion would be, and a bad "sensation".

I wanted to try non medication avenues first, that's why I haven't taken it.

I take your point about GAD. My counter argument to that is that I don't have anxiety about any other part of my life. I can do work presentations, meet strangers and give talks to them, can go to busy football stadiums and shops etc. I also don't worry about other aspects of my health. If I have a headache, I don't think tumour. I only worry about one thing and that's my heart. In fact, when I get headaches, I worry it's heart related.

Is it possible to have GAD about just one specific thing?

The last thing I'd say is that it does feel like it consumes most of my thoughts for most of the day, and that's true to an extent. I can focus on work and if you met me, you wouldn't be able to notice anything. I can function, but part of my brain is always on this issue, ready and waiting for the next worrying sensation.

I also don't feel depressed. Most of the time, I feel reasonably ok, can laugh at tv, and my everyday life is functioning. I feel a bit down because I can't solve this problem but I don't think I'm depressed.

[ricardo]

Damian

I honestly don't know, GAD means what it says and you seem to have a pretty normal life otherwise and do things most of us high anxiety suffers could never entertain.

A fixation about one part of your body, your heart, yet nowhere else stumps me, hopefully somebody else can help you.

[damianjmcgrath]

Ha I'm obviously pretty special!

Its stumped me too and makes me think maybe there is an underlying problem. If I could lighten my mood or my thoughts, I reckon I'd be a lot better. My negative thoughts contribute massively. I don't know how to stop fixating though. That's the one key area I need help with.

[sputnikmoon]

Everything you've written I can relate to... It's a post that I can very much have seen myself writing verbatim at some stages of my life!

None of your symptoms seem out of the ordinary for anxiety and panic and most importantly, they are atypical for heart issues.

Yes, looking at it like a check box of symptoms, some of them overlap with cardiac symptoms... But heart issues that would produce those symptoms would also have other more severe warning signs before you got to that stage, that you don't mention at all.

You need to remember the heart is a VERY simple mechanism. People think it's some mythical organ because it's important... But the only way nature could guarantee the mileage our bodies need was for it to be simple and never stop for 50+ years.

Heart issues don't really hide - people who die from sudden cardiac death usually have never had a stethoscope to their chests, let alone an ECG - and in the postmortem they are found to have a pretty obvious flaw.

Hearts are 4 chambers and a coil of wires that either work, or they don't work. If they don't work with a potential to be lethal, it's obvious...

If you have symptoms that are transient and aren't caught on an ECG, that's usually because the symptoms are minor and aren't detrimental to the continuous function of the heart - it'd just be some PVCs that are literally considered as dangerous as a hiccup... Unless you had severe structural issues, which would be obvious from just listening to a heart with that kind of structural defect :p

The anxiety about jogging and going out I can totally relate to, been battling it for 10 years now... Had very dark periods - yet my body is still here doing its job and everything I ask of it, like a faithful servant with only the natural creaks and hiccups you'd expect from an organic machine. We're not robots :p

You're here today because you're from a long line of people, who for hundreds of thousands of years have been walking the earth... Your body knows exactly what it's doing to keep you alive, just relax and trust it.

[damianjmcgrath]

That's the exact advice that the CBT guys told me and every book or podcast says. It is true, it's correct advice. I know deep down I'm probably fine. I know that if I have a heart problem, it would have to be one that comes and goes, evades ECG and echo testing, and one that I've had for 18 months without killing me or giving me any life altering differences at all. That sounds like quite a rare problem lol!

I understand your entire post. I really do.

My main problem is when I get panicky, and the aches are bad, I don't know how to ignore it or how to accept it. I wish I could. I just can't. It's so worrying that I can't get my mind off it. How did you manage it?

[Fishmanpa]

I've had two heart attacks, bypass and stents. I WISH I got the test results you did!

Don't know what to say really... just a reality check I guess :shrug:

Positive thoughts

[sputnikmoon]

Yea - when your mind clicks into that mode, it can be really tricky to snap back out.

It really is a case of being strict with yourself and having the discipline to not dwell, mixed with a pinch of time.

Time makes it easier for you to recognise your quirks and know that they have never endangered you in the past. You'll be all "I can't quite get my breathe and my hearts thudding and feeling hollow" and then you'll remember this has happened plenty of times before and you'll begin coming back down much quicker and not getting into that head space quite as often.

You'll then realise you've had a few days between episodes rather than having them daily, which then turns into having them weekly, a few times a month, and eventually not being able to put your finger on when it last happened.

One thing I notice is I can now go weeks without issue... Then have a bad day or two which I pull myself back out of. Then I might be fine for months and months with the odd minor episode... But then have a week of having all the old symptoms coming back and me taking myself to A&E.

One thing that definitely happens is you become much better at "knowing" yourself and your symptoms and rather than having a heart flutter that would freak you out for days, it'll just freak you out for a few minutes. Or even the odd flutter that you literally brush off and doesn't phase you!

One thing I try and recommend is not to take medication if you feel you can avoid it. I was on pills for years and was a bit better, but still had meltdowns regularly and was petrified of the symptoms. They had a lot of iffy side effects too that mixed in with the health anxiety and fuelled it.

When I came off the pills I set about actually getting my head straight and that's when I began having a marked improvement in symptom reduction. The pills basically acted as a crutch and didn't allow me to actually get the mental skills that are needed to deal with the anxiety.

You need to continue being disciplined, not getting too entrenched in set backs, you'll have bad times like this - but you'll also have good times again, followed by other bad times... that are then more quickly replaced by good times as you build your confidence in your body.

There is no quick fix, no one will have a magic technique that will see you sorted by tomorrow... You've spent so long looking in on yourself and hyper analysing everything, that it'll take time to fix those reflexes and start looking back out at the world :p

[damianjmcgrath]

I'm always searching for that magic technique :)

Thank you for your advice. It's really nice knowing people are listening. You're obviously right as well. I know what I need to do, I just need to actually do it.

The anxiety is a tricky beast though. One day, I'll get indigestion type pains, then it'll be a shaky vibration feeling, then it'll be pains during/after exercise, then it'll be a fast heart rate randomly, then it'll be a sharp stabbing pain in a different location, then I'll notice I can't walk and talk as well as I used to, and that'll set my head off thinking perhaps my heart isn't pumping enough oxygen, then it'll be a dizzy spell, etc.

I can't quite get used to something, but I need to lump them all together, and say "right, this is anxiety, lets consciously push it to the back of my head, get on with things, and if I collapse, then at least that means there's a proper problem and someone should be able to find it and cure it. If I don't, then that's good!". Over time, that should start becoming subconscious.

It's really tough. Like a migraine, if someone says ignore it, you'd be like "no way, it's really bothering me." I just need to make that effort to get past it.

On a slight side note, and I've been meaning to ask this for a while in this forum - anxiety has a habit of changing and giving you other symptoms randomly. How do you know that a particular symptom is anxiety related, and how do you quieten that voice that says "this is new, I shouldn't ignore this, this is something real, go and get checked"?

[sputnikmoon]

Haha, just reading this bit made me laugh:

"anxiety is a tricky beast though. One day, I'll get indigestion type pains, then it'll be a shaky vibration feeling, then it'll be pains during/after exercise, then it'll be a fast heart rate randomly, then it'll be a sharp stabbing pain in a different location, then I'll notice I can't walk and talk as well as I used to, and that'll set my head off thinking perhaps my heart isn't pumping enough oxygen, then it'll be a dizzy spell, etc."

They are the EXACT symptoms, every single one, I get and the EXACT conclusions I draw up when I'm having a bad time with it :p

As for knowing which to take seriously... I've never actually had a real issue, sure, the panic symptoms are severe - but I think when it is something bad, you aren't actually panicked, if that makes sense?

You don't see people having strokes, arrhythmia and heart attacks pacing rooms, flapping around, telling everyone they're dying, tapping their feet and crying... They are calm, but aware that something very painful and severe is happening ?

[damianjmcgrath]

I really should keep a diary, but looking back, it's weird how my cycle of different aches occurs soon after I've read something. For example, I read how a cardiac problem would get worse through exercise and better at rest. Then, "randomly", a few days later, I got chest pains and heaviness and tightness when exercising or exerting myself, and it went away at rest. Almost as if the anxiety wanted to convince me it was real! Doesn't seem fair!

Then I read that proper heart problems are normally in the middle, not left side, and then I randomly got pains in the middle too.

It's clever, because now the helpful logic I had of "oh, this must be anxiety because it's not in the middle" is gone, etc.

Your logic about knowing when it's real makes sense. I guess I'll be able to tell the difference. I've moaned quite a bit about my symptoms but the truth is, it's never been bad enough to warrant painkillers. It's just a dull ache - using the same example, but I wouldn't take painkillers with indigestion, because it's not a pain, it's just an annoying dull ache. I guess with a real heart problem, the pain would be much bigger.

The NHS websites don't help by saying "most attacks have no pain, so just be aware of dizziness and weird sensations". If I followed every bit of NHS advice, I'd never leave A&E! I actually spoke to my father in law, who has had a heart attack, and he described a crushing pressure, moving about, getting worse, to the point where he absolutely knew he needed help. Granted, not all heart problems are the same, but I'm going to assume it's anxiety unless I physically cannot stand it anymore.