How to rationalise/retrain your heart rate expectations?!

[ankietyjoe]

A brief history :-

Several years of on and off anxiety, which I'd managed to control with meditation and plain old practise.

2 years ago I was ordered (literally) by the GP to go to A&E as I had sustained tachycardia (120bpm for several hours). All tests were fine, it was put down to a very bad infection I was carrying, combined with immense amounts of stress. This happened again 2 weeks ago, even more stress (involving 3 lawyers, 2 freeholders, 4 months mortgage arrears and a £60k legal bill over something that's not my fault - taking 5 years to resolve) and another infection. All tests showed normal again.

Now, I know I shouldn't, but I keep checking my pulse.

The issue is that I think my expectations for what my heart rate 'should' be at any given time are now way off.

When I wake, historically my HR would be 58-66 or so. More recently it's been about 10-15 bpm higher due to the infection and stress.

During the day it can be anything from 75-100bpm depending on whether I'm sitting/moving around. I would say the daytime average is about 85.

My stupid head has an issue when it goes much above 85 now. I find it very difficult not to lay down and wait for it to settle every time it rises towards 90-100. To make matters worse I can tell what my heart rate is by standing still and just 'feeling it', without checking a pulse point. I"m rarely more than 2-3 bpm off.

Yes, I'm obsessed. :wacko:

I'm trying to get into a CBT program again via the GP, but they're reluctant because I won't take AD's. According to them I need to go down that road first. I disagree.

I know it's a good idea to keep moving around and let my heart do what it needs/wants to do, but the 2 trips to A&E cause very powerful alarm bells in my mind. I don't have an issue with my heart rate going up to 150bpm+ for several minutes if I have a PA or run up the stairs, but the idea of it going up and staying there is scary. Unfortunately history has proved that it can actually happen.

[Strawberry_3]

Bless you, sounds like you've been having a really stressful time! :(

I can 100% relate to the obsession with pulse-checking and evaluating.

Last year I woke up with an incredibly rapid pluse. when the paramedic arrived, it was 165bmp. It stayed that was for a couple of hours because they couldn't figure out why it was so high or give me the right medication (they thought it was SVT but when a Cardiologist checked my ECG tracing, it turned out to be sinus tachycardia). Turns out I have 'Inappropriate Sinus Tachycardia' and it played up while I was having a really stressful time. Even though I've been reassured that a high heart rate can simply happen and not cause any issues, I became quite paranoid.

The heart is a strong muscle and can generally sustain a high HR, it's important to remember this. And if you've been checked over by a doctor and had it found that your heart is healthy, there's no need to panic (although I feel like total hypocrite...).

What I try to do is, when I feel the urge to check my pulse, I tell myself 'no, I won't check it for 3 minutes.' and sometimes the urge passes or I get preoccupied, sometimes I check it straight away anyway. I also try and tell myself ''just let it do its job in peace!''

Checking it isn't going to control the rate. Sometimes, it'll beat harder/faster in times where we don't think it's appropriate. This is often because something else totally normal is going on in the body that we don't even know about which might be influencing it (hormones etc.).

If you can hear your pulse when laying down, or if you're generally hyper-aware of your heart beating sometimes, then it can be helpful to put some music on and focus on the beat of that (or even a metronome!).

This is something that you can overcome but it does take time and work. You can do this :) x

[Fishmanpa]

Just want to comment concerning the meds/CBT. You know you're spiraling and obsessing so that's a given. CBT requires a concerted effort. Note I said "concerted". It requires concentration and logical thinking. Right now that's not happening. Sometimes, depending on the severity of the issue, meds can help get your head in the right place to make that concerted effort. They're not a solution but a tool to help you get from point A to point B.

When I suffered with depression after my 1st heart attack, I was prescribed Zoloft. I can 100% say that it helped me, along with one on one therapy to get through the valley. I was on it for 6 months. All I'm saying is to seriously consider it as a means to an end.

Positive thoughts

[Josh1234]

I keep my heart rate above 160 for like 30 minutes at the gym. It's totally safe. Think about marathon runners.

[ankietyjoe]

Bless you, sounds like you've been having a really stressful time! :(

I can 100% relate to the obsession with pulse-checking and evaluating.

Last year I woke up with an incredibly rapid pluse. when the paramedic arrived, it was 165bmp. It stayed that was for a couple of hours because they couldn't figure out why it was so high or give me the right medication (they thought it was SVT but when a Cardiologist checked my ECG tracing, it turned out to be sinus tachycardia). Turns out I have 'Inappropriate Sinus Tachycardia' and it played up while I was having a really stressful time. Even though I've been reassured that a high heart rate can simply happen and not cause any issues, I became quite paranoid.

The heart is a strong muscle and can generally sustain a high HR, it's important to remember this. And if you've been checked over by a doctor and had it found that your heart is healthy, there's no need to panic (although I feel like total hypocrite...).

What I try to do is, when I feel the urge to check my pulse, I tell myself 'no, I won't check it for 3 minutes.' and sometimes the urge passes or I get preoccupied, sometimes I check it straight away anyway. I also try and tell myself ''just let it do its job in peace!''

Checking it isn't going to control the rate. Sometimes, it'll beat harder/faster in times where we don't think it's appropriate. This is often because something else totally normal is going on in the body that we don't even know about which might be influencing it (hormones etc.).

If you can hear your pulse when laying down, or if you're generally hyper-aware of your heart beating sometimes, then it can be helpful to put some music on and focus on the beat of that (or even a metronome!).

This is something that you can overcome but it does take time and work. You can do this :) x

Thanks for the good advice, it's stuff I already 'know' but you often need to have it drummed into your head. I"m getting better at not checking, but I need to retrain my brain to not respond in a negative way when my heart rate is 80-90bpm when I'm sitting or laying down. I'm VERY out of shape from a couple of years of trying to do as little as possible 'just in case'.


Just want to comment concerning the meds/CBT. You know you're spiraling and obsessing so that's a given. CBT requires a concerted effort. Note I said "concerted". It requires concentration and logical thinking. Right now that's not happening. Sometimes, depending on the severity of the issue, meds can help get your head in the right place to make that concerted effort. They're not a solution but a tool to help you get from point A to point B.

When I suffered with depression after my 1st heart attack, I was prescribed Zoloft. I can 100% say that it helped me, along with one on one therapy to get through the valley. I was on it for 6 months. All I'm saying is to seriously consider it as a means to an end.

Positive thoughts

While I see what you're saying, I will have to respectfully disagree. I've had CBT before and it worked pretty well. This was several years ago when my anxiety was relatively new and less ingrained.

I also practice meditation and mindfulness which are the tactics that allow me to handle panic attacks when they happen (which is rare nowadays).

The other concern is that my partner nearly died during childbirth in 2014. I actually sat there and watched her lose 2 litres of blood, get rushed into ER and then was kept away from me for the next 24 hours while she was in ICU. Along with abuse she received as a child this has left her with a very severe case of PTSD, which she is being treated for.

I simply cannot risk the potential side effects of 'it'll get worse before it gets better' that AD's often bring. I can manage the panic and anxiety fairly easily without meds, but I'm looking to logically retrain my brain regarding the checking and worrying about heartrate.

I was offered diazepam as a quick fix now and again, but I'd still prefer to deal with this mentally.


I keep my heart rate above 160 for like 30 minutes at the gym. It's totally safe. Think about marathon runners.

I get that, and I'm fine with my heartrate raising with a trigger (exercise, sex etc). Up to a point, as I mentioned before I'm very, very out of shape so 110-120bpm is all I need to get to for now.

My main goal here is to regain a more realistic view of where my heartrate should be at any given moment.

For example :-

85bpm sitting down - Fine, because of the stress I'm under
130bpm when I get up to go to the loo - Fine because I'm out of shape and it's normal and it'll come down again.
100bpm when I'm cooking and messing about in the kitchen - fine because I'm moving about and doing stuff.

All those numbers freak me out right now because a part of my brain says 'RESTING HEART RATE SHOULD BE XXXXX'

It's a complicated web we weave........ :huh:

[Strawberry_3]

Me again...

I was thinking the other day about how, back in prehistoric times, and more recently in history, people of course had hearts and different heart rates and ectopic beats etc. but they had no way of knowing or measuring these things. Someone could suddenly have had a heart rate of 150 for no appropriate reason, and they'd have just not known. Because heart rate is measurable nowadays, it makes it matter more to us, and some of us want to perfect it!

People in times gone by got alone fine without knowing what the 'correct parametres' of heart rate were. :)

[ankietyjoe]

Me again...

I was thinking the other day about how, back in prehistoric times, and more recently in history, people of course had hearts and different heart rates and ectopic beats etc. but they had no way of knowing or measuring these things. Someone could suddenly have had a heart rate of 150 for no appropriate reason, and they'd have just not known. Because heart rate is measurable nowadays, it makes it matter more to us, and some of us want to perfect it!

People in times gone by got alone fine without knowing what the 'correct parametres' of heart rate were. :)

Sorry I missed this post.

I think there's a lot of mileage in the 'ignorance is bliss' way of thinking.

Sadly the Pandoras box of knowledge has been opened and cannot be closed again now! :D

[Fishmanpa]

My main goal here is to regain a more realistic view of where my heartrate should be at any given moment.

With respect, I believe your goal should be not to be concerned or forever in a self monitoring mode concerning your heart rate. Realistically, you'll never achieve your goal as our hearts react differently day to day, hour to hour and minute to minute depending on way too many factors to even take into consideration.

Positive thoughts

[ankietyjoe]

With respect, I believe your goal should be not to be concerned or forever in a self monitoring mode concerning your heart rate. Realistically, you'll never achieve your goal as our hearts react differently day to day, hour to hour and minute to minute depending on way too many factors to even take into consideration.

Positive thoughts

I couldn't agree more.

I think one of the problems with the monitoring that goes along with actual heart related incidents is that my perception about what my heart should be doing has become very skewed. All I'm looking at doing is retraining by brain to accept what you're saying, I'm not looking to satisfy the need to constantly check and re-check.

If I'm deliberately doing some exercise (walking usually) and my heart rate is at X level, I'm fine. If I'm at the supermarket and it's at the same level, I'm not.

2 years ago my GP gasped when she took my heartrate and said 'you really must get to A&E right now'. My heart rate was 120bpm, and had been for a few hours at that point. I spent the night in the ICU ward (even though I felt fine) and was sent home the next day with no explanation but 'all the tests are fine so it's probably stress related'.

I have no closure from that visit and have been waiting for it to happen again, which it did a month ago. Same deal, infection, huge stress and then hospitalised with tachycardia. Not a panic attack, uncontrollable fast heart rate. Again, no diagnosis just shrugged shoulders and 'yeah it's probably stress'.

The first hospital visit was the trigger for the checking to start (before that I just used to be aware that my heart was thumping, but didn't check the speed). I'm trying to move away from the effects of that event.

[Fishmanpa]

Anxiety and stress can be there even when you're not feeling it. I always use the campfire analogy. When you're really stressed out, your anxiety is like a raging campfire. When you calm down that fire is not raging but there are still a bed of hot coals hot enough to melt glass. All you need is a little fuel and it's raging again.

I have the feeling that may be what's going on. That being said, I know you have an aversion to psych meds but perhaps a beta blocker will help stabilize your heart rate and prevent the episodes you've experienced. I take them along with BP meds and have for close to ten years. It's worth a conversation with your GP. Many here take them for anxiety and panic attacks.

Positive thoughts

[Strawberry_3]

I couldn't agree more.

I think one of the problems with the monitoring that goes along with actual heart related incidents is that my perception about what my heart should be doing has become very skewed. All I'm looking at doing is retraining by brain to accept what you're saying, I'm not looking to satisfy the need to constantly check and re-check.

If I'm deliberately doing some exercise (walking usually) and my heart rate is at X level, I'm fine. If I'm at the supermarket and it's at the same level, I'm not.

2 years ago my GP gasped when she took my heartrate and said 'you really must get to A&E right now'. My heart rate was 120bpm, and had been for a few hours at that point. I spent the night in the ICU ward (even though I felt fine) and was sent home the next day with no explanation but 'all the tests are fine so it's probably stress related'.

I have no closure from that visit and have been waiting for it to happen again, which it did a month ago. Same deal, infection, huge stress and then hospitalised with tachycardia. Not a panic attack, uncontrollable fast heart rate. Again, no diagnosis just shrugged shoulders and 'yeah it's probably stress'.

The first hospital visit was the trigger for the checking to start (before that I just used to be aware that my heart was thumping, but didn't check the speed). I'm trying to move away from the effects of that event.

''...and have been waiting for it to happen again'' ''...I'm trying to move away from the effects of that event''

I totally can relate to what you said here. For ages I was stuck in the mindset of 'well it happened once, surely it will happen again'. But you've nailed it by saying that you're trying to move away from the effects of the event. You need to change how you feel about it, which is hard but so necessary. It was very dramatic and frightening, and it's difficult to forget how you felt at the time and you probably feel you need to do all you can to prevent it from happening again. But please find some reassurance in the doctors' findings- if they thought it was 'stress-related' and sent you home, then they didn't think it was anything serious. They would easily have detected an abnormality if there had been one.

I had a hospital appointment the other day for something unrelated to my heart and they needed to check my pulse and BP. my heart rate was 144 because I was nervous. There would have been a time where I'd have totally freaked out because of that, but instead I just accepted that my heart is capable of over-reacting to my emotions! Another person's HR might have just gone up to 110- that would be normal for them, but 144 was normal for me. It's taken me a while to accept that.

A fast heart rate for no apparant reason doesn't always mean something bad is happening to it. :)

[ankietyjoe]

The weird thing is that when I have a really fast heart rate from anxiety (this really only happens at night now as I can pre-empt it during the day) I'm fine with it. I say fine, I can manage......:D

This can be anything from 140-160 bpm for a few minutes, and that I can deal with.

What I find harder is when it gets over 90bpm and stays there. This usually happens after I've been up and about on my feet for a while, or also after eating a big meal. When it gets closer to 100bpm I really start to tense up.

It's only happened twice, but it got fast and didn't come down for several hours or more and I'm still reeling from the after effects of that.

My first line of defense is telling myself it's not dangerous, but I still can't carry on as normal.

I'll find a way, but not worrying about it every time it goes over 85bpm will be a bloody good start! :doh: