Health Anxiety Creeping Back

[Anglo]

I had health anxiety for around a year, it came out of nowhere and I was finally able to beat it (mostly) after therapy and after going through some workbooks.

I recently went to the doctor about my asthma (normal check up, I didn't ask to go but they wanted me to as a matter of routine) where the nurse asked questions about my chest.

She was worried that some of the symptoms I was having was from a heart problem and not asthma, so she brought in the resident paramedic who had a little chat with me.

On my dad's side, all the males have ended up with heart problems (with my dad being the closest relation) so I've always been worried it'd come and get me someday.

The paramedic booked me in to see him the following day, he didn't think it was too urgent since I've been having regular chest pain on and off for a few years and I don't get some other symptoms he was looking for.

Both the nurse on the first day and the paramedic on the second day listened to my heart and did my blood pressure and both were normal.

The paramedic is sending me for blood tests at some point and said I should await a call to book in an ECG just to rule out my heart.

I've always been aware and conscious of my heart but I've never let it get the better of me. Well these past couple of days I've been really anxious about my chest and heart and I'm hoping it's just the health anxiety creeping back and not something more serious.

My reasoning is what are the chances that I can have these symptoms for a couple of years then only a day or so after a paramedic shows slight concern that I suddenly have something serious going on? It seems more likely that it's just on my mind now and driving up my anxiety.

I've tried getting my heartbeat up by exercising too to see if the pain increases or starts up but it doesn't, so that tells me it's not a heart problem also.

Even though I have these logical processes going around my head, I still can't shake the anxiety and the feeling like all of a sudden I do have a heart problem and suddenly it's gotten serious.

[NoraB]

I had health anxiety for around a year, it came out of nowhere and I was finally able to beat it (mostly) after therapy and after going through some workbooks.

It fascinates me when people say this because I've yet to hear from somebody with HA where there wasn't an obvious trigger. It's generally the case that there's been an illness with them or somebody close to them, a death, or it's in connection to childbirth or becoming a parent. Health anxiety doesn't come out of nowhere and it can be helpful to understand what the trigger is..

On my dad's side, all the males have ended up with heart problems (with my dad being the closest relation) so I've always been worried it'd come and get me someday.

Another cause of HA; genetic diseases (it was ovarian cancer with me - closest relation being my mother)

I've always been aware and conscious of my heart but I've never let it get the better of me. Well these past couple of days I've been really anxious about my chest and heart and I'm hoping it's just the health anxiety creeping back and not something more serious.

Given your family history, it's common sense to get chest pain checked out but a lot of people don't understand that the majority of people who present with chest pain in A&E are diagnosed as non-cardiac - as in anxiety. Heart symptoms and sensations go hand in hand with anxiety because it's the normal part of the stress response (fight or flight) where your heart is designed to speed up in order to get blood pumped round the body faster (for speed etc). I've been to A&E twice with chest pain and with a heart rate of over 145 bpm (and sustained for several hours) and it was anxiety on one occasion and a combo of a reaction to MSG and anxiety on the other..

I've tried getting my heartbeat up by exercising too to see if the pain increases or starts up but it doesn't, so that tells me it's not a heart problem also.

The rationality is there, it's just that fear overrides it..

Even though I have these logical processes going around my head, I still can't shake the anxiety and the feeling like all of a sudden I do have a heart problem and suddenly it's gotten serious.

My guess (going by own experience) is that the physical symptoms of fight or flight are constantly causing you to doubt what's rational. My heart would bang away like an old barn door, skip, jump, and do all sorts - and it's hard to think rationally when this happens - but my heart is fine..

Your heart is doing a fabulous job; it's just that you're misunderstanding the situation. When we think scary thoughts we trigger the fight or flight response. The heart responds as it should do, but this feels wrong because we haven't just had a near miss in the car, or almost been knocked down by a bus etc. We expect our hearts to race, skip and bang in these situations, right? But we're literally just sitting here and our hearts are going nuts!! Your body is trying to protect you from harm but your brain doesn't know the difference between fear because of actual danger or what's simply imagined; it reacts the same way.

[Anglo]

That's a very detailed and well thought out reply to everything I said. Thank you.

I never did pinpoint what triggered my HA. I've got genuine health problems that I'm managing and I've had a couple of traumatic experiences in the past few years which definitely made me fear certain illnesses but the irrational fear seemingly came out of nowhere. Maybe it was a mix of everything I was already worried about that eventually developed into its own anxiety.

Since posting this, I've had chest pain and other strange symptoms elsewhere on my body but I've managed mostly to keep my cool and remember that I've had hundreds of times where I've thought I was dying or something was seriously wrong but I'm still here and able to worry about it so I'm probably going to survive this time too.

[NoraB]

I never did pinpoint what triggered my HA.

There will be something, believe me..

I've got genuine health problems that I'm managing and I've had a couple of traumatic experiences in the past few years which definitely made me fear certain illnesses but the irrational fear seemingly came out of nowhere. Maybe it was a mix of everything I was already worried about that eventually developed into its own anxiety.

Looking at your historical posts it appears that you were a member here some years ago? And you came back on last year? So you have a history of HA? (mine goes back to the age of 5)

You say you've had some traumatic experiences over the last few years?

My latest (and worst) phase of HA started the day my mum died. Her death triggered a lot actually, but it also triggered my worst ever period of HA. Trauma, whether it is something that happens to someone else or to ourselves, can flare our health anxiety up BIG TIME..

Since posting this, I've had chest pain and other strange symptoms elsewhere on my body but I've managed mostly to keep my cool and remember that I've had hundreds of times where I've thought I was dying or something was seriously wrong but I'm still here and able to worry about it so I'm probably going to survive this time too.

This is really great rationalising, and this is what I do too..

I think that some people can 'beat' their HA, especially if they don't have a history of MH disorders. A death or an illness can trigger HA in anybody, just as any MH condition can affect people who have not previously experienced one. But for people like myself (and anybody who has a long history of anxiety issues) I think it's a case of control, rather than cure. I know that the potential for HA to get back into the driving seat is always there which is why I need to constantly be challenging my thoughts and so far it's worked for me. I haven't gone down that rabbit hole since 2017 and that's despite some significant health issues to deal with..

When it comes to chest pain..

Anxiety causes chest pain because it's down to the stress response (fight or flight) where the muscles tighten & contract and there are lots of muscles in the chest area. Tight muscles cause all kinds of sensations, such as tightness, burning, numbness, twitching, spasms etc and it's easy to confuse this normal bodily response (fight or flight) to heart issues. When the body becomes hyper-stimulated (as happens with chronic anxiety) these heart symptoms can be constant because the body is constantly in stress mode. This plays into the fear that there 'must' be something wrong with the heart. Also, a lot of anxious people have IBS with symptom's such as bloating and many IBS symptoms are felt in the chest area too. People with uncontrolled HA bypass what's rational and go straight to what they fear and if there happens to be a family member who has/had heart issues, then that 'has' to be what's happening here, right?

Exercising to see if there is chest pain can be hit and miss and for the reasons I've explained. You might experience some chest pain due to your body being primed for fight or flight and confuse this with heart issues so you need to think rationally here..

[Anglo]

Hey Nora, thank you for another detailed reply. I'm sorry to hear of your traumas. As horrible as it is to experience trauma, it's always somewhat reassuring to know you're not alone with the cruel things that life can throw at us.

To answer your question about whether I've had HA for a while, I've always been a worrier. I was a worrier ever since I was little. I remember being too nervous to go to parties with school friends and I wasn't very good at speaking to the shop keeper and little things like that.

I was poorly a lot as a child. I was never worried that something was seriously wrong though. I started needing help mentally probably towards the end of primary school and then a few more times during secondary school. Ever since then I've been in and out of therapy for one thing or another. The HA itself started a few years ago after a traumatic allergy-related incident. The HA crept into my life and I didn't realise I had it until it engulfed me.

The reason I'm messaging again now is because I'm having chest pains again. I'm able to give everybody an update on what happened back in May/June.

The paramedic told me to look out for chest pain that spreads into my arm or jaw and if that happens then to go to A&E. I woke up from a nap one day and my arm felt weird. I assumed it was because I'd slept on it funny (we've all been there) and didn't think a whole lot about it but shortly after I was getting chest pains also. Eventually I couldn't take my mind off the chest pain/sensations and the weird feeling/pains in my arm. I ended up going to a local health centre where they did an ECG, said it looked fine but sent me to A&E as a precaution.

The A&E wait was ridiculous and I ended up going home after a few hours of not being seen. The following morning I was woken up by the paramedic checking in on me, just out of sheer coincidence. I told him what happened the day and night before and he told me to go back to A&E and don't leave this time, especially because I was still experiencing those symptoms. I went back to the health centre where they did another ECG and a chest x-ray, both of which were fine. They also took my blood where they advised me that my troponin levels were elevated enough for them to be concerned, albeit the level wasn't very high.

I spent all day in A&E, I had another ECG and another blood test where my troponin level was reduced but still over the threshold they normally like to see. A doctor from the medical team saw me and sent me home. She assured me that I hadn't suffered a heart attack but she couldn't tell me what had caused my raised troponin levels or my chest and arm pain. She referred me back to my GP who booked me in to see a cardiologist for a stress test (or something similar, I can't remember the exact name).

It's been a few months and I haven't heard anything yet, though he did say it could be about 3 months before I do hear anything.

Since all of that happened, I've of course been a bit on edge about my situation but I've been mostly able to reassure myself that the odd aches and pains I feel aren't related to my heart, or at least it's not a heart attack. If I had raised troponin levels on the day enough for them to investigate me for a potential heart attack, only for them to later rule it out (and the doctor was sure to tell me that it absolutely was not a heart attack), then the pains I'm feeling right now are almost certainly not a heart attack or anything serious either.

That was an extremely scary day for me, as I'm sure you can imagine. Having witnessed what my dad went through with his heart problems and after hearing what the other men in my family had experienced with their heart issues, I was understandably thinking the worst. The relief I had when the doctor told me it wasn't a heart attack was enough to bring me to tears and make me feel like I'd had a second chance at life. It sounds silly typing that out and hearing it back, but it's true. I really was that scared.

And I'm scared now. I'm scared that the pains that have been in my chest for the past few hours and that I've felt on and off for a while are something serious. I tell myself over and over "it's not your heart, it's anxiety" or "it's not your heart, it's muscular" or something else. I remind myself that I haven't died yet, so why would I this time? I've had tests and the doctors said it wasn't a heart attack. Yet I'm still so very frightened that it's enough to stop me going to bed. It occupies my mind so much that I can't distract myself by doing things I enjoy.

I came back here to read other people's worries about their chest pains so I can see for myself that it's not just me who gets scared over my pains and so I can remind myself yet again that chest pains aren't necessarily anything to actually be concerned about. It helps but it doesn't at the same time. I can feel the pains as I type this now and it's so scary.

I wish I could just go "huh, those pains again" and carry on with my day without it descending into fear.