Reader’s Question

I’ve had a problem that’s been going on for two years. I feel like my heart is racing and like I hear every beat of my heart. It’s not constant — it comes and goes, usually once I am at home and have attempted to relax. It got so bad at one point that I couldn’t even concentrate at work and had to take a leave of absence for a couple of weeks.

I am back at work now. While I was on leave I went to the doctor’s to see if something was actually wrong with my heart. I had EKGs, a Holter monitor, cardioechogram and blood work, but they all came back normal. My symptoms seemed to subside over the course of 6 months, but now they are back. I have them every single day, mostly when I get off work and am trying to relax.

I’m just wondering if there could be some kind of “mental” component to my problems. I it all in my head? I know I have psychological issues. I have cut on myself and have probably been what you could call “depressed” most of my life. Mostly, though, I’m upset about these symptoms. I worry when they will hit me again and how many hours they will last. I find myself becoming obsessed with knowing what’s wrong with me.

Have you ever heard of this kind of stuff happening to anyone else? What does one do about it?

Our Clinical Psychologist’s Reply

The symptoms you describe are actually quite common for someone experiencing an anxiety disorder. And often, depression and anxiety go hand-in-hand.

The thing that perplexes most anxiety sufferers is the lack of understanding about the vicious circle of symptoms and response. Because sometimes symptoms occur at a time when they’re “trying” to relax, anxiety sufferers sometimes doubt that their symptoms are really an expression of their anxiety. Even getting a medical clean bill of health is sometimes insufficient to allay such fears. To further complicate things, it’s a natural, biological response to regard the symptoms (especially racing, pounding heartbeat) as a potentially dangerous thing. This response, of course, only heightens one’s level of anxiety, intensifying symptoms and predisposing a person to “obsess” about their condition.

Of course, it would be most helpful to visit with a mental health professional specializing in anxiety and depression to help guide you through the issues you know you need to work out. But even in the absence of formal intervention, there are some things you can do to break the vicious cycle: reinforce in your mind the notion that although your symptoms might indeed be quite distressing, they are not an indication of imminent doom but rather the expression of a level of anxiety that has become too high. Taking the secure thought that the symptoms obviously can be controlled (as they are when you’re too busy to notice them at work or are otherwise not preoccupied with them) and ignored will help them subside more quickly and more frequently over time. Also, reinforce yourself for changing the nature of your “self-talk.” Get good at spotting when you’re saying negative, worrisome and insecure things to yourself and change those thoughts to positive, confident, secure thoughts. You don’t really have to believe in the positive thoughts at first, but you have to change the insecure thoughts. The more frequently and reliably you do so, the quicker you’ll find your problems with anxiety fading away.