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You are in: Home > Heart Information > Living With Heart Conditions > Angina > Coping With Anxiety

Coping With Anxiety

• Anxiety and panic attacks
• Recognising anxiety
• Physical symptoms
• Emotional problems
• Effects on behaviour
• Controlling your anxiety
• Breathing control
• Ask for help

Anxiety and panic attacks

Some people become very anxious when they have been diagnosed with angina. Anxiety, or panic, attacks are usually brought on by a tiny thought that goes through your mind, sometimes without you even really recognising it.

A fearful or negative thought triggers a rush of adrenaline that causes real physical symptoms as it increases the heart rate by as much as walking up a hill does. As you become aware of these unpleasant symptoms you start to feel that there is something wrong and the symptoms worsen.

By now the heart is beating fast, you may be sweating and breathless and even feeling some chest pain.

This is what it may feel like to have a panic attack.

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Recognising anxiety

Anxiety can affect people in many different ways, physically, emotionally and behaviourally. It's possible to mistake symptoms of anxiety for illness.

Learning to recognise your symptoms, and knowing the difference between anxiety–related chest pain and angina, will help you to control them and understand what is actually happening.

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Possible physical symptoms include:

• Headaches
• Muscle tension or pain
• Stomach problems
• Sweating
• Feeling dizzy
• Bowel and / or bladder problems
• Breathlessness and / or palpitations
• Dry mouth
• Tingling in body
• Sexual problems

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Possible emotional problems include:

• Feeling irritable
• Feeling anxious or tense
• Feeling low
• Feeling of apathy
• Feeling low in self esteem

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Possible effects on behaviour include:

• Temper outbursts
• Over drinking and / or smoking
• Changes in eating habits
• Withdrawing from usual activities
• Being unreasonable
• Being forgetful and / or clumsy
• Rushing around

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Controlling your anxiety

Learning how to cope with these feelings will give you the power to control the very unpleasant symptoms involved and help you to deal with what is actually happening. Controlling your anxiety can actually help prevent angina from coming on.

There are some techniques that you can learn that will, with practice, help you to deal with any situation that makes you feel anxious:

• Learn how to talk yourself out of panic by concentrating on how you actually feel and not how you imagine you are going to feel.
• Replace negative thoughts with positive images of you doing things without any problem.
• Try and remember that most things are not as bad as you think they are going to be.
• Learn to check your breathing so that you don't breathe too fast (hyperventilate) and practise breathing control. Counting one thousand, two thousand, three thousand helps.
• Learn and practise a relaxation technique.

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Breathing control

This is a very simple way of learning how to breathe normally and restore normal breathing when you are anxious.

It involves gentle breathing using the lower part of your chest and stomach, with the upper chest and shoulders relaxed.

Breathing control has been found to be very helpful during an angina attack, so it is worth practising this when you feel calm and symptom free, so that it can be used easily when you are having an attack.

• Settle yourself in a relaxed position
• Make sure that your back is supported
• Rest your hands on your lower rib cage / stomach
• Keep your shoulders and upper chest relaxed
• Feel the gentle rising and falling under your hands as you breathe in and out
• Find a rhythm that is comfortable for you (counting your breaths might help)
• Concentrate on the lower part of your chest moving rather than the upper part
• Do not try to take deep breaths, concentrate on breathing slowly
• Try not to gulp air, swallowing a couple of times helps this

The more you practise this the easier it becomes. You will then be able to practise it standing and then go on to using it whenever you are anxious or exerting yourself, or during an angina attack.

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Ask for help

All of this is quite hard to take in at once. Some people find it easier to learn these techniques with the help of a professional e.g. a psychologist or counsellor. Ask your doctor to refer you if you think this would help.

Relaxation CDs are available in bookshops and supermarkets. Some community centres run relaxation classes – your local library, or health centre, should have information about local classes.

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