Has anyone seen the video re cardiac anxiety? I'm trying to figure out what comes first the anxiety or the list of symptoms ie palpitations chest pain etc. Has anyone dived into this research?
Dr Guptas video: Has anyone seen the... - Atrial Fibrillati...
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TillyBoss
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I think that the relationship between anxiety and palpitations is transactional. If sombody becomes anxious, the physical manifestions of that anxiety will manifest themselves as a raised pulse, hyper alertness, shortness of breath ect. Equally the symptoms of Afib can can both initiate anxiety or exacerbate an existing anxiety state. There is often a marriage between the 2. I think that the emotion of fear drives this process. Fear drives the negative thoughts and they shape behaviour (ie more palpitations etc). Deep breathing, mindfulness and yoga can help to discourage the anxiety and help to reduce the symptoms of Afib.
I wonder if they did a survey re the percentage of people who have a fib also having anxiety issuess
I am not aware of any research on the subject. I think that if Afib is symptomatic then there will almost certainly be a degree of anxiety. Asymptomatic Afib is much less likely to generate anxiety. I imagine that this is likely to be the experience of many who use this platform. Regards
Yes, I need to finish watching that.
I still consider anxiety is an issue 11yrs post AF diagnosis. I would say it is a normal reaction with us all having different levels dependent on how we address the issue.
Anxiety is both a physical and cognitive issue. Very, very briefly but do please read up on this - Physical because of the ANS - autonomic nervous system Sympathetic side = Fight or Flight response.
Cognitive - because what we think and often catastrophise eg: I feel palpitations (ANS kicking in) normal alert/alarm physical reaction AND then think OMG I’m going to die, I have a deep sense of doom etc etc actually increases the alarm and anxiety.
This makes it hard sometimes for doctors to know exactly if there is a serious problem or a bodily reaction induced by cognitive induced anxiety - hence monitors etc.
If you are a person who already has anxiety ‘disorder’ you will suffer a lot more than those who done’t.
There is a good article in The New Scientist discussing new research on what anxiety actually is and caused by in the first place which basically says that we don’t know much more than it is a dysfunction or mismatch between reality and ourselves as to how we react to an existential threat and or imagined threat.
Still like to know whats comes first or does it matter?
Think of anxiety as an alarm system - your body is alerting you that something is amiss, now that may be an appropriate reaction OR it may be that your thoughts CREATE palpitations because you are anxious so it really it can either or AND both.
Best example is walking through the woods and out of the corner of your eye you see what you believe to be a snake - you will be on high alert, freeze, ready to fight or flee - we all have a dominant disposition. You look more closely and realise what you thought to be a snake was actually a stick that looked like a snake. The appropriate reaction would then be to say to yourself - ‘oh, it’s only stick, I need not be fearful’ (self talk).
Some people however are not able to do what is called ‘self soothe’ so they stay in a constant, high alert state and can be traumatised by even the slightest worry. This constant state of arousal is corrosive to the organs of the body, especially heart and can create palpitations and so anxiety becomes chronic and self perpetuating and symptoms become physical. That is where therapy and meditation and breathing exercises can really help you learn how to self soothe but unfortunately for a very few people even that does not help. It is then that a referral to psychology/psychiatry may result in a diagnosis of Anxiety Disorder which is then treated through Consultants with mix of medications and therapy and education.
The actual mechanisms are well known, what is not known is WHY some people are not able to relax, no matter what and seem are resilient to trauma whilst others have PTSD for the rest of their lives, despite best efforts of skilled medics, psychiatrists and therapists.
Hope that helps.
Health anxiety is one part of a pre-existing "general anxiety disorder" (GAD), so it is the mind prone to anxiety that is there and perhaps unrecognised until the health issues occur. "Cardiac" anxiety is a kind of health anxiety that can occur when the mind notices the heartbeat, either its thudding (i.e. the valves closing), or it racing, or from palpitations. It can be very hard to control this kind of anxiety since the mind is "hard-wired" to protect the body and the heart is one of the most vital to its functioning.
Eventually, however, since time never stops and life continues much as before, the mind comes to recognise that the heart that it once noticed and reacted to so strongly to is still there, still beating healthily if not perfectly, and that the physical health really hasn't become worse. At that point, the anxiety will lessen and life will go on more comfortably. That is until a different stress-inducing heart sensation is noticed, when the anxiety might rise again, forming these cycles of worry.
The way out of this is to accept that the heart issues are, despite how they feel, safe for the future health because they are arising from a part of the heart, the top chamber called the atrium, and not from the important ventricles, the pumping part, at the bottom. Of course, the downstairs isn't thrilled with the chaos upstairs, but not in a way that is risky to its and your future health (assuming, if needed, an anticoagulant is taken along, if needed, with other drugs to help calm the effect of the AF or whatever it is on the ventricles, such as a beta blocker).
In the US, much more than here, some people take anti-anxiety medicines to help. Unfortunately these can be habit forming and are frowned upon in the UK and Europe.
There are some excellent books written to help calm an anxious mind. One highly regarded series that is rather old now but hasn't yet been surpassed is by the late Dr Claire Weeks. If you search her name on the Waterstones or Amazon website and order one of these, it will help you a great deal.
Steve
My Afib tends to come in clusters. Two months nothing and then a cluster of weeks with daily episodes. I can shorten a cluster by taking Xanax, I have found. Not sure though if that is the best solution. Not getting into a new cluster at all to start with would be much preferred. It’s all about avoiding stressors.
You know, I sometimes wish we had Xanax (alprazolam) over here but our NHS dislikes benzodiazepines with a vengeance, although some GPs are warmer to them. They can be bad drugs, for sure, but, as you seem to have found, they also can be, when sensibly used, very useful. The only GP prescribe-able "equivalent" over here is Valium (diazepam), which is rather too slow acting and long-lived in the system to have the same effect.
Steve
My GP prescribes Xanax with caution, and only use it for the purpose that I described here. I would not dream of taking it on a daily basis, because the longest time I took it in one go was 5 days, and I already felt uptight and stressed when I stopped after that. So, yes, to be used with care!
Yes, that heightened anxiety it creates is noticeable well, on diazepam it is less striking, and comes a few days after, but much the same). I imagine diazepam to be safer since it does act more slowly and less acutely. I suspect Xanax to be the better drug for this use, though. Many GPs in the UK seem to prefer to prescribe a long-term SSRI antidepressant which, to me, is not good medicine.
Steve
That's a great way to look at a fib, upstairs downstairs- I'll take that on. As I replied to another person I'm trying to get into my head what came first chicken or egg (a fib anxietyor anxietyafib)... or does it matter?
I wish I had a better answer. I have such an anxious nature regarding health issues and at times I would love something to take to calm a troubled mind.
Steve
I've been anxious since the cradle... beginning to suspect all that anxiety screwed up the upper levels of my heart a bit... although i just got a report back from my echocardiagram and it says my heart looks good just some age-related issues, so the engine looks good but the spark plugs might need to be changed!
Well put and much like me. I’m waiting for an echo and eventually an MRI to check if I can safely be given flecainide.
Steve
I heard them mention flecainaide but they said, I think, more side-effects than it was worth.
I have heard the same but many here seem to find it useful. I also have a left bundle branch block, which, despite my specialist not worrying about it, does lead me to think it is part of why I get so many ectopic beats (and feel pretty wretched with them although able to carry on as usual).
Steve
Sorry to hear that hope it works out for you
Thanks. From posts here, it seems there are many who get a kind of discrete PAF with no other symptoms in between episodes. I often wonder just how many people are like this and how many are like me and have much more frequent episodes of palpitations that can go on for days or even weeks, yet feel put much just as bad as when I have AF, although without the faster rate, so without the "breathy" feeling that brings on.
Steve
Hi. Thanks for posting this reassuring message. I have GAD including Health Anxiety and after I was diagnosed with AF I certainly began to focus my worry on heart matters, to the point that when I do get worked up my AF gets worse and I suffer from a tight chest and the usual palpitations. I recently saw a cardiologist who basically said what you have said. I am not yet at the stage where I can ignore the symptoms but since the cardiologist confirmed that the medication I am on - rivoroxaban and tildiem - are doing a good job I think I must keep working on reducing my anxiety and taking the symptoms as they come: easier said than done sometimes. I was interested in you mentioning Dr Claire Weeks' book as I have found that to be supremely helpful and which I used well before getting a diagnosis of AF. She is very old fashioned now but her basic messages are sound. I sometimes re-read sections if I want to calm down. The trick seems to be: OK I have AF, so do lots of other people, you are on the right meds, keep in touch with your GP/cardiologist (if you have one), seek their advice when you need it but then go out there and live your life.
Thanks for such a lovely reply. Yes - she does sound a little quaint these days but goodness what common sense and understanding of the anxious mind she had! Her book should be required reading for anyone suffering with anxiety.
Your doctor sounds a good one!
Steve
Hi - well yes. It was the cardiologist who really gave me a good examination as I have found my GP to be not that concerned. It seems to be, oh yes you have AF, loads of other people in this practice have it too, read up about it on the NHS app and take the tablets!! My surgery knows I have as I have previously been on medication for it but once again GPs are not ,I have found ,particularly clued up on the effects anxiety can have. It was great to have 40 minutes with the cardiologist as I am sure that my GP could not have given me half that time. Nice to find another person who has read Claire Weeks.
I think few people understand anxiety but a GP should know better. Even their dislike of benzodiazepine drugs, the only available true anxiolytic medicines, seems to me to point to a general lack of real interest in the condition.
It's also one of those conditions in the same basket as depression and insomnia that many think they have had and so feel they understand it well enough to offer advice. The number of times I have been told how to solve my sleep problems by well-meaning people is countless. Even the "experts" generally have not suffered themselves and offer anodyne suggestions. I am very lucky to have a far more understanding family doctor.
Steve
You are lucky Steve. My surgery is very good, very efficient but like lots of others doesn't appear to have the time to sit down with patients and help them understand their condition. I have sleep apnoea which is often associated with AF but find it really difficult to use my CPAP machine. The cardiologist suggested losing a bit more weight would be really helpful so the salads and crispbreads are out of the cupboard again!!
Cathy
I’ve written a few times here about my wife’s late aunt who ran the most successful local diet club that can be imagined, so much so that the local Weight Watchers club had to close.
Her mantra was simple: don’t change what you eat, just eat a little less of the same each day. She was convinced that fad diets were destined to fail every time. She also believed that - all else being equal - that calories consumed must be fewer than calories expended. She recognised the need for daily exercise but she didn’t believe in exercise as a way in itself to lose weight.
I know some disagree with this and point to other causes of weight gain such as water retention and metabolic rate, but in general terms her system was a success. Slow but sure was also what she herself went for as she, too, was always watching her weight. She used to say that the weight had originally crept on and the best way to lose it was over the longer term to let it creep off.
Steve
My feelings entirely. Fad diets don't work basically and I have tried a few in my time. You get so hungry that you give up after a very short time. I usually follow the British Heart Foundation's Eatwell Plate and just eat a little less. I do swim - only twice a week I have to admit - and my husband and I go for a walk about twice a week - a gentle one as I have arthritis in one foot and this restricts me. However my husband is in a walking group which regularly does 12 miles a day - NOT for me!! Ah well, onwards and upwards as they say. I hope you continue to keep well and not let your AF stop you doing the things you like doing. Best wishes,
Cathy
P.S. I'm not following my diet tomorrow however as we are going out for a lunch time meal to celebrate our 46th wedding anniversary!!!
Enjoy your romantic lunch out, Cathy! We’ve been married since 1975 so we’re a year or two ahead of you both.
Steve (& Wendy)
Will do. Nice to share ideas in this really supportive forum. Thank you for your very sensible advice. With best wishes. Cathy (and David)
Hi Steve, around 30yrs ago now I went through a very bad period of anxiety & developed agoraphobia.My GP put me with a community physchiatric nurse who advised me to read Dr Claire Weeks book Self Help For Your Nerves which I found extremely helpful.
She had indeed got such common sense & understanding of the anxious mind.
Since being lucky enough to get the dreaded AF I actually purchased it again & re read it & still found it helpful.
I find your replies with regards to anxiety quite comforting.
It is not easy at all to live with an anxious mind so it helps to have people who truly understand.
That was a lovely post to read, so, thank you for your kind words. Yes, few people understand anxiety and, sadly, it's often implied that it's a weakness or a lack of strength. That "weak-strong" mythology sits deep in the public's psyche to form a horrible attitude to any mental illness. I have an elderly friend who knows me very well, but still says things like, "I don't let myself get anxious / down...". People who don't suffer seem to think they are strong for not letting themselves be affected. They don't know how lucky they are.
Steve
How well you put that, I totally agree.
Except for the many typos! Whoops. I've corrected them.
Steve
🫣
I don't think it helps or informs one's treatment approach to arrythmia to know whether anxiety has been a contributory cause of AF or if the symptoms of AF have caused anxiety. You can think of both as being true.
Did anxiety play a part in me developing AF? Yes.
Did my AF cause me anxiety? Yes.
I think judging all replies I will treat the anxiety a lot more aggressively but maintain meds, diet etc and see if it mitigates it... trying acupuncture today as there reports that, in some cases, it reverses af and bring you back to sinus rhythm (if you're lucky) But the usual caveat it was a small study
Well - many complementary therapies seem to produce a 30%+ positive response rate or thereabouts, so go into it with a positive mind and hope you’re one of the lucky people whom it helps. Sadly, I’m one of the 70%!
Steve
Different strokes for different folks. You just need to find something that helps you.
May I also suggest you look at Human Givens who are the only people I know who actually have a training programmes for long term anxiety and quite a few books on the subject. go to usual prefix and then hgi.org.and then click on the Resources tab - quite a lot of free stuff to download with good, science based info.
I watched it and it wasn't clear but I eventually came to the conclusion that he's talking about generalised anxiety or health anxiety that can cause palpitations etc. rather than, say, having AFib or other heart conditions and feeling anxious about it.
And I still don't know what palpitations actually are - as opposed to the symptoms of AFib.
I'm still getting educated, it's a long haul
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