Coping with anxiety when you have a heart condition

Why do people with heart conditions feel anxious?

Many people worry about the future when they’ve just been diagnosed with a heart condition. It’s common to feel anxious after a life changing heart attack or surgery or when having symptoms such as chest pain. Anxiety about whether a device like a pacemaker or ICD (implantable cardioverter defibrillator) will not work properly is also very common.

Feeling anxious, worried or fearful is a natural response to life changing experiences. For most people the fear and anxiety eases off as they come to terms with their condition and learn how to manage it.

But it’s important to recognise when these feelings carry on for longer than usual and start affecting your health, relationships and quality of life.

What are the symptoms of anxiety?

You may be experiencing anxiety if you:

• feel in shock after your experience and are afraid to do the things you used to
• spend a lot of time thinking about something bad that might happen
• feeling nervous – in public, alone or with company
• always look back to the event and avoid doing things out of fear – e.g to avoid a heart attack or trigger an abnormal heart rhythm 
• have trouble sleeping because of overthinking
• you're experiencing restlessness due to constant worrying.

In more extreme cases of anxiety after a life changing event, some people may experience post-traumatic stress disorder (PTSD).

Further support

If these feelings carry on for longer than usual and start affecting your health, relationships and quality of life, it’s important to talk to someone professional.

• Call the Anxiety UK helpline to speak to someone - 08444 775774 (open 9.30am to 5.30pm, Monday to Friday)
• Mind Infoline - For mental health advice. Call 0300 123 3393 or email Mind. You could also look into Mind’s mental health groups in England and Wales.
• Join our online community to talk to others experiencing the same, and read other people’s experiences and tips for living with heart and circulatory disease.
• NHS Improving Access to Psychological Therapies (England).
• Health in Mind has free NHS services for anyone with a long term health condition needing emotional support.
• Scottish Association for Mental Health – 0800 917 3466.
• Hafal (Wales) – 01792 816600.
• Inspire - N. Ireland– 028 9032 8474

Panic attacks

Sometimes severe anxiety results in panic attack symptoms such as a racing heartbeat, feeling faint or lightheaded, shortness of breath, shaking, chest pain and nausea.

Panic attacks can have very similar symptoms to a heart attack. If you have sudden chest pain and your heart is racing, it’s important to call 999 immediately.

Read our Heart Matters article to find out more about the difference between a heart attack and a panic attack.

How can I improve my anxiety?

Sometimes anxiety can send you into a cycle of unhealthy habits. This could be not eating healthily, not being active, drinking alcohol or smoking to relax you in the short term. But this can make you feel worse in the long term and impact your anxiety and heart condition.

We have some tips to help your anxiety:

• Our BHF nurses can talk to you about any fears you’re having, call our Heart Helpline.
• Do something active – such as going for a walk, a bike ride or some gardening. Research shows this helps reduce anxiety.
• Look for reputable yoga and meditation videos online and do these at home.
• Write a worry list, crossing off things you can’t control and ranking what’s left in terms of importance. You could allocate a time to tackle these.
• Talk to family and friends about how you feel – by video or phone call.
• Avoid stressful situations when you can by saying no to anything that increases anxiety.
• Spend time at home doing calming activities you enjoy such as crafts or reading a book.

If you’re starting a new activity or getting back into something you haven’t done for a while, set yourself realistic goals. Be easy on yourself, you don’t need to achieve everything at once.

Visit our healthy living section for more information.

It’s wise to check with your GP or pharmacist before you start a new exercise regime or if you’re unsure how much you should be doing.

Breathing exercises for when you feel anxious

Focusing on your breathing gives you a break from the anxiety. Using breathing techniques as a tool may help train your mind to overcome attacks of anxiety when they happen.

• Let your breath flow as deep down into your belly as is comfortable, without forcing it.
• Try breathing in through your nose and out through your mouth.
• Breathe in gently and regularly. Some people find it helpful to count steadily from one to five.
• Then, without pausing and holding your breath, let it flow out gently, counting from one to five again.

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