Chest Heaviness and Anxiety
By: Dr. Suzanne LaCombe, Updated: October 2, 2013.
Reviewed by: Dr. Carole Gaato
Heaviness or tightness in the chest are symptoms common to anxiety, angina and heart attacks. If you have not already done so and are wondering which condition best describes your symptoms--it's best to see a doctor.
Check at the bottom of this page to find an additional resource to help you understand your symptoms.
If your doctor has confirmed that you are NOT suffering from a heart attack or angina, you might consider the following:
When folks arrive in my office after a series of visits to their doctor they are understandably concerned. Often, they haven't received a clear diagnosis from their physician. They don't yet realize that the tightness in their chest, the dizziness, the shaky feelings or blurry vision are from anxiety.
Anxiety is actually the number one reason people see psychotherapists.
Even so, it's often missed in the offices of medical practitioners. Thousands seek help from their doctors for "other" health conditions that while similar to anxiety attack symptoms , are believed to be otherwise. (e.g dizziness is associated with low blood sugar, tightness in the chest with heartburn).1
In situations such as these, the depth of the problem is not being assessed. Nor is the magnitude of the stressors impacting the individual being acknowledged. The problems are not being associated with anxiety and dysregulation of the nervous system.
You see, unlike the more chronic, long-standing feelings of anxiety, anxiety attacks symptoms occur suddenly and without warning (at least they appear to come out of nowhere).
Sufferers ordinarily assume there's no connection.
It's isn't that people come in informing their physician that they have had an anxiety attack, it's that the symptoms mimic so many other health problems. The mistaken conclusion is that the attack is related to some organic problem. For instance, anxiety attack symptoms are often confused with the symptoms of a heart attack.
Indeed, it is sometimes only after several visits to the emergency hospital that the true diagnosis of an anxiety attack becomes confirmed.
And unfortunately, sometimes anxiety is never diagnosed and the individual continues to believe they are suffering from some strange ailment that the doctors are baffled by. They never receive the proper treatment. Without a clear diagnosis they may even feel victimized by the medical establishment.
The main problem is that anxiety attack sufferers have had high activation for sometime without awareness. They have been living with high activation for so long, it has become their "norm". The anxiety attack then appears to arise without warning.
How could this be so?
If the nervous system is dysregulated, it is almost inevitable that the activation will increase over time. This is a subtle process and for most people they have little awareness until their symptoms are "shouting" at them.
Let me explain.
Because the nervous system is constantly adapting to new states (see Tracking your Progress for more information), and the tension in the body easily finds a homeostasis (with each new state becoming the "norm"), inaccurate perceptions are inevitable. Folks miss the fact that their nervous systems have changed.
So even though the body has become more tense and dysregulated, the individual assumes "this is the way I have always been". An additional irony is that the anxiety sufferer feels more aware with their bodies and the aftereffects are a multitude of sensations that feel strange and uncomfortable.
[Don't get me wrong. They're not imagining these unpleasant sensations. Natural bodily processes even painful ones can seem weird when heightened. But this topic is worth discussing in more depth at a later point.]
So, what accounts for the sudden onset of anxiety attack symptoms?
One of the natural consequences of dysregulation is high activation (i.e. high levels of arousal). Moreover, the ways the nervous system copes with high levels of arousal is through dissociation (i.e. feeling less in one's body).
Dissociation is akin to a somatic numbing and will fluctuate depending upon challenges both internally (i.e. illness, PMS) and externally (i.e. day-to-day stressors). In other words, we can seamlessly move in and out of dissociation on a minute to minute, hour to hour or daily basis. For example, an individual might feel "relaxed" just before "suddenly getting an anxiety attack".
In actual fact, the "relaxed" state was dissociative, an experience that numbs body sensations. As these folks are momentarily (or otherwise) resourced and they move out of dissociation they feel an onslaught of panic and anxiety. This fluctuation can wreak havoc with one's sanity. It's crazy-making!
Not to mention...
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1 "Panic disorder remains a common, debilitating condition, accounting for more than 20 percent of U.S. hospital emergency room visits." From: Effectiveness of Psychodynamic Psychotherapy for Panic Disorder 3-Mar-2007, Newswise
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