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'Is stress damaging my heart?'

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Q: I have anxiety and panic disorder, and when I am stressed my symptoms (chest pain and palpitations) get worse. I am terrified the stress is damaging my heart. I had ECGs a year ago and they were all fine. I also have low cholesterol, so my doctor thinks I have nothing to worry about, but should concentrate on relaxation and therapy. Am I damaging myself physically, and do you think these symptoms are an indication of something serious?

Catherine, 33.

our online advisors reply:

Hi Catherine. I appreciate that these symptoms are distressing for you, and that they can feel scary. However, it's important to keep in mind that your doctor has carried out the appropriate tests and, due to the results of these, believes that there is nothing for you to worry about. Our article examining the debate about stress and heart problems weighs up the evidence on whether long term stress can harm the heart.

However, your symptoms seem much more likely to be connected with the anxiety and panic you experience, rather than any problems with your heart.

Chest pain and palpitations are common symptoms of anxiety and panic, which can be very upsetting and frightening. Perhaps the worst thing is that they seem to have the ability to cause the person experiencing them even more anxiety than they are already under.

There is an article about panic attacks in the mind section. It goes into detail about the symptoms and causes, and offers ideas for overcoming panic and anxiety. At the end of the article there is a list of resources for people who suffer from anxiety and panic attacks. The list includes an organisation called No Panic, which runs a freephone helpline on 0808 808 0545 (every day, 10am-10pm). Their website is at www.nopanic.org.uk.

You say that your doctor has advised you to concentrate on relaxation. Learning to relax can help enormously and I wonder how you are getting on with this. The article at www.healthy.net may be helpful as it explains lots of different techniques for relaxing and reducing stress.

The stress gym in our stress section also has ideas for beating stress, including exercise, which can be good for helping you cope with anxiety. If you want to find out about complementary therapies which might aid relaxation, try our new complementary medicine site.

You also say that your doctor mentioned therapy. It could be that they were referring to cognitive behaviour therapy (CBT), which is now thought to be the most effective treatment for persistent panic attacks. If you would like to try this, the best thing would be to return to your GP and ask whether you can be referred to a therapist. You can read more about CBT in our mind section.

I hope that this helps Catherine. Take care.

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