Cardiac neurosis???????

[no_name]

Hi everybody, i am new here and in great despair. I would appreciate some help if you don't mind.

I have an anxiety disorder. I was diagnosed with GAD with panic 10 years ago. I was able to keep it under good control for the last nine years. Due to stressful events (bought house, changed relationship, etc...), my panic attacks (PA) have re-manifested themselves last year.

After about 6 months of suffering, introspection, alot of reading and such, i was able to eliminate the PA's. But a couple of things still plague me.

1. A serious fear of heart disease has manifested itself. Even after 4 ecgs, holter monitors and 5 doctors confirming my heart is very healthy.

2. Intense physical symptoms related to my heart when i become active as in sharp chestpains and hundreds of skipped heartbeats (extrasystole) when i let's say shovel dirt or something.

3. I am also experiencing depression symptoms (acknowledged by my doctor) due to the fact that i get alot of skipped heartbeats and can't shake them.

Now, this is what i am doing now to get better:

daily meditation (mindfulness by Dr. Kabat-Zinn)
daily ashtanga yoga (10 minutes)
Excellent diet
I don't smoke BTW.
counter thoughts to my negative thinking
using someself help methods to modify/re-learn the way i think.
I still drink 4-5 beers daily though (self medication)

Now, these are my questions:

1. Can the brain be so powerfull as to create extrasystole heartbeats like i am experiencing when i try to be active?

2. Any advice on how to eliminate this fear?

Thank you for your time.

 

[Daniel E.]

Besides the yoga, are you doing other exercises like walking to help reduce stress/anxiety?

Most importantly, what did your doctor(s) say regarding the palpitations on exertion? Did they say you just needed to relax more since they didn't find an underlying problem other than your previously diagnosed panic disorder?

Everything I have read has mentioned alcohol as a possible trigger of palpitations, so your 4-5 beers a day sounds like a bad idea:

If the patient is diagnosed with a noncardiac, psychiatric, or nonarrhythmia cardiac etiology, the underlying condition is managed according to the diagnosis. In some patients, a thorough history, physical examination, diagnostic testing, and cardiac monitoring all fail to reveal any abnormality or etiology for palpitations. These patients should be advised to abstain from caffeine and alcohol, as well as foods or stressful situations that appear to trigger palpitations. Fortunately, the majority of patients with palpitations have benign diagnoses and can be treated with reassurance. Fortunately, the majority of patients with palpitations have benign diagnoses and can be treated with reassurance.

Diagnostic Approach to Palpitations (Feb. 2005)

Also:

Non-heart-related causes: Certain medicines, herbal supplements and illegal street drugs can make your heart beat faster. Medicines that can cause palpitations include asthma inhalers and decongestants. Caffeine (found in coffee, tea and soda), alcohol and tobacco can also cause palpitations. People who have panic disorder feel their heart pounding when they are fearful of something or having a panic attack. Some medical conditions, such as thyroid disease and anemia, also can cause palpitations.
http://familydoctor.org/831.xml

My 2-cent, non-medical, layman hypothesis: Your existing anxiety may make you hypersensitive to normal heart palpitations, especially if you don't exercise much aerobically:

Heart palpitation is typically an expected sensation when the force and rate of the heartbeat are considerably elevated. After strenuous exercise we are apt to notice the thumping of our heart against the chest wall. As we begin resting, that sensation may continue briefly until we recover from our exertion.
http://www.anxieties.com/panic-step1b.php

 

[Daniel E.]

It seems you may be worrying about the wrong thing. If you continued your current level of alcohol consumption, you would be at greater risk for heart disease, liver disease, cancer, etc.:

At risk: Men: >14 drinks per week, >4 drinks per occasion Women: >11 drinks per week, >3 drinks per occasion, or CAGE score of 1 or higher for past year, or Personal or family history of alcohol problems
Alcohol-Related Problems: Recognition and Intervention

 

[Daniel E.]

More reassurance:

Palpitations are the awareness that your heart is beating forcefully, rapidly, or irregularly. There often is a feeling of "skipping beats" or "fluttering in the chest." They can occur in normal healthy people, as well as in people with heart problems.

Palpitations can be very frightening. But most palpitations do not indicate underlying heart disease. If you are having palpitations, there is a good chance that nothing is seriously wrong.

Normally, people do not notice their hearts beating. But palpitations are common in everyday life and can happen to anybody, regardless of whether the person has an underlying heart abnormality...


Q: Every once in a while, I could swear that my heart actually skips a beat. Can this be harmful in the long run?

A: A feeling of skipped heartbeats is a very common description of palpitations. In most cases, it has nothing to do with how well your heart is performing. You are especially likely to notice skipped heartbeats if you are tired or have had too much caffeine or alcohol.

excerpted from What Are Palpitations? - Yahoo Health

Now, this is what i am doing now to get better:

daily meditation (mindfulness by Dr. Kabat-Zinn)
daily ashtanga yoga (10 minutes)
Excellent diet
I don't smoke BTW.
counter thoughts to my negative thinking
using someself help methods to modify/re-learn the way i think.
I still drink 4-5 beers daily though (self medication)

You may want to add therapy into the mix as well. If you tried therapy before and didn't like it, just try a different therapist. Within 1-2 sessions, you may already see some things you missed when analyzing yourself. (This is always the case with me.)

Of course, aerobic exercise, music, and antidepressants can help as well and would be much healthier than alcohol.

 

[David Baxter PhD]

Also, I'm not certain about the characteristics of ashanga yoga but you might derive more benefit from hatha yoga where the emphasis is more on relaxation...

 

[no_name]

Thank you all for the comments. Well, i have been to 4 doctors in the last year and was diagnosed each time as being healthy and the skipped beats are benign.

It seems, from my understanding that alot of my "psychosis" right now stems from these skipped beats. Everytime i jump on my motorcycle ang go for a ride,my heart will start skipping and continue to do so until i come back home and relax for an hour.

Now this is very puzzling to me and sorta reinforces the premise that the extrasystole beats are indeed anxiety related. But i can't seem to shake them loose.
So, with this said then, any good therapists in the Ottawa region i could set up a couple of sessions within the next week or so? I am from Gatineau.