About five years ago, I woke up one morning with the sharpest pain in my chest. So sharp it felt like there was a little person living inside my sternum squeezing my heart anytime I tried to breathe. My mind had a field day: This doesn’t feel normal, what if there’s something wrong with my heart? Should I call my mom and have her give me an extremely detailed family history? Can anxiety cause chest pain? Is that what’s happening here or am I dying?
I won’t take you through the full spiral or subsequent doctor’s appointment (that would take a while), but it turns out that, yes, it was anxiety.
How to know if this is anxiety-fueled chest pain or nah.
The incredibly frustrating answer is that it’s hard to tell whether chest pain is an actual medical emergency or a symptom of anxiety. Pulmonologist Barbara Mann, MD, an assistant professor of medicine at Icahn School of Medicine at Mount Sinai, frequently sees patients whose chest pain is rooted in stress or anxiety. And while it might take a bunch of tests to confirm that it’s not something like a heart attack, pneumonia, or a blood clot, “you never want to be wrong in that scenario,” she adds.
All of this is to say that while there are a few signals that this uncomfy or even painful feeling in your chest is anxiety, it’s also completely rational (and even recommended) to see a doctor to rule out any physical issues.
But if the question still plagues you after you’ve brought it up to your doc and they cleared you as healthy, these steps might help you figure out what’s going on…
1. Think about what you’re doing right now.
Are you in the middle of a tense conversation or stuck on a train underground for much longer than you’d appreciate? Stress or anxiety could be to blame for sudden chest pain in those scenarios—especially if you’ve felt this sensation before and had a doctor confirm you were good to go. If the pain woke you up out of a dead sleep or is different from anything you’ve felt before, it’s worth taking more seriously, says Dr. Mann.
2. Pay attention to the sensation.
“One thing that would distinguish between [anxiety and] a concerning medical condition is the type of chest pain,” says Dr. Mann. A tight feeling in your chest is most often associated with anxiety, she adds. But if you feel a crushing pain or like there’s pressure on your chest, definitely get to a doc asap. Also worthy of medical attention: pain that gets worse with exertion (like walking or jumping jacks), pain that radiates to your jaw or arms, pain that does not resolve with time, and pain that is associated with profuse sweating or nausea. Other red flags to look out for are a heart rate above 100 beats per minute while you’re at rest or an irregular heartbeat, adds Dr. Mann.
3. Try the distraction test.
Similar to shortness of breath caused by anxiety, if the chest pain subsides after you take a beat to focus on something else, that’s a great sign this is not a life-threatening event, says Dr. Mann. So hop on Pinterest, take a quick walk around the block, or try a grounding exercise for five to 10 minutes and see how you feel after.
Why does anxiety cause chest pain?
The fight-or-flight response that kicks in when your brain detects a threat, whether it’s warranted or not, is responsible for this very unpleasant phenomenon. When that happens, your body releases adrenaline, which speeds up your heart rate and breathing to supply your brain, organs, and muscles with extra in-case-of-emergency oxygen—super helpful if you’re sprinting from something scary. But breathing quickly can also drop your carbon dioxide levels, constricting the blood vessels in your heart and causing chest tightness or pain, says Dr. Mann. You might also feel a little dizzy, lightheaded, and short of breath, she adds. Yay biology!
Hyperventilating can trigger or add to your chest pain too. “[Breathing] too fast or taking too big of breaths for a long period of time could make your chest muscles distort, and that could feel uncomfortable,” adds Dr. Mann.
If you’re dealing with health anxiety, which is common in people managing conditions like OCD, generalized anxiety disorder, and panic disorder, you might be more prone to false alarm chest pain. And, FWIW, hyper-fixating on symptoms to the point where it interferes with how you show up in the world is a major indicator of somatic symptom disorder. Dr. Mann says that this is extremely common among patients who come to see her for chest pain. “It can be really tricky because even patients who have somatic complaints get sick sometimes,” she says. So if this sounds like you, It might be worth reaching out to a mental health pro who specializes in treating anxiety for help.
How can you deal with chest pain from anxiety?
In the short term, distracting yourself with a social scroll, physical stroll, or some diaphragmatic breathing (inhaling through your nose to inflate your belly) can take your mind off catastrophizing worst-case scenarios about your health. But if these coping mechanisms morph into reassurance-seeking rituals, they’ll start to lose their effect, says Jonathan Abramowitz, PhD, anxiety researcher and professor at the University of North Carolina at Chapel Hill.
To avoid that, Dr. Abramowitz suggests adding more stress-reducing activities and habits into your everyday life to reduce anxiety overall. That could look like making time to go outside, talking to the people that get you more frequently, journaling, or doing any other activity that makes you feel more chill.
Prioritizing those anxiety-fighting habits is a great move for the long term, but it’s also important to get more comfortable with the idea that we can’t always know exactly what’s happening inside our bodies, says Dr. Abramowitz. When anxiety-related chest pain comes up, the goal is for you to be able to tell yourself that things are probably OK and that it’s fine to focus on something else until it goes away, he adds.
If that sounds easier said than done, it might be a good idea to see a mental health pro who can help you learn to manage your anxiety or health anxiety in a way that makes sense for you.
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
