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Can Anxiety Cause Chest Pain?

Can Anxiety Cause Chest Pain?

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It's the middle of an ordinary day, no different from any other, but you suddenly feel a sharp pain in your chest. Every breath is a struggle, and that sets your heart racing even faster. Could it be a heart attack? Or is it something else?

If you've ever experienced that tightness in your chest, you know just how scary it can be. While chest pain may indicate numerous medical concerns, its connection to anxiety and anxiety-related disorders can be alarming.

In this guide, we’ll outline some causes of anxiety chest pain, how to distinguish it from more severe conditions, what to do when you experience it, and what you can do to find relief and prevent anxiety chest pain from happening.*

What causes anxiety-induced chest pain?

When our body senses a threat, real or perceived, a cascade of responses occur, from the release of stress hormones to an increased heart rate. These bodily changes are designed to help you react quickly in the face of danger.

But what happens when these responses cross over from protective to problematic? Anxiety-related chest pain can manifest in various ways:  

  • Some may experience it as a dull ache 
  • Others may feel a sharp, piercing sensation
  • The pain can be localized or spread across the chest

This pain is often triggered by muscles tensing in response to stress.

In addition to muscle tension, anxiety can also trigger changes in your breathing patterns. Shallow, rapid breathing, commonly known as hyperventilation, can make chest pain worse by disrupting the balance of oxygen and carbon dioxide in your bloodstream. This, in turn, can lead to tingling sensations or numbness in the hands.

What does anxiety chest pain feel like?

Anxiety-induced chest pain can vary from person to person. For some, it may feel like a dull ache or pressure, while for others, it could be a sharp, stabbing sensation. It's often accompanied by feelings of tightness or constriction in the chest, which can be pretty distressing.

It may prompt you to suspect the worst, which only perpetuates the anxiety cycle. In the midst of this distressing experience, it’s important to remember that anxiety-induced chest pain, as opposed to other conditions, is generally harmless.

Anxiety chest pain vs. heart attack

On the surface, it looks like a fine line. Anxiety chest pain and heart attack symptoms can overlap, sharing features like shortness of breath and dizziness. However, there are some distinctions:

  • Location and duration: Anxiety chest pain tends to be more fleeting and can change location, whereas heart attack pain typically remains more localized and can last for longer periods.
  • Character of pain: Sharp, stabbing sensations are more commonly seen with anxiety chest pain, while heart attack pain is often described as pressure or tightness.
  • Associated symptoms: Anxiety-related pain can be linked to a known trigger and may occur alongside other symptoms of anxiety, such as panic attacks. Heart attack pain is less likely to be tied to a specific stressor and often presents with a more extensive mix of symptoms.

The bottom line: Anxiety chest pain is usually short-lived, tends to come and go in response to stressors or triggers, and often resolves once the underlying stress or anxiety diminishes.

Empty hospital bed in an emergency room

Seek emergency care

Without an evaluation from a medical doctor, it’s impossible to determine if anxiety is the cause of your chest pain. Symptoms like chest pain or tightness could signal a life-threatening condition like a heart attack.

Whether you’re being treated for anxiety disorder or not, you should go to the emergency room if you’re experiencing symptoms consistent with those of a heart attack. 

Heart attack symptoms

Recognizing the symptoms is crucial for prompt intervention and potentially life-saving action.

  • Chest pain or discomfort: Often described as pressure, tightness, squeezing, or aching in the chest area.
  • Pain or discomfort in other upper body areas: This may include the arms, back, neck, jaw, or stomach.
  • Shortness of breath: You could have difficulty breathing or feel like you can't get enough air.
  • Nausea or vomiting: Some individuals may experience stomach discomfort or vomiting.
  • Light-headedness or dizziness: You may feel faint or dizzy, which may be accompanied by clamminess or sweating.
  • Cold sweat: Sudden, unexplained sweating, especially if it's accompanied by other symptoms, can be experienced.
  • Fatigue: You may feel unusual tiredness or weakness, often sudden and overwhelming.
  • Palpitations: Irregular or rapid heartbeat, fluttering, or pounding in the chest may be experienced.
  • Loss of consciousness: Fainting or passing out, particularly if it occurs suddenly and without warning, is a sign.

If you’re unsure of the cause of your chest pain, don’t risk it: go to an emergency room immediately. A physician can conduct tests to identify different causes of chest pain.

What to do if anxiety is the cause of chest pain

If cardiac concerns are ruled out, and you’re still experiencing anxiety chest pain, these immediate or proactive strategies might  help relieve chest tightness from anxiety when it occurs.

Take stock of the situation

If the feeling is related to anxiety, remind yourself that you are likely not in immediate danger and that what you're experiencing, while real, should pass.

Focus on your breathing

Deep, slow breathing can help regulate the body's stress response. It counters hyperventilation, which often causes the tingling and numbing sensations that can accompany anxiety-related chest pain.

Free mental health resource: Deep breathing exercises

Use the 3-3-3 rule

Name three things you see, hear, and touch. This grounding technique can bring you back to the present, away from the spiral of anxiety that intensifies the pain.

Try talk therapy

In the long run, talk therapies like cognitive behavioral therapy (CBT) or psychotherapy can help you identify and manage underlying anxiety triggers, reducing the frequency and intensity of anxiety-related chest pain incidents.

Free mental health resource: Trigger Log worksheet

Consider medication as an option

For persistent or severe cases, medication is an option. Antidepressants and anti-anxiety medications can help regulate brain chemistry and alleviate distressing physical symptoms.

When it comes to chest pain, it's essential to recognize when it’s rooted in anxiety and to act accordingly — seek proper help, take healthy measures to relieve the immediate panic, and develop coping strategies for the future.

Woman looks up smoothie recipes on tablet

How to prevent anxiety chest pain

​​While it's not always possible to stop anxiety-induced chest pain entirely, there are steps you can take to reduce the frequency and intensity of episodes.

  • Limit caffeine: Caffeine is a trigger for anxiety in many people, so you may want to drink less coffee, tea, or energy drinks if you're prone to anxiety or have a related disorder.
  • Moderate alcohol and smoking: Alcohol and nicotine can actually increase your overall anxiety levels, and cutting back could lead to more manageable stress responses.
  • Eat healthy: A balanced diet can help support physical and mental well-being, and certain nutrients like omega-3 fatty acids have been linked to reduced anxiety symptoms.
  • Get some exercise: Regular physical activity is a natural stress reliever and mood booster. 

Given that chest pain indicates you’re experiencing mid- to severe levels of anxiety, you may also want to consider working with a licensed mental health professional to develop personalized strategies for minimizing the psychological and physical symptoms of anxiety.

Understanding anxiety disorders  

Just like it can be difficult to distinguish anxiety-induced chest pain from cardiac-related events, it can be challenging to determine if you’re just feeling anxious or if you have an anxiety disorder.

For that reason, chest pain associated with anxiety may not just be limited to fleeting moments of stress. Because this chest pain can be a sign of high levels of anxiety symptoms, it could be an indicator of an anxiety disorder

Anxiety disorders form a category of mental health diagnoses that relate to excessive apprehension, worry, nervousness, and fear that can significantly impact daily functioning. They include a range of conditions, such as generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder.

For individuals with anxiety disorders, chest pain may be a recurring symptom, and they may also encounter other physical symptoms, such as palpitations, dizziness, and gastrointestinal issues. 

If you find that anxiety-induced chest pain is frequent or persistent, it may be time to seek professional help. A mental health professional can assess your symptoms, provide a diagnosis if necessary, and recommend treatment options to help you manage your anxiety symptoms and improve your quality of life.

Do I have anxiety?

If you’re wondering this, you can take an initial step to assess the level of your symptoms with our free 3-minute anxiety screener


Images by rawpixel.com, DC Studio and pressfoto on Freepik.

*The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.


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This constant state of alertness can even lead to physical symptoms of anxiety that can significantly impact one's quality of life. Common symptoms of anxiety Anxiety can manifest in various ways, affecting both the mind and body. Most commonly, people with anxiety-related disorders will experience the following: Excessive worrying Feeling agitated or restless Fatigue Difficulty concentrating Irritability Tense muscles Trouble sleeping These symptoms can significantly impact daily life, making it challenging to perform everyday tasks and enjoy normal activities. Key differences between OCD and anxiety While OCD and anxiety disorders share some similarities, there are key differences in behaviors, thought patterns, and the focus of thoughts that can help in telling the two types of disorders apart. Behaviors Behaviors associated with these conditions can greatly interfere with day-to-day functioning and are often key indicators of the underlying disorder. Here’s how the two differ in behaviors:  OCD: Involves repetitive or ritualistic behaviors or mental acts (compulsions) performed to reduce the distress caused by obsessions. Anxiety: Involves behaviors aimed at avoiding anxiety-provoking situations or events, such as avoidance of social gatherings or excessive preparation for events. Thought patterns Thought patterns are a critical component in distinguishing between OCD and anxiety disorders. These are the major differences for both: OCD: Characterized by intrusive, unwanted thoughts that the person recognizes as irrational but cannot control. Anxiety: Involves persistent worrying about future events or everyday situations, which, while often exaggerated, are more rooted in reality compared to the intrusive thoughts in OCD. Focus of thoughts Understanding where thoughts are centered can help in identifying a specific disorder. This is how the two conditions differ in this area: OCD: Thoughts are often centered around specific themes like contamination, harm, or symmetry. Anxiety: Thoughts can be generalized and involve worrying about a wide range of everyday issues, such as work, health, and relationships. Recognizing differences can aid in distinguishing between OCD and anxiety disorders, which can help lead to more personalized and targeted treatment options. Is OCD a type of anxiety? OCD was previously considered an anxiety-related disorder because it involves significant anxiety and distress caused by obsessions and compulsions. However, OCD has been reclassified as an obsessive-compulsive and related disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as of late. This reclassification reflects the distinct nature of the obsessions and compulsions in OCD, which distinguish it from other anxiety disorders. How to tell if I have OCD or anxiety Because OCD and anxiety disorders can have overlapping symptoms, it will take a mental health professional to make a clinical diagnosis. However, you can educate yourself on the main differences between the two to gain more clarity before talking with a mental health professional. Let’s take one last look at the symptoms of both to help differentiate between the two. OCD symptoms Intrusive, unwanted thoughts or images (obsessions) Repetitive behaviors or mental acts (compulsions) performed to reduce distress Significant time spent on obsessions and compulsions, interfering with daily life Recognizing that obsessions and compulsions are excessive or unreasonable Anxiety symptoms Excessive, uncontrollable worry about various aspects of life Physical symptoms such as increased heart rate, sweating, and trembling Avoidance of anxiety-provoking situations Difficulty concentrating and sleeping Persistent feelings of restlessness or being on edge How are OCD and anxiety diagnosed? Diagnosing OCD and anxiety disorders involves a comprehensive evaluation by a mental health professional. This typically includes: Clinical interview: To discuss your symptoms, medical history, and impact on daily life. Questionnaires: To assess the severity of symptoms using standardized clinical tools. Observation: To note behaviors and physical signs of anxiety or compulsions. Diagnostic criteria: To make a diagnosis using criteria from the DSM-5. A thorough clinical evaluation and diagnosis inform a personalized treatment plan.  Can you have both OCD and anxiety? Yes, it is possible to have both OCD and an anxiety disorder, and co-occurrence of these conditions can be relatively common. While having one can increase the risk of developing the other; the likelihood of developing both is greater for those with OCD because of the condition’s severity. When both conditions are present, treatment plans should address OCD and anxiety symptoms to ensure comprehensive care. Why that matters: The presence of one condition can exacerbate the symptoms of the other, creating a complex interplay that can be challenging to manage, especially without ongoing professional help. What other conditions could it be? Several other conditions can present with symptoms similar to OCD and anxiety disorders but also have distinct treatment options. This makes a clinical evaluation or talking with a licensed professional all that more important. Conditions that could look like OCD or anxiety include: Depressive disorders: Persistent low mood, loss of interest in activities, feelings of hopelessness, and changes in appetite and sleep patterns. Attention-deficit/hyperactivity disorder (ADHD): Symptoms like difficulty concentrating, restlessness, and impulsivity can resemble anxiety and OCD, especially when the individual engages in repetitive behaviors or experiences significant worry and distractibility. Phobias: Intense fear of specific objects or situations that result in avoidance behavior. Body dysmorphic disorder (BDD): Obsessive focus on perceived flaws in appearance, leading to repetitive behaviors, such as mirror checking, and significant distress. Undergo an evaluation with a licensed professional to discuss personalized treatment for your specific condition. Are the treatments different? Not always. There are similarities in treating OCD and anxiety disorders. Medication Medication is a common treatment option for both OCD and anxiety disorders, often helping to manage and alleviate symptoms. For both conditions, medications are often combined with therapy and other interventions. Therapy A therapist can provide non-medication strategies and support in managing symptoms for either condition. By learning essential tools and techniques, therapy fosters hope for long-term recovery and resilience for people with OCD as well as for those who have anxiety-related conditions. Coping strategies Techniques such as mindfulness, relaxation exercises, deep breathing, and stress management may be particularly helpful. Lifestyle changes like regular exercise, balanced eating, and sufficient sleep also may help. By incorporating healthy coping strategies into your daily life, you are on the road to improving your mental health. How Cerebral can help If you are experiencing symptoms of OCD or an anxiety-related disorder, seeking help from a mental health professional is essential to getting the care you need. Online mental health services like Cerebral offer a convenient and accessible way to receive support for OCD and anxiety disorders. Cerebral provides: Therapy: Access online sessions with licensed therapists. Medication management: Consult with credentialed prescribers virtually to see if an online prescription and managing medication is appropriate for you. Educational resources: Explore articles, in-app exercises, and free mental health resources to help understand and manage symptoms. Services like Cerebral can be particularly beneficial for those who have difficulty accessing traditional in-person care due to geographical, logistical, or personal reasons. Our team of experienced mental health professionals is here to explore personalized care and support if appropriate for you.  Do I have anxiety? Only a mental health professional can determine the answer to that question by conducting a clinical evaluation for an anxiety disorder. But, you can take a free 3-minute self-assessment to get a better sense of the level of your anxiety symptoms.  Images by freepik, freepik, and master1035 on Freepik. *The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.
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