How Anxiety Affects Your Heart Rate

It's not uncommon for your heart to pound in response to stressful situations. And it's easy for a racing, out-of-control pulse to leave you feeling even more anxious.

But what's normal and what isn't? And how can you tell if your amped-up pulse is just worry-related, or whether you're dealing with a health condition?

Here's a look at how anxiety really affects your heart rate (and vice versa) and what you can do about it. Plus, the number-one indicator that stress is the culprit.

Feelings of stress or anxiety set off the body's fight-or-flight response, an automatic physiological reaction to perceived threats or dangers. This drives up your heart rate, making you feel like your pulse is racing, pounding, fluttering or even that your heart is skipping beats.

Most healthy adults have a resting heart rate between 60 and 100 beats per minute. The average heart rate when you're stressed is higher: "When someone is anxious, their heart rate is above 100 beats per minute, often between 120 and 150 beats," says Ashesh Parikh, DO, a cardiologist with Texas Health Plano and Texas Health Physicians Group. "If they're having a panic attack, it can rise to 200 beats per minute."

Anxiety can affect your body in other ways, too. You might tense up or tremble, sweat, breathe faster or have stomach cramps or diarrhea, per the Cleveland Clinic. All of these reactions are part of your fight-or-flight response.

All of these responses are normal, by the way. They're simply how the body evolved to help you escape from harm's way.

"Heart palpitations are rarely dangerous, especially if they're due to an anxiety-provoking situation. They're primarily unnerving, and they resolve when the anxiety-causing situation is controlled," Dr. Parikh says.

A racing, pounding or fluttering heart can also be a symptom of an arrythmia, or an irregular heartbeat. So how can you tell if your speedier-than-normal pulse is from anxiety or a heart problem?

Truth is, arrythmias share some of the same symptoms of extreme anxiety or panic attacks. Disorders that cause irregular heartbeats can also cause anxiety, chest pain, confusion, gasping or trouble breathing, dizziness or weakness, notes the National Heart, Lung, and Blood Institute.

But you can usually tell an anxious pulse from how it comes on. If your heart starts to race when you're in a stressful situation and slows down as you start to feel calmer, there's a good chance it was from anxiety, Dr. Parikh says.

On the other hand, if you notice your heart rate speeding up, fluttering, skipping beats or even slowing down when you're feeling calm and cool, that could be a sign of an arrythmia, he says. (It's worth pointing out, too, that these out-of-the-blue pulse changes can definitely ‌make‌ you anxious and, in turn, cause your heart rate to speed up even more.)

Major stress can sometimes trigger an anxiety or panic attack — a sudden episode of intense fear that can feel like you're losing control, having a heart attack or even dying. Per the Mayo Clinic, these attacks are marked by:

• Sense of impending doom or death
  
• Racing or pounding heart
  
• Sweating
  
• Trembling or shaking
  
• Chills
  
• Hot flashes
  
• Nausea
  
• Abdominal cramping
  
• Chest pain
  
• Headache
  
• Dizziness or faintness
  
• Numbness or tingling
  
• Feeling unattached to reality
  

Panic attacks can be incredibly frightening, but they aren't physically dangerous and don't actually mean that something is wrong with your heart.

Still, it's a good idea to seek medical attention if you've had one, so you can find ways to manage the problem or keep it from happening again.

An unusually fast, pounding or fluttering pulse can stem from an actual heart problem, especially if the palpitations don't seem to be tied to an anxious mood, per the Cleveland Clinic. Other possible culprits include:

• Heart rhythm problems, such as atrial fibrillation
  
• Myocarditis, or heart inflammation caused by a viral infection
  
• Thyroid problems
  
• Heart valve disease or other structural heart problems
  

It's hard to stop a panic attack in its tracks. But relaxation strategies can help you ride the wave of your symptoms so they're a little more manageable. The Cleveland Clinic recommends the following:

• ‌Take deep breaths:‌ Breathe in slowly through your mouth and exhale slowly though your nose. Try to close your eyes and direct as much of your attention to your breath as possible.
  
• ‌Remind yourself what's happening:‌ Knowing you're having a panic attack and that it will end can help you keep unrealistic fears in check.
  
• ‌Relax your muscles.‌ Check in with one muscle group at a time (your jaw, your shoulders, your fists and so on) and relax them if you notice they're tense.
  
• ‌Focus on the present.‌ Try to home in on something that's right in front of you to feel more grounded.
  

Heart palpitations caused by anxiety don't need to be treated. But if anxiety is making your heart race, addressing the ‌anxiety‌ can help reduce your palpitations and help you feel better overall, Dr. Parikh says.

Start by talking with a therapist or another mental health professional. Sometimes talk therapy or strategies like meditation or support groups can help you get a handle on your anxiety.

Anti-anxiety medications or antidepressants can help you manage your symptoms, too, per the American Psychiatric Association.

Seek emergency medical attention if your heart rate goes above 200 beats per minute, Dr. Parikh recommends, or if you're experiencing chest pain, shortness of breath, weakness, dizziness or fainting.

You should also let your doctor know if you experience a rapid heartbeat or heart palpitations when you're not anxious, Dr. Parikh says, as these could be signs of an arrythmia or other heart disorder.