More than half (54%) of all working days lost to ill health in 2018/19 were caused by stress, depression or anxiety. Although the figure was not much different to the previous year, the overall trend is upwards, indicating that more of us are succumbing to stress and anxiety in the workplace.
Work-related stress, depression or anxiety is defined as “a harmful reaction people have to undue pressures and demands placed on them at work” in the Health and Safety Executive report “Work-related stress, anxiety or depression statistics in Great Britain, 2019”.
Anxiety symptoms are often mistaken for a heart attack and it’s easy to see why. Feeling anxious triggers a release of stress hormones that act on the same parts of the brain that regulate cardiovascular functions like heart rate and blood pressure. The result can be heart palpitations, breathlessness and pain in your chest.
Stress is the way your body responds to a particular trigger or situation. Under normal circumstances, it is a short-term state that subsides naturally. Anxiety is a more sustained long-term feeling that can have a detrimental effect on many different aspects of your life including work and ability to socialise.
Common non-cardiac causes of chest pain include a condition called generalised anxiety disorder. In addition to pain in the chest, the condition is characterised by excessive or persistent worry for six months or longer, sleep problems, feelings of tension, irritability or restlessness and problems concentrating.
People who have generalised anxiety disorder are more likely to suffer from heart attacks and other heart problems. If you already have heart disease, then anxiety symptoms on top increases your risk of heart attack. Scientists believe there may be several reasons for this. Prolonged anxiety can alter your body’s stress response and cause inflammation in the body, which damages the linings of the artery and can cause a build-up of coronary plaque.
Stress hormones can result in disturbance to your heart rhythm, high blood pressure and greater risk of heart attack. Studies show that people with anxiety have low levels of omega-3 fatty acids and this can be linked to a higher risk of heart disease. In addition, the platelets become more viscous when a person has anxiety or depression, making the blood more prone to clotting.
It can become a vicious cycle as a diagnosis of heart problems can lead to increased anxiety which may then exacerbate the risks of further heart problems. People may develop unhealthy coping mechanisms, such as smoking, drinking or eating unhealthy food, which can also damage heart health.
There are many different ways you can help yourself if you suffer from anxiety. GPs run a scheme called Reading Well Books on Prescription which gives you free access to books that might help. It’s important to take good care of your physical health and to try and manage your worries. A way to do this might be to dedicate a particular time of the day to focus on what is worrying you or to write your worries in a notebook or on pieces of paper and put them in a jar. That way, they are not going round and round in your head. Simple breathing exercises can help with anxiety as taking slow, deeper breaths can calm the body’s stress response. Mindfulness and meditation can be helpful ways to cope with anxiety.
If self-help treatments aren’t enough, other treatments are available including:
Talking therapies such as Cognitive Behavioural Therapy which focuses on how your thoughts, attitudes and beliefs affect the way you behave and feel. It teaches you new coping skills for dealing with your problems.
Applied relaxation therapy teaches you how to relax your muscles during stressful situations.
Medication can be helpful for some people. Antidepressants may be offered if you are suffering from depression or a drug called pregabalin for generalised anxiety disorder. Beta-blockers are sometimes used to treat physical symptoms such as palpitations and rapid heartbeat. In the case of very severe anxiety a benzodiazepine tranquilliser may be prescribed but these can be addictive so a low dose and short course of drugs is normally recommended.
A panic attack is an exaggerated fear response to perceived danger or stress. Symptoms can come on very rapidly and might include:
Heart racing and struggling to breathe
Feeling faint or dizzy
Feeling very hot or cold, trembling or shaking
Feeling disconnected from your mind, body or surroundings
People who experience panic attacks sometimes worry they are going to have a heart attack or die. However, although panic attacks can be frightening they are not life-threatening and there are things you can do to manage the attack. Different things will work for different people so experiment to see which of these techniques helps most for you:
Focus on your breathing. Try to breathe in and out to a count of five.
Focus on your senses – taste a mint, touch something and notice how it feels, be aware of any smells around you.
Stamp up and down on the spot – for some people this can help to control their breathing.
If you experience lots of panic attacks with no obvious trigger or cause you may be diagnosed with panic disorder. Treatments may include talking therapies or medication.
The impact of anxiety and stress on your mental and physical health means it is important to develop healthy coping strategies. If you are concerned about your heart health or would like a diagnosis of symptoms such as chest pain or breathlessness, talk to the London Heart Clinic who can provide rapid diagnosis and an effective treatment plan.