Chest pain is felt by 12–16% of people¹ at some point in their life. Given that your chest holds important organs like your lungs and heart, any chest pain may indicate a serious problem, and it is important to see your doctor immediately for a diagnosis and management of your chest pain.
Regardless of the cause, experiencing chest pain can be stressful and cause feelings of anxiety. In some cases, the chest pain itself may also be caused by anxiety, specifically due to a panic attack.
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Panic disorder is a type of anxiety disorder in which people may frequently experience chest pain as a symptom during a panic attack. Panic attacks are described as periods of intense fear in which you might develop some of the following symptoms:
Fear of going crazy or dying
Difficulty regulating temperature
When a group of people described their worst panic attacks, over three-quarters mentioned chest tightness as a symptom.²
Experiencing chest tightness as part of a panic attack can cause further distress and worry. You may believe that you’re having a heart attack, which can further lead to increased anxiety, fear, or panic.
There are different ways to describe chest tightness that is caused by anxiety. For some people, it may simply feel as though they have pulled a muscle in their chest. For others, it may feel like:
A dull and constant ache
A sharp, cramping, shooting pain
A burning feeling deep in the chest
An uncontrollable muscle twitch
A numb sensation
Chest tightness is more likely to occur when anxiety or stress comes on suddenly rather than building gradually.
If you are experiencing any chest pain for the first time, you should immediately seek professional medical help to ensure an accurate diagnosis and treatment.
When you’re faced with stress, fear, or a challenge that causes anxiety, this activates the flight-or-fight response, which ultimately helps the body prepare to face the danger or protect itself from that danger.
Part of the fight-or-flight response involves tensing the muscles, which can cause feelings of stiffness or tightness in different parts of the body.
When your body is subjected to stress, it also produces higher levels of hormones, like adrenaline and cortisol.
It’s suggested that during times of panic,¹ you can experience an increased heart rate, which may cause chest tightness; however, the conclusions from research aren’t clear.
When anxiety is the main cause of your chest tightness, the most effective solution is to treat the underlying anxiety. Various treatment options are available for working through anxiety. These techniques may not work for you in every situation, but they are good tools to have on hand to try at any given time.
1. Breathing exercises
Have you ever noticed when you feel anxious that your body can tense up? This tension can affect your breathing; you might find yourself holding your breath, or your breathing rate might increase.
Calming breathing techniques can be done anywhere and only require a few minutes to be carried out. It can be helpful to set aside time to really work on breathing deeply, in through your nose for 5 seconds and exhaling out through your mouth for 5 seconds.
To optimize the exercise, try and let the air flow deep into and out of your lungs. This process helps to slow the rate of breathing.
You may also feel tightness in particular parts of your body — perhaps the muscles around your neck feel stiff. Incorporating some gentle stretches and rotations can help bring movement back into your muscles.
2. Follow the 3-3-3 rule
The 3-3-3 rule is a trick used by some people to help manage the anxiety causing their physical symptoms. The first trick to applying the 3-3-3 rule is when you feel the anxiety coming on, you must be able to stop and acknowledge the feeling. Then comes the 3-3-3 strategy:
Look around and try to name 3 things you can see within your surrounding environment. Notice the details — the colors, the textures, the age.
Listen to the noises around you and take note of 3 different sounds — how loud are they? How high or low is the pitch?
Move your body. Choose three different parts of your body to adjust — move your head side to side, tap your foot, or touch your thumb to each finger.
The idea of the 3-3-3 rule is that it distracts your brain and helps create a sense of control.
3. Use a smartphone app
It’s not uncommon to carry a smartphone with you most of the time. There is a diverse range of smartphone applications designed to help you manage your anxiety. Some of these include:
Applications designed for journaling about your emotions/fears
Educational applications that teach you about what your anxiety means
Situational applications that present a range of circumstances and strategies to help overcome them
Applications that provide guided meditation and relaxation
Creative applications where you can color or draw to help calm the mind
Smartphone applications can come at a cost or free of charge. It’s best to download a few and figure out which are most helpful to you.
4. Limit alcohol and smoking
While alcohol and smoking can feel like an aid to numb stress and reduce anxiety, these substances can worsen your mental health.
If you’re a current smoker, you may get a sense of relaxation when you have a hit of nicotine. However, this sensation is temporary; research has shown that smoking actually increases anxiety and tension in the body.
In the same way, people may drink alcohol to try and change their mood to feel more relaxed; however, alcohol is a depressant. It causes chemical changes³ in your brain that increase your feelings of low mood and anxiety.
5. Talk therapy
Talk therapy treatment can be offered in a group or an individual setting when it comes to working with general anxiety or panic disorders. A therapist will be able to work with you to talk through different situations that cause your anxiety and share strategies on how to best cope.
If you are experiencing chest pain for the first time
If your chest becomes tighter or more painful
If there are changes in your chest pain (for example, if it starts to radiate)
If you develop other symptoms besides chest tightness
If you experience heaviness, discomfort, or pain in your chest that lasts more than 10 minutes (in this case, call for help immediately)
Chest tightness that is severe or chronic shouldn’t be ignored. If you have any health conditions that place you at increased risk of heart disease, such as diabetes, high blood pressure, a family history of heart disease, or obesity, then you’re at a higher risk of having a heart attack.
Even if you believe your chest pain is caused by anxiety, it is important to still seek help to ensure that this is the correct diagnosis. If this diagnosis is confirmed, then you can work with your doctor on a treatment plan for your anxiety/panic disorder.
Anxiety can cause a number of physical conditions in addition to mental distress. Though it can feel frightening at the time, chest tightness caused by anxiety won’t last long. To treat anxiety-related chest tightness, it’s important to manage the underlying cause: anxiety.
Thankfully, an abundance of tools and strategies are available to help reduce your stress and manage anxiety. Having a good understanding of the techniques accessible to you will help you feel more in control of your anxiety and reduce its associated symptoms.
Alcohol and mental health | Mental Health Organization