Can Anxiety Cause Chest Pain? Answers From a Psychiatrist
Chest pain is an incredibly troubling sensation—it sparks fear about an imminent emergency, like a heart attack. But does chest pain always have a physical cause? Or can mental health conditions—like anxiety—cause chest pain? We turned to our board-certified psychiatrists for answers.
What is anxiety?
Anxiety is a normal response to a stressful situation; a way for our bodies to warn us of danger and force us to be on alert. An anxiety disorder, however, occurs when symptoms of anxiety are out-of-proportion to the situation at hand, impossible to control, and/or start to interfere with your everyday life.
Anxiety disorders are the most common diagnosable mental health conditions. An estimated 30% of adults will experience an anxiety disorder at some point in their lives. Symptoms are both mental and physical and require professional support to treat and control.
Can anxiety cause chest pain?
Yes, anxiety can cause chest pain. If you’ve experienced anxiety-related chest pain, you know how unnerving it can be. Understanding the why behind the feeling can help ease your mind. The cause is two-fold:
First, anxiety-induced chest pain can be the result of the changes in your blood pressure and heart rate that happen when you experience anxiety. Feelings of anxiety can activate the sympathetic nervous system, a network of nerves that controls the body’s stress response, AKA your fight-or-flight response.
This response, designed to help you respond to danger or threats, involves the release of certain hormones, including adrenaline and cortisol, which cause a rapid increase in your heart rate and blood pressure. For many people, this can lead to sweating, hyperventilating (rapid breathing), and chest pain that feels like a dull ache.
Additionally, anxiety can also cause muscle spasms in the chest or esophagus, which can feel like chest pain or chest tightness.
In fact, many mental health conditions can cause physical symptoms. Sufferers of depression, for example, often experience excessive sleepiness, insomnia, or fatigue. People with ADHD sometimes experience appetite changes. And anxiety disorders can cause chest pain, headaches, gastrointestinal symptoms, or restlessness.
When should I seek emergency care for my chest pain?
It’s impossible to know if anxiety is causing your chest pain without an evaluation from a doctor. Chest pain or chest tightness can also indicate a serious health crisis like a heart attack. If you are experiencing acute chest pain or other heart attack symptoms, it’s important to call the emergency department and seek immediate medical attention to rule out any emergent conditions.
If you’re not sure what’s causing your chest pain, don’t risk it: seek emergency care immediately.
What are other symptoms of anxiety?
Anxiety disorders can cause a number of symptoms beyond chest pain, both physical and mental. Symptoms depend on the particular anxiety disorder. There are many different anxiety disorders, but the most common are:
Generalized Anxiety Disorder (GAD)
Generalized anxiety disorder (GAD) involves a general, persistent feeling of dread or fear that usually lasts for at least six months. Many people with GAD describe themselves as having been a “worrier” for as long as they can remember.
- Feelings of restlessness or irritability
- Excessive worry or fear that is difficult to control
- Increased heart rate
- Chest pain
- Sweating or shaking
- Gastrointestinal distress
- Sleep problems, including insomnia
Panic disorder is characterized by sudden, intense periods of extreme fear or terror (panic attacks). These attacks may be triggered by a particular stressful situation, or may seem to come out of nowhere.
- Pounding heart or heart palpitations
- Chest pain
- Trembling or sweating
- Feelings of impending doom
- Feeling out of control
- A need to escape the current situation
- Avoidance of situations or environments for fear of having a panic attack
Social Anxiety Disorder
Social anxiety disorder involves an intense fear of everyday social interactions. People with social anxiety disorder are excessively afraid of situations where they might be judged by others.
- Sweating or shaking
- Feelings of extreme fear or self-consciousness
- Pounding or racing heart; chest pain
- Avoidance of social situations as much as possible
Phobia-related disorders involve an intense fear of a particular object or situation, like flying, blood, public speaking, or spiders.
Symptoms are triggered by the specific phobia and include:
- Feelings of dizziness or faintness
- Pounding or racing heart; chest pain
- Gastrointestinal distress
- Hot or cold flushes
- Shortness of breath
How is anxiety treated?
If you’re experiencing chest pain that you’re concerned could be a result of anxiety, the first step is to seek emergency medical care to rule out a life-threatening condition, like a heart attack, heart disease or other heart problems, or even a severe asthma attack.
Once any physical causes of chest pain have been ruled out, it may be tempting to self-diagnose and attempt to treat your anxiety disorder on your own. However, the first and most important step to treating any anxiety disorder is getting a clinical diagnosis from a qualified mental healthcare professional, like a psychiatrist.
Anxiety disorders are treatable. There are many treatment options available that can make a huge difference in your quality of life. Getting a diagnosis from a qualified psychiatrist will allow you to access the tools and resources that can dramatically improve your symptoms.
With Talkiatry, you can see a psychiatrist from the comfort of your home, and you can schedule your first appointment in a matter of days. To get started, take ourfree online assessment, to see if Talkiatry is right for you and get matched with a psychiatrist.
Depending on your symptoms and needs, your psychiatrist may recommend medication as part of your anxiety treatment plan. There are many medications that have been shown to be very effective at managing the symptoms of anxiety.
- Antidepressants, including SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors). Although classified as “antidepressants,” they’re also FDA approved to treat the symptoms of anxiety. They work by boosting the availability of certain chemical messengers in the brain. It may take a few weeks to see the full effects of these medications.
- Anti-Anxiety medications, including benzodiazepines. This type of medication may be recommended if you have an acute anxiety disorder, like panic disorder. These medications work very fast to decrease your panic, anxiety, and worry and are most effective for short-term use.
- Beta Blockers, a type of medication typically used to treat high blood pressure. Beta blockers block the action of certain hormones like adrenaline, which is responsible for many of the unpleasant physical symptoms of anxiety, like rapid heartbeat, shaking, and trembling.
Not all of these medications will be appropriate for everyone with anxiety. If you don’t respond to one medication, it’s possible you’ll respond to another, which is why it’s important to work with a provider who can tailor your treatment to your specific needs.
Your psychiatrist may recommend therapy in addition to medication to help manage your anxiety. Typically offered by a therapist, talk therapy can be an important tool to help you understand and overcome your anxiety.
In the course of your treatment, your therapist may also introduce specific, structured approaches that have been proven to help manage the symptoms of anxiety, including cognitive behavioral therapy (CBT), an evidence-based therapy technique that’s been shown to successfully help treat anxiety symptoms. CBT teaches you to recognize thought patterns or behaviors that lead to feelings of anxiety, and then develop new ways of thinking that will minimize these feelings.
Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety, depression, trauma, ADHD, and more. Get started with a short online assessment.
The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.
Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.
Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.
Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.