Chest Tightness: Is It Linked to Anxiety Disorders?

Chest tightness and mental disorders?

Hello, Doctor: I graduated with a degree in law and currently work in a bank as a legal collections officer.
I'm not sure if my anxiety is due to the pressure of wanting to take the national exam or if it's related to my personal emotions (for example, I get very irritated and frustrated when I see cars parked in the alley, and I tend to get upset over small things).
Every day, I feel anxious without knowing why; my chest feels heavy and uncomfortable, and pressing on it causes pain.
I also find it hard to concentrate and can't focus on reading.
I went to a health check-up at a clinic and even had a cardiac function test at Taipei's Heping Hospital, both of which showed no issues (though my cholesterol level is 230—does that matter?).
Is this what is referred to as psychogenic chest pain? It really feels heavy and painful, and I'm worried that I might have anxiety disorder or generalized anxiety disorder.
However, my eating and sleeping patterns are normal, and I've been gaining weight.
Whenever I mention my anxiety to friends, they laugh and say I look happy and that I’m gaining weight, which doesn’t seem like someone with anxiety.
I've also hesitated to enter the psychiatric department at Heping Hospital several times, and I’m considering seeing a family medicine doctor, but I’m unsure what to do.
I sincerely ask for your guidance.
Thank you!

Xiao Riwen, 30~39 year old female. Ask Date: 2005/10/25

Dr. Chen Wenyu reply Psychiatry

Hello, in regard to the "national examination," many professionals have gone through this experience, and it can indeed be very stressful, especially with the decreasing acceptance rates.
Naturally, this leads to increased pressure.
Everyone reacts differently to stress, and common responses include irritability and a tendency to lose one's temper.
As long as these reactions do not result in significant declines in interpersonal, occupational, or social functioning, they may not require excessive concern, but they should still be monitored.
How can we manage stress? In addition to cultivating hobbies and engaging in entertainment, regular exercise is an excellent way to relieve stress.
When feeling the urge to lose your temper, taking a moment to "think twice" is a sign of maturity.
Consider whether expressing anger will be helpful, whether it might harm innocent people, or whether you might regret it later.
Before reacting in anger, it may be beneficial to temporarily remove yourself from the situation to allow your emotions to settle, which can lead to a greater sense of accomplishment in managing your feelings.
"Complaining (voicing your concerns)" is also a common method of stress relief, but it's important to choose the right person to confide in.
Seek out a good friend (someone who won't gossip and is willing to keep your confidence) to talk to.
If you're concerned, consider speaking with a psychiatrist, who has received more specialized training in psychological counseling and has more experience than a general practitioner.
This could provide you with even greater support.
Thank you for your message!

Reply Date: 2005/10/25

More Info

It's understandable to feel overwhelmed when dealing with anxiety, especially when compounded by work and study pressures. Your symptoms, including chest tightness, difficulty concentrating, and emotional distress, can indeed be linked to anxiety disorders. While you have undergone thorough medical evaluations that ruled out serious physical conditions, it's essential to recognize that anxiety can manifest in physical ways, often referred to as somatic symptoms.

Chest tightness is a common symptom associated with anxiety. When you experience anxiety, your body enters a "fight or flight" mode, releasing stress hormones like adrenaline. This response can lead to muscle tension, including in the chest area, which may cause discomfort or pain. It's important to note that while this discomfort can feel very real and distressing, it is often not indicative of a serious medical condition, especially since your heart function tests have returned normal results.

Your mention of feeling irritable and easily frustrated, particularly in response to minor annoyances, is also a common feature of anxiety and stress. The pressure of preparing for exams or meeting work expectations can exacerbate these feelings, leading to a cycle of anxiety that can feel unmanageable. It’s crucial to address not only the physical symptoms but also the underlying emotional and psychological factors contributing to your distress.

Regarding your cholesterol levels, while a cholesterol reading of 230 is considered borderline high, it is unlikely to be the direct cause of your anxiety symptoms. However, maintaining a healthy lifestyle, including a balanced diet and regular exercise, can positively impact both your physical health and mental well-being. Exercise, in particular, is known to be a powerful tool for alleviating anxiety and improving mood.

You mentioned that you find it challenging to seek help from mental health professionals, which is a common barrier for many individuals. However, it’s important to remember that mental health services are designed to provide support and guidance. A mental health professional can help you explore your feelings, develop coping strategies, and determine if you might benefit from therapy or medication. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders, helping individuals identify and challenge negative thought patterns and behaviors.

In the meantime, there are several self-care strategies you can implement to help manage your anxiety:
1. Mindfulness and Relaxation Techniques: Practices such as deep breathing exercises, meditation, or yoga can help calm your mind and reduce physical tension.

2. Regular Physical Activity: Engaging in regular exercise can help release endorphins, which are natural mood lifters.

3. Healthy Sleep Hygiene: Ensure you are getting enough restful sleep, as fatigue can exacerbate anxiety symptoms.

4. Limit Caffeine and Alcohol: Both substances can increase anxiety levels, so moderating your intake may help.

5. Talk About Your Feelings: Sharing your thoughts and feelings with trusted friends or family members can provide relief and support.

6. Set Realistic Goals: Break down your tasks into manageable steps to avoid feeling overwhelmed.

7. Seek Professional Help: If your symptoms persist or worsen, consider reaching out to a mental health professional. They can provide a safe space for you to discuss your concerns and explore treatment options.

Remember, you are not alone in this experience, and seeking help is a sign of strength, not weakness. Taking proactive steps towards understanding and managing your anxiety can lead to significant improvements in your overall quality of life.

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