In this blog we will discuss the symptoms, causes and treatment of Cardiophobia.
An intense fear of the heart is called Cardiophobia. It is a type of specific phobia which comes under the category of anxiety disorders in the DSM-V.
Someone suffering from it experiences extreme anxiety when they feel their heart racing or see a picture of it.
Even the thought of having a chest pain can instigate unpleasant feelings.
Sufferers have a constant feeling of palpitations, increased heart rate and or chest pain.
This is because they fear they might die of a heart disease.
Despite having repeated medical tests and examinations of the heart, they still assume that they are suffering from a certain heart problem.
It is normal for one to assume they might be suffering from a heart disease if they develop specific symptoms for it.
But, excess anxiety and recurrent thoughts of dying from a heart attack or amplifying worry if experiencing chest pain, despite being healthy is specific to Cardiophobia.
Individuals suffering from Cardiophobia try to avoid every possible thing/situation which might result in heart attack.
This repeated avoidance can turn into compulsions.
One will not only develop OCD in the future but can also suffer from other health related problems.
As the DSM-V suggests, anxiety and avoidance affects one’s social and occupational functioning.
For example, one will avoid running because of the fear that an increase in blood pressure can result in a heart attack.
They will assume every minute pain in the chest or left arm to be a sign of an impending heart attack.
Sufferers will exercise in excess or eat almost no food in the strive to remain healthy. This can cause one to develop eating disorders.
One will prefer staying near a hospital so in case of a cardiac emergency they can get immediate medical help.
A child suffering from this specific phobia will avoid seeing pictures of a heart in their course books and or not study the subject at all in order to minimize anxiety.
Cardiophobia is an irrational fear of the heart. One fears of dying because of a heart attack or any other heart related disease.
Small signs of chest pain can also instigate extreme anxiety.
Symptoms of Cardiophobia
People with Cardiophobia, like in all other phobias, experience intense anxiety when exposed to heart (in pictures or feel chest pain).
They’re unable to control this anxiety and thus, end up feeling more anxious. This anxiety, in extreme cases, can give rise to full-blown panic attacks.
The sufferer goes into flight or fight mode because of an adrenaline rush. In this state, the body’s physiological responses help one make decisions when in fear causing situations.
They either decide to escape the situation (flight) or stay and combat their fear (fight).
In the case of Cardiophobia, the physiological symptoms that are produced when exposed to the fear stimuli (including extreme anxiety) cause the person to escape or avoid that situation.
Sufferers don’t have the courage to fight with their fear because of the unpleasant, terrifying experience the body goes through.
Sufferers in Cardiophobia get anxious because of excess anxiety. They get terrified of the fact that this anxiety too can cause one to have a heart attack/disease.
This makes them stay in the vortex of fear and intensifies their phobia.
Including anxiety, Cardiphobia has a number of other physiological symptoms which include:
- Excessive anxiety when exposed to heart/feel chest pains
- Excessive anxiety when thinking about heart
- Inability to manage anxiety
- Full-blown panic attacks
- Avoiding getting exposed to heart or a heart attack
- Increased heart beat
- Muscle tension
- Feelings of dizziness/fainting
- Feeling depressed
- Fear of an impending doom
- Excessive sweating
- Hot/cold flashes
- Butterflies in the stomach
- Drying up of the mouth
For one to be diagnosed with Cardiophobia, a person should experience at least 3-5 of these symptoms (including anxiety).
Causes of Cardiophobia
Like every other specific phobia, Cardiophobia is a result of either genetics or a past traumatic experience.
Someone who has a family history of anxiety disorders or specific phobias has a higher chance of developing Cardiophobia than someone who doesn’t.
This is because they are genetically predisposed to develop it.
Genes and neurotransmitters also play a significant role in this genetic predisposition.
This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship.
According to this, one with a genetic predisposition will not develop symptoms of Cardiophobia until and unless there is some trigger event, instigating anxiety or fear related to the heart.
This trigger event can be for example, someone who already suffers from hypertension or other heart related problems will be extremely conscious of their health and the activities that may lead to more severe problems.
They will get extremely traumatized even at the slightest pain in the chest or an increase in blood pressure.
Also, someone who has a family history of heart disease is likely to develop them in the future.
Therefore, they will have a constant fear of developing them.
An individual who lost their loved one’s or heard someone die of a heart disease can also develop Cardiophobia.
Someone who has Illness Anxiety Disorder (IAD) is very likely to get afraid of any slight pain in the chest or change in their heart functioning.
Thus, have a higher chance of developing Cardiophobia.
People who have a fear of death can also develop this irrational fear of heart.
Therefore, Cardiophobia is caused by both genetics and environmental factors.
Treatment of Cardiophobia
Cardiophobia, like all other specific phobias, has no exclusive type of treatment that is specifically designed to treat it.
Like all the other specific phobias, Cradiophobia is treated by a number of different therapies including, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms.
• Cognitive-Behavioral Therapy (CBT)
It is one of the most frequently used treatments for patients with almost all kinds of mental disorders.
Cardiophobia is defined as the irrational fear of the heart. Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones.
The patients are helped out in analyzing and justifying the way they feel about their fear stimuli.
Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts.
The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.
The ABCD stands for:
i. A (antecedents) a situation or triggering event.
ii. B (belief) the thought that comes to one’s mind when in that triggering situation.
iii. C (consequences) the symptoms/feelings caused by that event/thought
iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to dispute/challenge those irrational beliefs.
This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.
• Mindfulness-Based Stress Reduction (MBSR)
MBSR is a meditation therapy, used to manage stress or anxiety. It is an 8-week program which includes group sessions.
Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.
In mindfulness meditation the person is told to, for example, focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.
This distracts the person’s attention from something stressful to something which is neutral and soothing.
For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.
This another form of treatment used with patients suffering from specific phobia or anxiety disorders. It is used with patients who know the cause of their phobia.
First, the therapist collects the patients’ history of different fears. They then identify the real cause of the particular fear/phobia the patient has.
They then discuss any new/latest event that triggered their anxiety and fear in the past few weeks.
People coming with specific phobias are told to imagine their distress causing stimuli.
The therapist then works with the individual in order for them to overcome their fear.
In the case of Cardiophobia, the patient will be advised on how to overcome his fear of the heart.
They do this by creating a positive imagery for the patients’ feared stimuli.
• Dialectical Behavior Therapy (DBT)
This is another effective therapy used to treat Cardiophobia. It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of specific phobia.
Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group).
i.Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.
The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling.
Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.
ii.Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts.
Individuals are told to focus on the present and be attentive to what is going on around them at the moment. This helps in breaking the link between their mind and any negative thought that might come to them then.
For example, a person is told to focus on his breath or on the sound of the wind around them, making use of their auditory sense.
iii.The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.
Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.
Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.
They are not just one of the many treatment therapies used for Cardiophobia, instead they are one of the most common ways of relaxation used by many people.
Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture.
Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.
Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga.
The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about their fear stimuli.
• Drug Therapy
Drugs are used to reduce the physical symptoms caused by Cardiophobia.
Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken.
This type of biological treatment is usually more effective if the cause of the phobia is only genetic.
However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation.
Two types of drugs are used in the treatment of this phobia:
i. Antidepressant Drugs
These drugs, as the name suggests don’t only treat depression but are also very effective in treating phobias.
Medicines like Paxil reduce the anxious feelings of a person and makes him feel calm. They need to be taken on a daily basis but not without a doctor’s advice.
i. Anti-anxiety Drugs
Medicines like Klonopin are anti-anxiety drugs.
They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms.
Whether the cause of Cardiophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).
Titles to read
- Fear and Faith: Finding the Peace Your Heart Craves
by Trillia J. Newbell
- Eye Movement Desensitization and Reprocessing (EMDR) Therapy, Third Edition: Basic Principles, Protocols, and Procedures
by Francine Shapiro
- EMDR: The Breakthrough Therapy for Overcoming Anxiety, Stress, and Trauma
by Francine Shapiro, Margot Silk Forrest, et al.
- Anxiety Disorders and Phobias: A Cognitive Perspective
by Aaron Beck, Gary Emery, et al.
Frequently Asked Questions
Q1) How do I get over my fear of a heart attack?
Cognitive therapies like CBT, EMDR and or medicinal drugs are effective ways of treating one’s anxiety related to heart attacks.
Q2) Is it anxiety or a heart problem?
Anxiety and heart attack have a few similar symptoms like breathlessness, increased blood pressure, muscle tension.
But, heart attack is a health problem.
Q3) How would you know if you are having a heart attack?
Tightness in the chest, nausea, breathlessness and fatigue are a few symptoms experienced when having a heart attack.
Q4) Does fear cause a heart attack?
Fear can cause heart attacks only to the people who are already at risk of having a heart disease or suffer from hypertension (increased blood pressure).
Examples of other interesting phobias