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How the heart influences what we perceive and fear (quantamagazine.org)
117 points by CapitalistCartr on July 17, 2020 | hide | past | favorite | 54 comments



My heart brought me a solid anxiety disorder. I have ventricular extrasystoles, been to a couple of different cardiologists, done longtime ecg monitoring, echocardiograms and everyone told me my heart is fine, and I should chill.

Coupled with low blood potassium levels and increasing distrust in my heart, I developed a fear that I could get ventricular tachycardia, and basically die instantly. I'm 33.

I know it's slightly off topic, but just be happy if you don't feel your heart beating and it's doing its work without you noticing. In my case, my anxiety disorder and fear is increasing adrenalin, making my heart stumble even more. It's so annoying knowing all that, but the emotions are just overwhelming and it's really hard to fight this.


I have had this exact feeling regarding my heart for a year and a half and until now felt nobody understood.

For me it is constant chest pain that comes and goes essentially whenever it wants. It is quite varied and never fails to keep worrying me with its novelty. Sometimes burning, sometimes squeezing, sometimes stabbing. Been to the doctor and ER dozens of times. No diagnosis. And it isn't even correlated with anxiety as far as I can tell, although the anxiety only makes it worse. Sometimes NSAIDs make the pain unbearable. Sometimes they don't.

It doesn't even make sense because as far as I understand the heart isn't innervated, so why is the pain always on the left side of my chest?

I went to urgent care and they reported my cholesterol levels, etc. were excellent.

It's so terrible because the heart is critically tied to our ability to continue living through unconscious action, and so anything regarding it feels completely out of control in the moment. Meaning your instant death is out of your control. Now have that on your mind for 365 days and see how it feels.

So after spending dozens of times trying to figure out if something's wrong with my body, seeing as it's probably trying to send some sort of signal, and completely failing to come up with an answer, what else is there left to do? Worry about dying every single day?

Early on I got so many palpitations I was sitting in bed holding a heart monitor on my chest until 3 in the morning. This was when I was 23 and started to regret all the life decisions I had made in college to feel this awful and scared about my health that young. Today if I get like three palpitations in the span of five minutes I'll be completely unable to keep focusing on work and go off trying to manage the anxiety in the hopes of not dying.

If anything it's pushed me to eat more vegetables and such, but I don't know if it will end up helping.


> Sometimes NSAIDs make the pain unbearable.

This sounds like an upper digestive tract issue. You should look into Roemheld Syndrome. https://cara.care/digestive-disorders/upper-abdomen/roemheld... I was having a lot of feelings of skipped heartbeats and my doc realized I was also having a lot of digestive issues so he told me that Roemheld seemed most likely. What I noticed is that skipped beats occurred around the time when I needed to burp. The burping releases pressure on the vagus nerve which goes to both the heart and the stomach. When I realized this my anxiety was much reduced.

In my case I found that I needed to limit chocolate consumption, sit up straighter and practice deep breathing.


The heart also is involved in powering the lymphatic system, though it's complicated. It powers it for part of the time, then part of the time, lymph is beyond its reach.

I have a history of heart pain and heart weirdness associated with certain health issues. It has gotten better over time as my health issues have improved.

I have come to believe that some of my heart issues -- especially pain in my chest, which is why I am replying to you -- are related to how the lymphatic system works and are related to health events that put a strain on my lymphatic system in some way.


Have you considered that it might be costochondritis?

I'm 23 and healthy. I went into ER a few months back with high heart rate, chest pressure, and palpitations. They couldn't find anything wrong with my heart, monitored me for a few days and discharged me without a diagnosis.

For 2-3 weeks after that I still had that same occasional chest pressure/tightness. This might be a coincidence but it started easing away when I started doing various exercises meant for costochondritis.


If it helps, I can completely understand your feelings. It's the same for me. If there are more palpitations "than usual", I lose my concentration and start thinking whether I should pay the ER a visit. All the best to you.


I have the exact same issue, been going on for three years now. I’ve also spoken to a psychologist, but nothing has helped so far. The feeling of chest pain is impossible to ignore. It feels hardwired.


I had a very similar pain in my chest and increasing my vitamin D intake made it stop. I would get your levels checked.


Have you tried supplementing with magnesium? Seems to help a lot of people with anxiety, including myself. There also seems to be a link between low magnesium levels and heart rhythm issues.

> The risk of heart rhythm problems with low magnesium levels is particularly high in people who also have low potassium levels. [0]

[0] https://www.health.harvard.edu/heart-health/ask-the-doctors-...


At the risk of sounding obvious, it is always a good idea to get labs drawn first and then consider supplements if needed. Blindly taking supplements can cause issues in the opposite direction.

Most of us taste our food before deciding whether to add salt, same should go with supplements.


Blood tests are not particularly useful for detecting magnesium deficiency. Deficiency is in the cells, not the blood, and blood levels are fairly transient.

That said, it is definitely something to discuss with a doctor. I've had good luck recently working with a naturopath who is highly knowledgeable about nutrition and has far more time to discuss such things as diet and supplements than any general practitioner I've ever visited.


I am your exact same age and have exactly what you described except for the potassium levels. It really sucks. It's weird to realize that most people out there don't feel their heartbeat constantly, because it's been a background noise almost my whole life.


Yeah, my potassium is not constantly low. It's great and sad to hear that there are people out there with similar issues. I also feel my heartbeat effectively all the time. Caffeine makes it worse, so does alcohol. I stopped drinking alcohol, it made it a tiny bit better.


When I experienced somewhat similar symptoms, I ended up stopping to consume any caffeine (was mostly tea for me), and significantly reduced sugar - and started feeling much better.

Other things that helped was regular exercise, with good cardio load, and getting enough sleep.

Hoping in God and the eternal life definitely helped with the anxiety part.

Hope you feel better.


Thank you.


Aside from VESs; isn't a strong heart beat that you can feel (and sometimes hear if someone puts their ear to your chest) a sign of a healthy heart? I'm not talking about fast palpitations, but rather feeling your heart through your chest wall, albeit at a regular, steady rhythm.


For the most part, your mind will tune out the regular, "background" rhythm of the heart. When it deviates from normal, or if you have certain special sensory differences to regular people, it makes you aware of it.

But normally your mind should tune it out unless you focus on it.


Not so sure. Palpitations are often nothing serious, but what I heard is that not feeling your heart beat is normal. Except when you exercise hard. I feel my heart pumping when I lay in bed an my pulse is 60-70 bpm.


I've been told otherwise by a doctor (not a cardiologist), and I've always wanted to know a definitive answer on this but it's hard to find information on the subject; almost all literature is focused on the rate of heartbeat, not on the loudness of the drumming itself.


Wow, I'm surprised how many replied and have similar experiences. There are a few things I'd like to add, because I did learn some things in the last 7 years since it started.

- Cognitive-behavioral therapy did not work for me. The thing is, as soon as your heart wants your attention, you're submissive. I talked a lot with psychologists, but it didn't get better.

- Running to the ER and being dismissed with good blood samples helps. But only for a limited time.

- Stress is very bad. Not long ago I had a very arduous business call with a former co-worker and I felt one extrasystole after another. As if my heart would want me to calm down ;)

- SSRI (e.g. Escitaloprame) are really powerful. They did not cure my extrasystoles, but they prevented things like panic attacks. Side effects are note worthy though, you pretty much lose a lot of your sexual energy.

- and if you're into medicine, SSRI may also produce new cardiac problems, such as QT-interval prolongation. It's a vicious circle.

In the end, I think, the heart is much, much more than a muscle. I always hope that someday I'll find a doctor who gives me the answer I'm searching for so long, what exactly is causing all this.


Did you try Mirtazapine? I could not sleep because my body would "randomly" produce adrenaline. I would feel my heart frequently. I woke up at night, typically at 2 or 3, and could not fall asleep again.

Mirtazapine is not an SSRI, but it is an anti-depressant that blocks adrenaline receptors. My resting-heartrate went from 95 to 55 from one day to another.

The first few days my body felt a little heavy, but after that I had absolutely no side effects at all.


What about cardiac coherence training?


I feel your pain, and it sucks. I was sent to an ER after my GP noticed something wrong with my heart during a routine checkup..that was easily the scariest afternoon of my life. There is something profoundly frightening about a doctor telling you to get your arse to hospital ASAP because your heart is fucking up.

Several stressful hours later, the verdict came back: nothing abnormal. Of course, ever since that incident, my heart as been on my mind a lot more than I'd like. Getting a single skipped beat or a few palpitations sets me on edge. But the attention only means I notice more "errors". No heart is perfect, they all skip a beat every now and again, so I "know" it's OK, but it doesn't feel OK anymore. It's a particularly unpleasant kind of anxiety.


>I know it's slightly off topic, but just be happy if you don't feel your heart beating...

When I was a kid I used to complain of episodic pains I would get in my heart, and as a child I described it as feeling like lightning shocking my heart. After some testing I was pretty quickly diagnosed with supraventricular tachycardia.

I feel pretty grateful as I never had to have a heart monitor, take meds, and as far as I can recall the last episode was sometime in high school (maybe 20 years ago), I hadn't really thought about it in a long time, but you made me realize now how bizarre it was to "feel my heart".


Is this an acute awareness of your heartbeat or is it that your heart beats more intensely?

I ask because I used to have panic attacks and I would become suddenly aware of my heart beating faster than normal but my heart rate monitor showed it was not, and my blood pressure monitor showed I was still normal - it was effectively only my awareness that was out of whack for whatever reason. I was turned on to meditation and can count on one hand the number of times I’ve had these panic attacks in the last year.


Fast, constant and rhythmical heart beats are nothing I worry about. Extrasystoles are pretty much one heart beat out of the normal rhythm (coming from the ventricle in my case), followed by a pause (compensatory pause). Your heart basically stops for one beat, and then resumes. And this pause feels really uncool.


I feel you. I occasionally get fairly strong palpitations that can last up to a minute in the worst cases (they seem to come in spells during various times of my life), and it does really feel awful. The first period it happened I got some bad hypochondria. (And I was thoroughly checked up multiple times. Nothing detectably wrong.)

I'm more used to it now, but the sense of doom still passes right through all my reasoning layers.


Yup. Hypochondria is what they told me as well. But in my opinion, most of the doctors don't experience this on their own, they read it in books and studies. That's why they often can't really help you.


If you do get a VT you can gently massage your carotid arteries in your neck until help arrives.

https://pubmed.ncbi.nlm.nih.gov/2737783/


I also have VESs (among other things), and I can confirm that they indeed feel quite nasty. In my experience, the heart seems to have a direct connection to the lower-level emotion-regulating parts of the brain, and any physical symptoms can trigger an overwhelming sense of imminent doom that completely bypasses the filters of my rational mind.

But I can also tell you that you eventually get used to it, and it just becomes a part of life. Feel free to drop me a line if you want to talk about it sometime (my username over at the big email provider with a G)


I have something similar. If you hook me up to an automatic EKG it will say I'm having an infarction right now. Makes me want to stay away from ERs as they'll put me on some treatment for heart attacks without thinking.

Right now the extra stress and weight gain gives me much worse heart palpitations. Its hard when that happens to relax when you have to think whether something serious is finally happening or just another blip.

This stuff is just supposed to work.... never had to worry about any health stuff when I was a teenager.


Yup, I was once misdiagnosed with Brugada syndrome by a young doctor. That really didn't help in making me more self conscious about my heart.


Have you done any mindfulness training?


I don't want to be rude because you are being helpful, but mindfulness is not the answer to everything. Mindfulness made me even more anxious because what I really needed was to see a psychologist.


Just to provide an additional data point, I've sought relief from anxiety in meditation, failed, and then found great relief in cognitive-behavioral therapy. You're exactly right in that what's needed sometimes is conventional help from psychologists.

A few years ago, I delved again into meditation, this time more traditional Buddhist ones. I can't say emphatically enough that there is some deep knowledge there. Mindfulness (i.e. cultivating stable attention toward internal & external stimuli) is just the tip of the iceberg.

Like you, I found the expanded sensory stream provided by mindfulness training to be somewhat overwhelming. Imho, what's necessary to work with it fruitfully are: 1) developing the capacity of non-abiding, or not attaching/identifying too much with the flow of mental events, 2) training the unconscious mind to competently manage one's attention & awareness, so that you don't have constantly "pilot" your self.

Two books I've found indispensable are: The Mind Illuminated - John Yates, and The Rinzai Zen Way - Meido Moore

Of course, there's no substitute for a good teacher. Just be aware that there are many charlatans & New Age types who aren't so helpful. Good luck!


Agree it's not a silver bullet, especially when someone needs actual medical help. But mindfulness can certainly help break the cycle of self perpetuating stress.


Tried it, with limitted success. Maybe I should dive in deeper.


My experience with lay practitioners (such as myself) is that you may have to try a few different things to find something that works while living a regular life. The Mind Illuminated, the Sedona Method, Louise Hay, the work of the stoics, yoga, qigong, therapy, all provide different approaches to developing emotional intelligence and managing difficult states of mind. I did zen meditation for a decade and while it provided many benefits I still struggled with anger in my day to day life. Two months of reading about and applying the stoic principles completely changed that.


It's not going to solve all of your problems. But I know it's possible to be so anxious that you can't even bring yourself to get other forms of help you need. And in other cases, it can help break the vicious cycle you described.

Learning to slow down and breathe are the simplest thing that many never learn.


Once talking to my therapist about anxiety I get at night and can't sleep, she innocently asked "Can't you listen to the sound of your own breath or focus on your heart beat..." she didn't get any further. I instantly said "Dear god, no. If I focus on my heart beat at any moment I spiral into an anxious depressed mess"


Look into EMDR.


I've got my first actual EMDR session on Monday. Did the setup session last time. Sounds like woo and too good to be true but then you look and it seems to be backed by solid science and credible people. Thought I might as well give it a try.


What you’re describing is common and you can recover, I recommend a book called DARE - it changed my life.


Shootout eyes are probably just a western trope (I would guess "soft eyes" would be more effective) but if saccades are tied to the cardiac cycle https://www.sciencedirect.com/science/article/abs/pii/S00100... it would, in principle, be advantageous to draw during an opponent's saccade.

(compare the scramblers in Blindsight)


> Cardiac activity can be divided into two phases: systole, when the heart muscle contracts and pumps out blood, followed by diastole, when it relaxes and refills with blood.

Respiration, acting through the sympathetic (fight or flight) nervous system (breathing in) and the parasympathetic (feed and breed) nervous system (breathing out) also impacts the heart as measured through Heart Rate Variability. Like many systems in biology, I suspect there is a network of feedback loops at play and they act in both directions.


The way I understand it is that this is partly a mechanical property as well: the chest cavity expands/contracts while breathing, which impacts how much room organs have, which can then stimulate nerves etc.


Im waiting on my emWavePro to come in the mail so I can start training cardiac coherence. The science behind it is fascinating.


A bit off-topic, but this has puzzled me for awhile: there are times when at night I will suddenly feel like my heart is beating ridiculously quickly and loudly. It subsides with deep slow breaths. The strange thing is that I've tried putting my hand over my heart during these episodes and physically it does not feel that my heart is beating abnormally. Any ideas what's happening?


Heart palpitations? I had a similar feeling when I got up in the night to urinate. I used a pulse oximeter to reassure myself that its okay and eventually over the weeks it stopped happening. I think there a lot of common causes as listed in the link below.

https://www.mayoclinic.org/diseases-conditions/heart-palpita...


thanks, didn't know what to search. striking to me that it seems to be all mental. I suppose it's reassuring that this is somewhat common


While sleeping? This is one of the signs of sleep apnea.



Reminds me of a personal experience I had with general anesthesia and a remembered "dream" segment of calmly wondering if I had died of complications and the afterlife was just this void. The current theory of mechanism for anesthesia is that it stops nerves from carrying signals to the brain which would be consistent with the lack of fear in considering what would be a premise of horror short story.


Q: Is the described effect moderated by blood pressure? In other words, if one's blood pressure is higher, does the systolic effect rise in intensity relevant to the neurological processes discussed in the article? I would guess so but the article doesn't really get into that.




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