Increased blood flow:

A pounding, racing heart results
from a surge of adrenaline that
causes stronger, more rapid
contractions to increase blood flow.
The heart compensates for quick,
forceful beats by taking a pause,
creating the sensation of thumping,
or “missing beats.” Palpitations are
a natural reaction to aerobic
exercise, infection, exhaustion,
caffeine, cigarettes, and troubling
thoughts.

Hot flashes and sensations of
“heating up” result from blood
rushing to the center of the body
due to increased heart action. To
compensate, perspiration helps cool
off the body. Coldness in hands and
feet may result from blood rushing
toward the center of the body.




Chest muscles contract:

Chest pain that feels like a pinprick
or stitch is caused when chest wall
muscles become tense. Sharp pain
is felt when the lungs expand during
inhalation. Deep breaths can be
difficult until discomfort passes. A
narrowing of arteries causes heart
disease.

Trouble breathing can happen when
tense chest muscles do not allow
enough room for lungs to expand.
To compensate, some people take
large gulps of air or start breathing
fast. Trouble breathing can also
result from obesity, pregnancy,
colds, asthma, and emphysema.

Hyperventilation happens when too
much oxygen collects in the lungs
due to rapid breathing and washes
out carbon dioxide.

Giddiness, Tingling, or Numbness
can be caused by oxygen collecting
in the lungs due to rapid breathing.
Physical conditions of anemia and
carpal tunnel syndrome can also
cause light-headedness or tingling.





Limb muscles tense:

Shakiness is the body’s way of
releasing muscle tension. It often
happens after lifting heavy objects.

Trembling can also be caused by
hyperthyroidism and low blood
sugar.

Feeling faint happens when blood
flows away from the brain to “feed”
tired tense muscles.




Throat muscles tense:

Difficulty swallowing can also feel
like a “lump in the throat” or choking.



Jaw clenches:

Dizziness, disorientation, and
floating feelings happen when jaw
tension puts pressure on the inner
ear. The same symptoms occur
when the inner ear is stressed on
amusement park rides. Fluid
retention from colds, allergies, and
thyroid problems can also strain the
inner ear.

Nausea, diarrhea, and blurred
vision happen when pressure on the
inner ear irritates nerves to the
stomach and eyes. Discomfort from
fluorescent lighting, cloudy days,
loud noises, and freeway driving
can stress nerve endings and also
aggravate inner ear problems.

Think: The heart muscle is very
strong and cannot burst. A “nervous
heart” is still in control and will
always return to its normal rhythm.

Act: Consult a physician to rule out
any physical problems: high blood
pressure, mitral valve prolapse,
menopause, hyperthyroidism, low
blood sugar, anemia, or a heart
condition.

Relabel palpitations as anxiety if
physical problems have been ruled
out.

Think: “Overheating” is a good
aerobic exercise. It is identical to
what occurs during heavy exercise.

Relabel changes in body
temperature accompanying
palpitations as a side effect of an
adrenaline rush and increased
heart activity.



Act: Have your doctor rule out heart
problems, particularly if you have
dull pain or pressure in the center of
the chest that radiates to the neck,
jaw, or left arm.

Relabel pain as “chest wall pain”
due to stress once heart disease is
ruled out.

Think: Breathing problems due to
anxiety are no different from having
trouble catching your breath after
heavy exercise. It is impossible to
stop breathing—just try holding your
breath.

Relabel symptoms as the result of
tense chest muscles if physical
problems aren’t present.

Act: Breath into a paper bag to
inhale carbon dioxide if too much
oxygen is causing hyperventilation.

Act: See your doctor if symptoms
occur at times other than during
rapid breathing.

Relabel giddiness and numbness
that accompanies troubled
breathing as the result of too much
oxygen from rapid breathing.



Think: Shaking can be a way to
express joy, as the Shakers and
other religious groups did.

Act: Unlock knees and let arms
hang loosely so they can tremble
freely. This allows shaking to pass
more quickly.

Act: Slow down to let any faintness
pass. Put your head between your
knees to return blood to your brain
if necessary.




Think: Swallowing is automatic.

Act: Try chewing a cracker without
swallowing.



Act: Notice how far your jaw can
drop with your mouth closed when
you’re not upset. Clenching and
letting go of your jaw can help
during panic. Give symptoms time to
pass. See your doctor for possible
inner ear problems.

Relabel symptoms as inner ear
pressure.

Act: Relaxing your jaw may help
blurred vision or nausea pass more
quickly. Without rushing, you can
find a restroom. If you tell yourself it
is okay to vomit, nausea often
passes.

Relabel symptoms that happen
during anxiety as irritation of
stomach and eye muscles.