Areas › Worry and anxiety › Breaking the worry loop
A hammering heart during anxiety is the body doing what it does when it is braced, not a sign that it is being damaged. For a lot of people that single piece of information is the thing that finally lets the panic drop.
The fear of the sensation is usually the bigger half of the problem: the heart races, you read it as something going badly wrong, and the fear feeds the racing. Getting checked once, properly, and then taking the answer seriously is what breaks that. After that the sensation can be treated as loud rather than dangerous.
Qur’an and Sunnah
He keeps hold of those whose death He has ordained and sends the others back until their appointed time (Quran 39:42). Your appointed time is not being decided by how fast your heart is going.
ٱللَّهُ يَتَوَفَّى ٱلۡأَنفُسَ حِينَ مَوۡتِهَا وَٱلَّتِي لَمۡ تَمُتۡ فِي مَنَامِهَاۖ فَيُمۡسِكُ ٱلَّتِي قَضَىٰ عَلَيۡهَا ٱلۡمَوۡتَ وَيُرۡسِلُ ٱلۡأُخۡرَىٰٓ إِلَىٰٓ أَجَلࣲ مُّسَمًّىۚ إِنَّ فِي ذَٰلِكَ لَأٓيَٰتࣲ لِّقَوۡمࣲ يَتَفَكَّرُونَ
God takes the souls of the dead and the souls of the living while they sleep- He keeps hold of those whose death He has ordained and sends the others back until their appointed time- there truly are signs in this for those who reflect
Qur’an 39:42read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
In a randomised controlled trial run within cardiac rehabilitation, six sessions of group therapy aimed at how people handle their own worrying improved anxiety and depression beyond the usual programme. Even where heart disease is genuinely present, the anxiety around it is treatable in its own right. This was a trial in an unusual setting, so the general point is stronger than the details.
Wells A, Reeves D, Capobianco L, Heal C, Davies L, Heagerty A, Doherty P, Fisher P. (2021). Improving the Effectiveness of Psychological Interventions for Depression and Anxiety in Cardiac Rehabilitation: PATHWAY-A Single-Blind, Parallel, Randomized, Controlled Trial of Group Metacognitive Therapy.. Circulation doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
When the alarm stops being read as evidence of danger, it stops setting off more alarm.
When not to
New chest symptoms, or an existing heart condition, need a doctor rather than reassurance from an article: get it checked once and then work on the fear.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Three moves, in this order: notice what is happening, settle the body, then put your attention somewhere useful. Short enough to remember when you are already going.
Being told not to worry has never once stopped anybody worrying, including you. If a friend said it to you tomorrow you would carry straight on.
Some people never ask for help because they assume everyone's head is like theirs. If yours has been running like this since you were small, it does not feel like a condition. It feels like being you.