Question:
I am 33 years old. I have had issues with depression before but choose to work through things in my mind without medications. I usually do not have a problem with this but lately my thoughts have been a little harder to control. I am constantly afraid something bad is going to happen. I have a huge fear of dying or someone that I love is going to die. I have definitely been under a lot of stress in the last year. From the passing of my step-daughter, to my father being sick, to moving from two different states, to starting school for a master’s degree, to having my step-grandchildren move in. However, I am starting to have physical symptoms. My heart has been palpitating and I was recently seen in the E.R. and they did all kinds of tests and determined that it was stress-related. It is hard for me to understand that stress could cause my heart to do that. My question is: Could my constant fear that something bad is about to happen really just be stress? What if it isn’t? How do I distinguish abnormal thoughts from a premonition?
- Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
- Dr. Schwartz intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
- Questions submitted to this column are not guaranteed to receive responses.
- No correspondence takes place.
- No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Schwartz to people submitting questions.
- Dr. Schwartz, Mental Help Net and CenterSite, LLC make no warranties, express or implied, about the information presented in this column. Dr. Schwartz and Mental Help Net disclaim any and all merchantability or warranty of fitness for a particular purpose or liability in connection with the use or misuse of this service.
- Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
Answer:
As to the first question you present, let me assure you that you are not “crazy.” Actually, that word is really meaningless and, furthermore, you are not describing anything even remotely related to psychois.
As to your second question the answer is yes, pressure and stress most certainly do cause heart palpitations. In fact, that is probably one of the most commons symptoms that someone is extremely stressed. To be more specific, the stress you are under is being expressed as extreme anxiety and that is the catalyst for the heart palpitations.
You report the fact that, in the past, you experienced symptoms of depression but were able to handle it by your self. However, as we age it becomes more difficult to cope with depression through our own devices. I do not mean to imply that you are old!! At age 33 you are wonderfully young. But, you are older than you were and things begin to change for all of us. What worked before does not work now. That is why you are feeling so uncomfortable.
By the way, I agree with you that you are under extreme stress. That is why I want to beg, push, urge, demand, pray, you go into psychotherapy. As we age, stress takes an increasing toll on our health. While these heart palpitations are harmless now, stress causes wear and tear on our immune system that can express itself in the form of increasing numbers of cold and flu viruses, high blood pressure, strokes, heart attacks and other types of problems. This will not happen to you any time soon but ten, fifteen twenty years from now you could begin to experience some real physical problems is you do not learn how to reduce stress. That is why I am urging you towards psychotherapy.
In fact, I would encourage you to seek Cognitive Behavioral Psychotherapy in order that you learn techniques to modify the thoughts that lead to anxiety and depression.
In addition, there are many self help types of activities that you should start now. Our site has a self help section and there are many self help books on the shelves of the public libraries and in the book stores. Here are a few suggestions:
1. Learn meditation and practice it twice a day, once after awakening and once before sleep.
2. Yoga is an excellent way to do both medation and stretch your limbs and muscles. There are community centers and other companies that provide instruction in how to do this and a place to do it with other people. It is enormously stress reducing and relaxing and is physically healthy. You should start with a beginners class.
3. Exercise: the kind that gets you out of breath, such as, running, bicycling, jump rope, etc. Other than a good pair of running sneakers, you need buy nothing in order to run. Start slow, combine a minute off walking and a minute of running for about fifteen minutes. The following week, increase the running time.
4. If you have any doubts about your physical health see your Medical Doctor and get clearance for this exercise. Its a wise thing to do anyway.
These are just a few self help suggestions.
Best of Luck to You.
