Article Thumbnail

Can You Die from an Anxiety Attack?

Please give me one less thing to worry about, and tell me that the answer is no

From a cursory Google search, the internet would have you believe it’s impossible to die from an anxiety or panic attack. But is that just what medical experts want anxious people to believe? After all, even if anxiety could kill, would they really tell a bunch of panicked people that?

Despite my paranoia, Bradley Katz, a physician and professor of neurology at the University of Utah Medical Center, maintains that “it’s not possible to die of an anxiety attack.” However, symptoms like “heart palpitations, chest pain, breathlessness, feelings of choking, feeling like you’re detached from yourself and hyperventilation” can make a person seem as if they’re about to die from one.

Our brains are very much convinced of this, too, as the limbic system activates our sympathetic nervous system. Known as fight-or-flight, our body’s response to an anxiety attack causes a spike in stress hormones like adrenaline and cortisol to give us extra energy for survival, which can last up to 30 minutes. Unfortunately, that’s more than enough time to send a lot of freaked-out people who would rather err on the side of caution to the hospital. Research shows that over a million people with panic attacks wind up in the ER annually, and other studies show that 50 percent of patients with panic disorder have sought treatment in the ER at least six times. 

Again, none of this is really an overreaction. In the short-term, anxiety makes it difficult to distinguish between real and perceived threats, which can lead to “a generalization of threats or even a fear of anxiety attacks themselves,” therapist and substance abuse counselor Sabrina Spotorno warns. “On a physical level, this can lead to hypervigilance, upset stomach, dizziness, sweats and increased heart rate.”

That said, anxiety in the long-term is far more concerning than any single anxiety attack. One large study of more than 30 million people found that those with anxiety were at a significantly increased risk of dying from natural and unnatural causes, especially if these individuals were also diagnosed with depression. Both panic disorders and generalized anxiety disorders are very common in patients who have coronary artery disease, and their risk of anxiety understandably increases after any major cardiac event — i.e., distinguishing between heart and panic attacks starts to feel like a game of Russian roulette.

Spotorno also acknowledges that “chronic activation of the sympathetic nervous system” caused by anxiety “can increase inflammation and lead to other health issues,” like increased blood pressure and heart arrhythmias. “There’s no definitive time frame for this,” she tells me, comparing the effects of anxiety to autoimmune diseases that can seem to come out of nowhere but are really more of a gradual progression and different for everyone.  

In terms of fixes (such as they are), the next time anxiety hits, instead of going to the ER, Spotorno recommends “reality testing” by doing some light physical activity, like walking up and down the stairs, to rule out a heart condition. From there, she suggests mindfulness exercises, like the grounding method and breathwork, in addition to online therapy via platforms like Monument, where she works, which may allow for quicker check-ins about anxiety than conventional therapy. All the while, it’s also good to keep going to your regular, preventative health-care appointments to uncover any underlying vitamin deficiencies or medical problems that could aggravate your anxiety further. 

“The more tools you can develop to regulate your stress response, the more you can trust your ability to mitigate this risk factor for chronic conditions to manifest,” Spotorno says.

One thing that doesn’t belong in this toolkit is thinking that your anxiety could be fatal. Even if it’s true in a very roundabout way, it’s a terrible hill to die on.