Why a Second Opinion Is Important When You Have Anxiety

Until I was 30, I was told with absolute conviction, “You have anxiety.” Nothing about that was surprising, and nothing about it is wrong. I do in fact have anxiety. I also have a heart condition that mimics anxiety. But for all those years, it was just assumed my heart rate increased because of my anxiety. No one questioned if things were more than just “mental.” It wasn’t until a chance encounter with a perceptive cardiologist that my anxiety became more than just “all in my head.”

When I passed out at work, the first thing I did was ask my psychiatrist what on earth to do. Medically speaking, I had no history of problems outside of depression and anxiety. My mental illness was always the “problem.” So when he gave me the name of a cardiologist, I was hesitant. However, I made the appointment and tried to keep my sky-high anxiety in check by reminding myself I only had to go once, rule out any heart problems, and move on. So I did. Little did I know, my anxiety was about to become much more complicated, and my condition was about to get an unexpected explanation from an unlikely source.

Test after test, I tried not to show how worried I was — not because I thought something was wrong, but because I just knew nothing really was. I felt I was wasting people’s time, and I hated that. But my cardiologist had no intention of writing off my occasionally racing heart as just anxiety. He accepted it was a factor, but he wanted to be sure there wasn’t more. I credit his determination and open-mindedness with the discovery that, in fact, my heart was racing on its own at times (at a disproportionally high rate to anything I was doing). While it’s benign and treatable, it sparked a revelation — an elevated heart rate can easily mimic and even cause anxiety. One can trigger the other, but it works both ways. Suddenly it wasn’t “all in my head” after all.

The combined forces of my trusted psychiatrist and newfound cardiologist changed the approach to treating my anxiety: Fix the heart rate problem first, and see if the anxiety comes down. So we did. Much like with so many psychiatric medications before, my cardiologist and I struggled with increasing doses and swapping drugs before we settled contently on a combination that seemed to help. It took almost six months, but in those six months, my panic attacks went from almost daily to almost non-existent. With my heart rate under control, an element of my anxiety had been drastically reduced. I didn’t realize it had happened until one day when I read an article about anxiety and realized I actually wasn’t as anxious as I use to be. I was rather stunned. I didn’t expect that to happen.

The right doctor had led to the right diagnoses, the right medication, and finally to relief.

But why had I spent well over a decade just accepting I couldn’t possibly have a heart problem as long as I had anxiety? The heart tends to give those who struggle with anxiety their strongest physical symptoms. As a result, it is exceedingly common for someone with anxiety to complain of chest pain or heart palpitations. But does having anxiety “protect” you from having physical problems of a separate cause? No. Of course not. But unless you have a psychiatrist willing to send you for a “second opinion,” it would be almost impossible to ever know if there is something physical going on.

Anxiety is still a part of my life, and always will be. It wasn’t until someone looked past my mental illness that it became clear there was more going on. The relief of receiving the right diagnoses isn’t something we talk about, but it should be. Second opinions aren’t just important for major medical decisions — they can alter the course of even the “smallest” part of a person’s health. Had my psychiatrist not been open to the possibility there was something else wrong, he would not have sent me to a cardiologist and I would never have known. That second opinion turned out to be more valuable than all the medications I had ever tried. That second opinion changed everything.

Editor’s note: Please see a doctor before starting or stopping a medication.

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