When It Feels Like Too Much

Living with a cardiac condition can lead to high levels of stress and anxiety in both patients and their families. Younger children may worry about uncomfortable or painful medical procedures, like blood draws and shots. Older children may feel self-conscious about the appearance of scars, have questions about their current or long-term health status, or struggle with feeling different from their peers. Fortunately, there are many strategies that can help patients and their families manage stress, overcome worry and cope with anxiety.

Symptoms of anxiety

The symptoms of anxiety are the result of the body’s “fight or flight” response — a normal reaction to perceived danger. This system releases natural chemicals that affect heart rate, breathing, muscles, nerves and digestion, as the body prepares to flee or defend itself from danger. When a person experiences anxiety, however, the body’s “fight or flight” response is overactive, triggering these physical symptoms even when there is no real danger. The physical symptoms of anxiety may include:

• Feeling sweaty and/or shaky
• Increased heart rate
• Shortness of breath
• Dry mouth
• Muscle tension
• Nervous stomach

These physical symptoms are often accompanied by repetitive worry thoughts (“what-ifs”), worst-case-scenario thinking, or even fear. For children, anxiety can also manifest through behavior. An anxious child may appear clingy, obstinate or highly emotional.

Managing anxiety

A certain degree of anxiety is normal when living with a cardiac condition. The ongoing stress of doctor’s visits and worry about the future can take its toll. The following strategies can help manage the symptoms of acute anxiety and alleviate the effects of persistent stress:

• Practice relaxation techniques, like deep breathing or progressive muscle relaxation. Mastery of these techniques can help combat anxiety during high-stress situations, such as medical procedures or hospital stays.
• Commit to self-care. It’s much easier to manage stress and anxiety with enough sleep, a healthy diet and regular exercise.
• Connect with others. Family members, close friends and community support groups provide an opportunity for patients and families to share their experiences and develop relationships with people who are experiencing similar challenges.
• Practice positive thinking. It can be easy to get stuck on a worry track or focus on the possibility of negative outcomes. Instead, focusing on something positive or remembering the coping skills that have worked in similar situations can help decrease the symptoms of anxiety.

In addition to these ideas, there are many ways parents can support a child experiencing anxiety. Here are a few:

• Validate the child’s feelings. Try not to tell them not to worry. Instead, provide understanding and reassurance that they are safe.
• Be a good role model. Kids learn by what they observe from the adults around them. Parents should model healthy behaviors, like talking about their feelings and using coping skills when faced with scary or overwhelming situations.
• Encourage children to face their fears. It’s natural for parents to want to protect their children from whatever is causing anxiety, but that isn’t always possible. As children successfully move through scary or overwhelming situations, their anxiety will gradually decrease.

More support

When anxiety or worry gets in the way of everyday life, it may be a sign of an anxiety disorder. Anxiety disorders often need additional help from a mental health provider, who will use evidence-based treatments to build on the skills described above. For additional support with anxiety, cardiac families can ask to be referred to the cardiac psychologist at Children’s Hospital of Philadelphia.

Contributed by Abby Demianczyk, PhD