Opinion: Anxiety doesn’t always start the way we think it does

“There’s nothing wrong with you, you’re just built different. Like a Ferrari,” said my cardiologist during my latest visit. 

I laughed. 

He went on to explain my test results and elaborate on his analogy. But first he asked me a question I thought was completely unrelated. 

“Are you an anxious person? 

“No doubt about it,” I answered. 

At times, in my average day-to-day life I felt like I had just run a marathon and my heart was racing. When I started taking my health more seriously and got on a consistent schedule with yoga, I noticed that my heart always felt like it was jumping out of my chest. No matter what emotions I was feeling or what external or environmental factors were involved, I always felt like I was riding on an adrenaline rush. It was hard to focus on the meditative type of yoga because I always felt my heart pounding in my ears and chest. 

The first stop in my journey for answers was my primary care physician who said my strong heart palpitations might just be anxiety, referring to the type of anxiety that starts with thoughts that often spiral out of control, triggering a body response such as elevated heart rate, sweating and a number of other responses. 

I shrugged off her response about anxiety because I thought for sure that wasn’t it–I felt in control of my thoughts. 

She referred me to cardiology just to make sure there were no abnormalities a simple electro-cardiogram couldn’t catch. After multiple cardiologist visits, I was given a heart monitor that tracked my heart rate for a specific amount of time. The cardiologist read the results of the heart monitor and said there wasn’t really anything to worry about. Something the heart monitor caught during the five-day period that I wore it, was a consistently elevated heart rate. 

The cardiologist elaborated on his car-heart analogy.

“You’re a Ferrari and I’m a Honda Civic,” he said. “We both start here (motioning at a start line for a race) and when we accelerate, I stay here and you’re way over there.” 

Hearing him compare me to a Ferrari, while he compared himself to a Honda Civic, was the peak of my visit. 

He said that my accelerated heart rate was probably causing me to feel anxious because from the moment I awaken–I’m racing. An overproduction of adrenaline starts to build up and the reaction is then felt throughout my entire body. 

Things started to make more sense.

The hyperactivity I struggled with as a child and was diagnosed and treated as Attention Deficit Hyperactivity Disorder–was that actually a misdiagnosis because in reality I just have an elevated heart rate, causing an overproduction of adrenaline? 

This ‘diagnosis’ suddenly made me realize why most of my young adult years felt like a constant disaster. I have a lethal combination of a wonderfully hyperactive mind and an overproduction of adrenaline building up in my body. No wonder I always felt tired.

After reading the results of my exam, the cardiologist prescribed blood pressure medication–something that made me feel like I had suddenly aged 50 years. 

The way he explained the medication and the way that I made sense of it, was that he was laying out speed bumps so this Ferrari can go the speed limit. 

“It’s going to make you feel better,” he said. 

In my head, I thought “Did this man just prescribe me with literal chill pills?” 

Yes, he did. 

At that moment, I heard my mom’s voice in my head always saying: “Ay tú, siempre bien acelerada.” Which roughly translates to: ‘you’re always racing for everything.’ 

If a lack of patience is hereditary or a learned behavior, I definitely got it from my mom. My biggest self-identified character flaws are my lack of patience and need to be in control of things I feel like others just don’t do fast or well enough–enter my job as editor. 

In 2023, I started seeing a psychiatrist regularly. At first, it was to deal with a painful break-up and the self-doubt, depression, suicidal thoughts and financial instability that came with the situation. Then, it turned into a long journey of identifying and facing the childhood trauma I carried on my shoulders. I knew I had to if I wanted to better the relationships in my life. 

This has been quite a journey of undiagnosed anxiety. I know for a fact it’s cost me a good amount of relationships and friendships. 

Though I started off with a low dose for the medication, I immediately felt a difference. 

The world seemed quiet for once. Like the noise I was somehow experiencing, was suddenly turned off. I realized I was no longer hearing my heart rate pounding in my ears. 

At the psychiatrist, I explained to her the new medication I started taking and she said it made sense that I experienced anxiety. According to her, it was the type of anxiety that starts in the body, with that overproduction of adrenaline and it works its way to the top, where it begins to affect my thoughts. 

It’s a bottom-up versus top-down approach to emotion generation.

At the psychiatrist, I explained to her the new medication I was prescribed and she said it sounded like what I was experiencing, sort of aligned with bottom-up emotion generation versus top-down. 

According to an article on the subject, “bottom-up emotions are immediate, ingrained responses to a stimulus–such as an instant feeling of fear in response to a car pulling out in front of us. Top-down emotions are more conscious responses to the way we think about a situation–such as a feeling of anxiety after deciding that we didn’t study hard enough for a test.”

The instant response to stress is based off adrenaline. The overproduction of adrenaline from these responses causes the physiological response of a very accelerated heart rate and thus, the feeling of some sort of urgency–at all times.

I thought about something she had also said to me a few months back when we had some of our first conversations about anxiety and pre-historic human beings. If I had been an early human, she says, I would have had a better chance at survival because of that ability to sense danger. She said I would have better chances than, let’s say a less sophisticated primate, who is able to stare at a leaf for an extended period of time and not sense the tiger lunging toward them at full speed, ready for its afternoon snack.

In short, the medication I’m now on, and a vigorous cardio routine will balance me out and release the overproduction of stress and adrenaline my body stores naturally.

There is no one way to treat anxiety and there is certainly no one way to experience emotions, or the psychosomatic responses that happen as a result of stress and anxiety.

This is your reminder to listen to your body.