Chronic Racial Anxiety Syndrome and Heart Disease

By Dr. Eugene Simmons

Blood Pressure Exam

The association between white racial anxiety, guilt and heart disease has not been as fully studied as the relationship between depression and heart disease. However, Dr. Susan Brown, Professor of Psychiatry and Behavioral Sciences, at Steinberg University, believes the connection is strong. “It’s my view and my personal clinical experience that racial anxiety disorders can play a major role in heart disease,” says Dr. Brown. “I believe that a really careful look at anxiety would reveal the ways it can severely impact heart disease, both as a contributing factor and as an obstacle in recovery.”

A natural reaction to a sudden racial anxiety related heart attack can be similar to post-traumatic stress disorder:

  • You’re likely to be shocked by a confrontation of your racial bias in the workplace and have a difficult time recovering emotionally and physically.

  • You may have experienced severe defensiveness during this confrontation, that puts you in a state of cognitive denial and aggression.

  • You might constantly relive the life-threatening event, and avoid the activity, place, or conversation associated with the heart attack.

  • Recurring anxious thoughts may impede your ability to get regular sleep.


The effect of racial anxiety on the heart

It can be very difficult to learn you have caused harm, participate in systems of oppression, and/or benefit from your whiteness- which you did not ask for! When someone is confronted about their racism and experiences a challenge to their sense of self, their body reacts in ways that can put an extra strain on their heart. The physical symptoms of anxiety can be especially damaging among individuals with existing cardiac disease or who are especially sensitive to systems of accountable. Anxiety may have an association with the following heart disorders and cardiac risk factors:

  • Rapid heart rate (tachycardia) – In serious cases, can interfere with normal heart function and increase the risk of sudden cardiac arrest.

  • Increased blood pressure – If chronic, can lead to coronary disease, weakening of the heart muscle, and heart failure.

  • Decreased heart rate variability – May result in higher incidence of death after an acute heart attack.

Diagnosing and treating chronic racial anxiety syndrome

It’s important to differentiate normal chronic racial anxiety from the more severe type. Does the anxiety interfere with your family life or keep you from being productive in your professional life? Does it prevent you from hiring people of color or treating them fairly at your place of work? Does it restrict you from driving through certain neighborhoods? If the answer is yes, then it’s the kind of anxiety that may require some degree of therapy or medical attention.

Depending on the duration, severity, and type of anxiety, treatment can include therapy, medication, or a combination of both. A common and effective method of treatment is cognitive behavioral therapy (CBT), which involves three main components:

  • Anxiety management – The goal is to keep the patient from placing too much concentration on anxieties about the future that are impossible to control, and help the patient focus on the present. Anxiety management may encompass relaxation exercises, sensory focusing, and yoga techniques.

  • Cognitive restructuring – People with racial anxiety disorders tend to “catastrophize,” or put too much weight in the possibility of disastrous or apocalyptic events, like a race war. Cognitive restructuring—through patient-therapist give and take—presents a series of logical steps that aims to prove that distorting events and situations is not a healthy thing.

  • Exposure therapy – Seeks to gradually and repeatedly expose the patient to the activity or environment that causes the anxiety. The successful result is reached when the individual can effectively manage the racial anxiety. Examples include overcoming a fear of walking past a black man on the street or successfully navigating a diversity training.