Can anxiety cause a heart attack, black-out or insanity? David Burns in his self-help book about overcoming depression, anxiety and interpersonal problems called The Feeling Good Handbook¹ states:


  ...neurotic anxiety results from distorted thoughts that have little to no basis in reality. If you are having a panic attack, you may believe that something terrible will happen if you let your anxiety get out of hand. You might think you'll pass out from a stroke or have a heart attack or go crazy. Although these fears seem legitimate, they're quite unrealistic because: (1) Anxiety never causes strokes or heart attacks. (2) Most people who are afraid of passing out during a panic attack have never once passed out when in a state of panic. In fact, you cannot pass out during a panic attack because your heart is beating rapidly and pumping extra blood to the brain. (3) Panic attacks never lead to insanity or loss of control. You are worrying about something that's blatantly unrealistic.


This is a revelation to me. Is it true that it is impossible for a panic attack to cause heart attacks? black-outs? insanity? If there are exceptions, how are they explained? Does this extend to all forms of anxiety, fears and phobias, not only panic attacks?

¹ Part III “Feeling confident: how to conquer anxiety, fears, and phobias”, Chapter 11: “Understanding anxiety”, page 212.
Recently we had and interesting symposium on stres, anxiety and psychoimunology.
Guest were psychologists from UCLA stresslab
In this website: http://www.uclastresslab.org/
you can find a bunch of researches which conect various human mental conditions (including anxiety) with interkulin 6 and cortisol. Those two supstances are conected to hearth attack and other diseases.
I hope this helps.