Fear can cause your heart to race and your body to sweat. A wave of nausea may overwhelm you as your chest tightens and breathing becomes increasingly difficult. Some may appear faint — while others start to tremble.
Many who experience these overwhelming sensations describe feeling "scared to death." The popular phrase may sound dramatic, but health officials say there's some truth behind it.
“It is true that if you get scared you can actually become scared to death,” Suzanne Steinbaum, a cardiologist and director of Women's Cardiovascular Prevention, Health and Wellness at Mount Sinai Hospital in New York, told Fox News.
But there's no need to panic, because it's not exactly common
“You don't really have this episode where you get scared and you die,” Steinbaum explained.
Older adults or those who have underlying heart conditions — such as coronary artery disease or high blood pressure, among others — are more likely to die after experiencing a moment of intense fear, as these conditions increase the risk for heart attack.
In other words, those with serious heart conditions are less likely to tolerate the body’s response to fear, which includes a “brain and whole-body response,” explained Katherine Brownlowe, a psychiatrist at Ohio State University’s Wexner Medical Center.
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“The whole-body response includes changes in the cardiovascular system, including increased blood pressure and heart rate, as well as a rapid release of stress hormones,” she said. These hormones include adrenaline and norepinephrine, among others.
Fear can cause our hearts to race, arteries to tighten and blood pressure to rise. Those with high blood pressure, for instance, typically have higher levels of plaque in their arteries, or a buildup of fat and cholesterol, among other substances, according to the American Heart Association. Under a moment of intense stress or fear, this plaque can rupture, potentially causing a deadly heart attack or stroke.
“We definitely would recommend that people with chronic health conditions consider avoiding ‘jump-scare’ situations such as haunted houses,” Brownlowe added.
But even with a healthy heart, prolonged psychological distress or chronic stress can affect the heart over time — ultimately leading to death in some cases.
“When we are frightened, our body produces cortisol, which messes with our metabolism and regulation of energy,” said Margee Kerr, a sociologist who studies fear and the author of “Scream: Chilling Adventures in the Science of Fear.” In fact, this primary stress hormone, “curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes,” according to the Mayo Clinic.
“Fear is an important signal to us that we need to pay close attention to a situation, and if we ignore that signal, we can be in big trouble.”
Normally, when a moment of fear or a perceived threat passes, our cortisol, adrenaline and other fear-associated hormones drop to back to normal levels. But for those who live under a constant threat, these hormone levels remain elevated, increasing the risk of heart disease, sleep issues, anxiety, depression and a variety of other health issues.
In a 2008 study published in the Journal of Social Science & Medicine, researchers observing residents in certain areas of Baltimore — a city known for its high homicide rates — found “violence is associated with psychological distress through perceptions of neighborhood disorder, and through experiences of violence.” Another study published in the journal JAMA Pediatrics in 2017 looked at the correlation between neighborhood violence and “cellular and biological stress in children,” and concluded its findings “provide the first evidence that objective exposures to neighborhood-level violence influence both physiological and cellular markers of stress, even in children.”
Kerr likened the experience of living with chronic stress to an idle car, which is “constantly running but never re-fuels.”
“It Impacts our body metabolically. The body starts running down, while the mind is riddled by anxiety,” she said.
That said, there can be positive benefits to fear, Kerr said. Those who willingly step into a haunted house or see a scary movie on Halloween may leave with “an improved mood."
“The theory is when we are scared in a safe space, it activates the sympathetic nervous system, which activates our fight-or-flight response,” she said. In these moments, Kerr said, our attention is re-prioritized — meaning we are thinking about what we are immediately experiencing, “not the future or past."
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“It resets our threshold for what’s distressing,” Kerr added, noting the body’s response to being scared in a safe space has a similar psychological effect to accomplishing a long run.
Brownlowe echoed Kerr's point that a “good scare” can lower anxiety and stress levels and boost moods.
“This theory suggests that the ‘scare’ experience can allow a person to decrease rational or ruminative thoughts which sometimes increase distressing experiences and emotions. Perhaps these experiences may also improve stress tolerance in some people. For example, if you watch the ‘Silence of the Lambs,’ you may then be less anxious about an upcoming difficult conversation with your boss. Those other potentially scary situations don’t seem as frightful after you’ve seen something much scarier,” Brownlowe said.
But these experiences are only beneficial for those who are willing participants, Kerr warned.
Someone who is peer-pressured into walking through a scary exhibit may feel a sense of shame or embarrassment, especially if they're unable to make it all the way through.
“They’re met with condemnation, self-doubt — opposite of what the potential [benefits] are,” Kerr said. Brownlowe said young children are particularly susceptible to fear, as they “lack the cognitive mechanism that allows them to understand that a scary movie or haunted house isn’t real.”
“Fear is an important signal to us that we need to pay close attention to a situation," Brownlowe explained. "And if we ignore that signal, we can be in big trouble."