The Mind-Body Connection
Unconsciously, the brain directs a host of processes that take care of themselves without our intervention. But what about our conscious thoughts? Do our feelings play a role in heart disease? Is a positive outlook part of a healthy life?
When we examine the role of the mind, it’s important to remember that the link between thoughts, emotions and heart disease is less clear than for other risk factors. We can’t measure feelings in the same way that we measure blood pressure or cholesterol or doses of medication. But there is good evidence that depression, anxiety and stress have a profound effect on general health and, more specifically, on heart disease development, duration and prognosis.
The Emotional Heart
About 50% of patients with heart disease experience depression, and those with long-term depression are twice as likely to suffer a heart attack or develop atherosclerosis. A third of heart attack patients develop depression, and this seems to increase the risk of death after bypass surgery. After bypass surgery, those with high rates of depression are less able to do the things they needed to do to improve their health, including physical rehabilitation, and are more likely to engage in activities that damage their health, like smoking and overeating.
Other emotions, including anger and anxiety, may also play a role. You may know someone that becomes “red in the face,” when angered or someone that worries so much that they tremble. These physical manifestations of emotion bear witness to physiological changes in the body: the release of hormones like cortisol and adrenaline, elevated heart rate and blood pressure, elevated triglycerides and blood sugar levels. If these emotions become constant, these physical manifestations become chronic, contributing to the progression of heart disease.
Your Heart Connects With Others
Some of the most profound recent findings relate to isolation and social support networks. People with poor social support, especially men, had less positive outcomes after being diagnosed with coronary heart disease. One meta-analysis found that loneliness is one of the most important risk factors for heart disease. Recovery from a cardiac event can take months. Those with strong family and social ties can have an easier time sticking to the physical rehabilitation and dietary changes a heart attack or stroke can require.
Of course, strong social networks can also help keep us from developing heart disease. It’s easier to exercise with friends — to join a sports team or find a gym buddy. Going out can be healthier than spending hours watching TV. In the same way that stress releases adrenaline and cortisol, human connections encourage dopamine, oxytocin and serotonin release.
The Texas Center for Preventive Cardiology considers psychological health an integral part of cardiovascular health. Although we do not offer on-site psychiatric care, we work closely with some of the most well respected professionals in the Austin area.
During the evaluation portion of our process, we will ask questions that can give us an indication of stress and anxiety levels. We may encourage you to work with software programs that can teach you techniques for reducing stress levels in difficult moments. We may try to discover if some level of depression is present. Based on this information, we may recommend that a patient make an appointment with a qualified professional.
But we are not here to judge, and we will not ask you to do anything that you are not comfortable with. Each patient is free to choose if and when to seek out counseling. Whether or not a patient chooses to receive counseling does not, in any way, prevent us from moving forward with other treatments. Preventive cardiology is, at its heart, a broad-based approach that seeks to find the right avenues for improving health, not force all patients into a predefined mold.
When we ask, “How are you?” it’s not a simple pleasantry — we really want to know. Your thoughts and emotions are a big part of your overall well being, and we want to help you improve every aspect of your health. It’s part of the way we integrate the practice of medicine with the practice of life.