February is Heart Health Awareness Month

Friday, February 14, 2020 - 9:00am

How Cardio Health and Mental Health Go Hand-in-Hand: An interview with Dr. Richard Lane

Cardiovascular disease and mental illness are among the top contributors to death and disability in the United States. This makes monitoring a heart patient’s mental health just as important as treating their physical condition. Dr. Lane shares with us how a cardiovascular diagnosis can affect us, our loved ones, and how to cope with a diagnosis in a healthy way. 

What increases the risk of cardiovascular problems among mental health patients?

The mechanisms linking mental illness and cardiovascular disease are increasingly being understood and likely involve multiple factors. Prolonged stress and emotional arousal can cause wear and tear on blood vessels and contribute to atherosclerosis (clogged arteries). Those same arousal mechanisms can promote inflammation, which can damage heart tissue if it is persistent. Stress can also cause blood to clot more readily, contributing to heart attacks and strokes. Another important factor is motivation for self-care; not following recommendations for taking medication, getting enough sleep, eating a proper diet, or getting regular exercise can all contribute to heart problems.

Why is the psychological response to a heart event important?

If the heart is injured or otherwise impaired, it can put the person’s whole life in jeopardy, making a heart event stressful. Emotions and stress influence nerves and hormones that directly influence the heart. Therefore, the way one copes with or responds to a cardiac event can have an influence on the heart itself as well as other organs. Also, depression and anxiety can occur in response to a heart event, which can affect social and occupational functioning.   

What are the differences in how people cope?

An important distinction is between approach and avoidance coping. Approach coping means recognizing the problem and taking active steps to deal with it, e.g., following doctor’s orders or experiencing and expressing emotions associated with the stress. Avoidance coping, on the other hand, involves ignoring the problem or not doing the things one knows one should do. Avoidance coping generally spares the person emotional distress in the short term, but because the problem is ignored, it leads to greater complications and worse outcomes in the long run.

How can loved ones offer support? 

Research shows that if partners assist the patient in following doctor’s recommendations, such as taking medications every day, the patient’s outcome is better. Partners and friends can provide valuable emotional support by listening attentively to a patient’s fears and concerns and empathizing, to really understand how that person feels and conveying that understanding. This helps people to feel less alone and supported. One can also provide support through practical assistance, e.g., driving to doctor and rehabilitation appointments. 

What should everyone know about heart health and mental health?

Mental illness associated with prolonged or persistent distress (such as anxiety and depression) has negative effects on the heart. Therefore, for those with heart disease or with risk factors for heart disease, it is important to screen for depression and anxiety and get it treated, as that will be beneficial for both mental health and heart health.