• Am I Stressed or Depressed?

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    Neither stress nor depression is good for your heart. When you have heart disease—and particularly after you’ve had a heart event, such as a heart attack or coronary artery bypass surgery — it is common to temporarily feel sad or overwhelmed.  Your emotions may stem from feeling powerless or frustrated at your limited physical capabilities. But they should go away within a few weeks after you are able to return to your normal routine.  

    Unfortunately, stress you experience due to a heart condition can quickly turn into depression before you are even aware of it. This is concerning because depression is not only a medical condition that requires treatment, but it is also a risk factor for cardiovascular disease. 

    Here are some startling facts about heart disease and depression:

    • Even for people who do not have heart disease, depression can increase the risk of a heart attack and the development of coronary artery disease. And if you are depressed, you are more likely to die from sudden heart problems. 
    • If you have heart disease, depression can increase the risk of an adverse heart event such as a heart attack or blood clots. 
    • If you have heart disease and are depressed, you are more likely to perceive a poorer health status, which decreases your quality of life.
    • If you are recovering from heart surgery, depression can worsen pain and fatigue and cause you to withdrawal from your social support system. This increases your risk of surgery-related illness and even death. 
    • If you have heart failure, depression increases your risk of being readmitted to the hospital and it increases your risk of death. 
    • If you have heart disease and are depressed, you are less likely to take your medications as directed. And negative lifestyle habits associated with depression—such as smoking, excessive alcohol consumption, lack of physical activity, poor eating habits and lack of social support—also contribute to your heart disease risk. 

    Up to 15 percent of people with heart disease experience major depression, whereas about 20 percent of people who have had a heart attack or coronary artery bypass surgery experience major depression. But many more experience some symptoms of depression, which may include:

    • Withdrawal from activities (for example, lack of motivation or lack of confidence in your cardiac rehabilitation program or another medical treatment program)
    • Lack of social support, or not responding when visiting with friends and family
    • Increased negative thoughts
    • Lack of experiencing pleasure
    • Tearfulness
    • Thoughts of suicide

    So, if you feel you may be depressed, speak to your doctor immediately or go to the emergency room, especially if you have thoughts of suicide. Before you can effectively cope with everyday stress, you might need psychotherapy or medication treatment for your symptoms of depression. The greater your depression is, the greater your risk of cardiovascular disease—so seeking treatment for depression as soon as possible will help your heart.

    Am I Angry or Happy More Often Than Not?

    How short is your fuse? The answer to this question plays a part in determining your heart disease risk. If your fuse is typically short (that is, if you are quick to anger), lengthening it may lengthen your life. There is strong evidence that anger, hostility, and cynicism are linked to increased heart disease risk, including increased mortality.  In fact, anger may influence heart disease risk as much as smoking, obesity, and inactivity. But on the bright side, keeping a more passive, positive outlook and engaging in frequent laughter may help improve your health and your quality of life.

    • Anger Issues

    Studies have shown that people who are angry more frequently and more intensely are at higher risk for all heart disease events, including heart attack, silent heart attack, and bypass surgery. They are also more likely to die suddenly from a heart-related event. 

    Men are more likely than women to act out their anger when stressed. This may be due to cultural factors and perhaps feeling frustrated that they can’t fix certain situations. In particular, young men who frequently become angry under stress have an increased risk of developing heart disease before the age of 55 (known as “premature heart disease”) and having a heart attack.

    However, both men and women may exhibit the traits characteristic of a “type A” personality, which is typically described as a go-getting, stressed, short-fused perfectionist.  And “type A” personality trait has also been associated with an increased heart disease risk. But the latest evidence suggests it is most likely anger or hostility that is responsible for the increased risk of heart disease in this group of people. 

    This is encouraging because while it is difficult to change some personality traits, it is possible to address anger and manage stress so it doesn’t overwhelm you.  

    Of course, the best course of action is to not get angry in the first place. But sometimes that is not possible. In those situations, it is best to acknowledge your anger and take positive steps to try to change the situation that is making you angry. Keep in mind sometimes this may mean removing yourself from the situation and venting your feelings to someone impartial who is ready to listen. If you take action and the situation still cannot be resolved, then it is best to accept it and let it go!

    • Mind Over Matter

    On the bright side, a positive outlook appears to offer some protection against heart disease. A promising recent study showed that people with heart disease who had optimistic expectations about their recovery (despite how severe their illness was) were less likely to die over a 15-year period than patients with pessimistic expectations. 

    This is great news! You may be in more control of your health than you ever thought possible. If you can think positively, you may be able to improve your heart health, feel better and live longer. 

    The theory is that optimists have better coping strategies, such as following prescribed medical treatment plans more diligently. Pessimists have negative thoughts and experience stress, which has damaging effects on the body and prevents people from following through with healthy lifestyle behaviors and their medical treatment plans.

    • No Laughing Matter: Laughing Matters

    While it’s not easy to prove, there is some evidence that laughing may help improve blood flow, immune response, blood sugar control, relaxation and sleep. It may not be the act of laughing that makes people feel better, but rather a positive attitude, a good sense of humor, and the support of friends and family might play a role, too. Regardless of whether laughter itself improves your health, it undoubtedly helps improve your quality of life and your happiness, which may impact your health.

    In general, most people (except perhaps those who are clinically depressed) have some control over their approach to life and health. You cannot control everything in life, but you can control how you react to everything in life. When you choose to approach life with a positive outlook and a sense of humor, you may successfully manage your stress and reap many rewards such as social support, happiness, and perhaps a longer, healthier life.