Did you know that there appears to be a two-way connection between mental health and heart health? Back in 2018, research showed that inadequately treated major depression raises the risk of cardiovascular events in people with a previous heart attack or stroke. Since then, the emerging field of psychocardiology has begun a deeper exploration of the link between the heart and the mind. Here is what you need to know.
Psychological Factors That Can Contribute to Heart Attacks or Strokes
Heart disease is particularly interesting, because there is a clear physical cause: plaque buildup in the arteries. If a chunk of plaque breaks off, it can lead to a blockage, potentially causing a heart attack or stroke. Yet heart conditions are seen more frequently in people with certain mental health disorders. We have long known that long-term stress, anxiety, or anger can raise the risk for heart troubles. Remember, the heart is a muscle. And just like any muscle, it can spasm. When the heart spasms due to a flood of stress hormones, it can lead to a heart attack.
In addition, the chronic, long-term presence of stress hormones can cause inflammation in both the heart and brain. In fact, many anti-anxiety medications, such as beta blockers, are also prescribed to people with heart disease. What has also become clear in past decades is that other mental health conditions can also lead to heart issues. Among people with schizophrenia, coronary artery disease is the leading cause of death. And those with schizophrenia often have shorter lifespans than people without the disorder. As it turns out, a stunning 30% of all heart attacks and strokes are caused not by physical conditions such as high cholesterol or diabetes, but by psychological factors.
Depression and Heart Disease
Moving back to the topic of depression, there is a strong bi-directional connection. Not only can depression increase the risk for heart trouble, but about one in five people who have a heart attack will develop depression afterward. People with heart failure also experience surprisingly high rates of depression. Heart conditions, especially a heart attack, can have a tremendous impact on a person’s entire life. From feelings of guilt to concerns about whether they will be able to properly raise their children after a heart attack, psychological impacts are frequent.
Once depression sets in, it can create a vicious cycle. People with depression tend to have stickier platelets, which makes hardening of the arteries more likely. Depression can also lead to arrhythmias, or irregularities in the heartbeat. Combined with damage from a previous heart attack, this can be especially dangerous for the heart.
A strong cardiac rehabilitation program coupled with plenty of social support and the assistance of a mental health therapist can break the cycle. People who have had a heart attack, experience depression, or both, can lead a completely normal life.
The Heart-Mind Connection
All of this begs the question: What is going on with this link between the heart and the mind? As it turns out, the heart actually serves as its own separate nervous system, which contains more than 40,000 neurons. It also acts as a part of the endocrine system, secreting hormones including oxytocin, which is the bonding hormone.
There appears to be a two-way street between what’s happening in the mind and what’s happening in the heart. That is, mental health difficulties can flood the heart with chemicals that can cause damage. But heart trouble can also do the same thing to the mind. This can cause a bit of a chicken-and-egg conundrum: Did the cardiovascular issues develop first, causing the mental health disorder? Or did the mental health disorder cause the heart issues?
Broken Heart Syndrome
Broken heart syndrome is a particularly powerful example of this link between the mind and the heart. Sometimes known clinically as stress cardiomyopathy, broken heart syndrome occurs when tremendous negative emotions create chest pain that mimics a heart attack. This condition is typically non-fatal and normally resolves within a few days or weeks. But while it lasts, it actually affects the pumping function in part of the heart. Though it can occur in any gender or age group, broken heart syndrome is most common in older women following the death of their spouse.
Keeping Your Heart and Mind Healthy
So, what can you do to reduce your risk of psychologically induced heart disease and vice versa?
- Avoid jumping to conclusions about any symptoms you have. Both heart disease and many common mental health conditions, such as depression, have symptoms such as fatigue or trouble sleeping. Even if you have been diagnosed with a heart condition or a mental health condition, don’t assume that your symptoms are due to your diagnosed illness. Keep an open mind.
- Maintain an open dialogue. Your healthcare provider needs to know about all of your symptoms and how they affect you. And don’t be afraid to ask questions. For example, someone with anxiety and chest pain might ask, “Could this be related to my heart?” A patient with heart failure and low energy levels might want to know, “Could depression be part of the issue?”
- Be mindful of overlap. After a heart attack or stroke, depression is extremely common. Make a proactive plan to rehab not only your body but also your mind. Find social support. Talk to a therapist. Consider your personal obstacles to treatment, such as lack of motivation or desire to practice healthier habits, and look for ways to overcome them.
- Treat yourself with kindness. Chronic stress worsens both heart disease and mental health disorders. Fight back by practicing self-care. Carve out time each day to do something that brings you joy. Prioritize sleep. Learn to disconnect at the end of the day and while on vacation.
The field of psychocardiology is relatively new, and there are plenty of things that researchers still don’t know. But it is becoming increasingly clear that the heart and mind are heavily linked. If you have either heart disease or any psychological disorder, now is the time to learn to recognize this overlap and start taking a more proactive approach to your mental and physical health.