After surviving a stroke or heart attack, your initial focus is more than likely on regaining your physical health. Slowly building your physical activity levels back up, improving your diet and nutrition, and following the recommendations of your provider. The effects of heart disease, however, can go beyond your physical wellbeing, taking a toll of your mental wellness, too.
Dr. Karen Sparks, psychiatrist, Behavioral Health Consult Services at Northern Light Acadia Hospital, recently sat down to answer some questions about the effects of cardiac disease on our mindset, and some steps you and your loved ones can take to overcome that.
Q: How can surviving a cardiac event like a heart attack or stroke change someone’s mindset?
A: A significant, life-threatening health event, like a heart attack, can lead to an existential crisis, or a period of reflection on the meaning of life and one’s purpose in it. Often this can result in a new-found appreciation for life, motivation to be fully present in it, and a shift in priorities. Other times, it can result in hopelessness, anxiety, and feelings of powerlessness.
Q: From a mental wellness perspective, what are some of the biggest issues survivors of cardiac events like a heart attack or stroke face?
A: It’s important to recognize that anxiety and depression have been shown to increase the risk of cardiac events in the first place. It is also not uncommon to develop clinical anxiety or depression syndromes after sudden cardiac events. The good news is that anxiety and depression are treatable conditions with medications and talk therapies if the other strategies mentioned here are not enough. And, treating these conditions at any time can improve both physical outcomes and quality of life.
Q: Unlike cancer and other diseases, cardiac events often occur suddenly, sometimes presenting few symptoms. It can upend your entire life in a split second. How does having that short window to process such a significant event differ from, say, a diagnosis of a longer-term illness?
A: Sudden cardiac events can be uniquely traumatizing in a way other illnesses are not due to their abrupt, life-threatening nature and compounding loss of control. This can result in acute fear and anxiety, avoidance, and withdrawal. The immediacy of the event also means that the person has not had time to develop social support, coping strategies for distress, and other adaptive skills.
Q: When you survive a cardiac event, do patients often have a newfound fear of a second one, and how can they overcome the anxiety around that?
A: “Cardiac distress” is a relatively new term which describes this very thing: basically, a persistent emotional state following a cardiac event that impedes the patient’s ability to cope with their condition. Cognitive behavioral therapy (CBT) is a formal treatment that can help change thought processes and decrease anxiety. Other strategies include good sleep hygiene, relaxation and mindfulness techniques, practicing gratitude, journaling, and self-compassion.
Q: Family is another piece of this. We wonder, ‘is this something I’m going to pass down to my children and then possibly their children,’ and we might even have a sense of guilt that can weigh on us. How do we work through that, while also ensuring our children understand that risk?
A: Guilt is a natural emotion, but it should not define our relationship with our family and children. Many of the self-care strategies above can be helpful in managing these feelings. In addition, local and virtual cardiac support groups can provide support, a sense of belonging, and coping strategies among people with a similar experience.