Heartfelt call on mental health
The blues can creep up on all of us from time to time, set off by stress or change, or sometimes for no obvious reason at all. But for cardiac patients chronic and prolonged periods of depression are exceedingly high.
Up to 45 percent of people living with congenital and acquired heart disease experience clinical depression, compared to just 5 percent of the general population. And around 70 percent of open heart surgery patients note peri and post-operative emotional, behavioral and cognitive disturbances. Feelings such as sadness, worry, grief, stress or anxiety, and sleep disturbances, nightmares and panic attacks are common following a cardiac event or surgery and can last for months and even years.
And whilst the co-occurrence of heart disease and mental illness is well established, psychological support is scant. The emotional and mental health needs of cardiac patients are scarcely recognised across health services. Yet depression is a key risk factor for cardiac morbidity and mortality. And with coronary heart disease being the leading cause of death in Australia, it beggars belief that our health system fails to address the directly correlated mental health needs of cardiac patients.
Organisations such as the Heart Foundation do a fantastic job in promoting physical wellbeing and lifestyle factors for optimal heart health across the lifespan (remember Jump Rope for Heart at school?). And for those affected by congenital and acquired childhood heart disease HeartKids undertake research and advocacy, and provide exceptional support to families in children’s hospitals across Australia. But there’s a real gap in psychological and emotional support for heart patients in general, and particularly for early and middle age adults. And a huge need for awareness and self care programs that empower cardiac patients to manage their physical and mental health needs.
Research by the British Heart Foundation found that just 15 minutes of meditative practice a day can radically reduce the risk of stroke, heart attack and premature death by 48 per cent, and also helps stave off the blues, reducing stress and anxiety. Positive emotions such as happiness and a strong sense of vitality can induce physiological benefits in the body and help lower the risk of heart disease.
According to the HeartMath Institute in the US the heart emits an electromagnetic field which is 60 times greater amplitude than the brain, and changes according to your emotions. And with a network of over 40 thousand neurons the heart literally has a mind of its own. So why isn’t mental health promotion and management a standard part of cardiac healthcare?
A key reason may be western medicine’s predominant specialisation in discrete body parts and focus on physical health, rather than integrative mind-body medicine. The training health providers undertake, as well as misperceptions and lack of information on the holistic psychotherapeutic benefits of mind-body practices are likely contributing factors.
Clinical trials and research on mindfulness practices for heart surgery patients in Australia also remain limited. Though international studies have demonstrated the positive outcomes of interventions in cardiac rehabilitation programs in the UK and US. It’s clear that beating the cardiac blues requires a change in both heart and mind.
We have to move beyond the reductionist paradigm and consider the complex interplay of psychosocial and biophysical factors influencing a person’s physical health and mental wellbeing. Living with heart disease can be isolating but no one needs to suffer alone or in silence. Seeking support from a general practitioner, connecting with fellow heart warriors, taking up meditation, spending time in nature and reaching out to family and friends can all help improve quality of life and aid recovery.
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This article was first published in The West Australian in Renée Gardiner’s weekly column in Agenda, 27 March 2021.