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April 2012
Your Thoughts Affect Your Heart
Dr P K Sahoo
 
“Even a happy life cannot be without a measure of darkness; the word ‘happy’ would lose its meaning if it were not balanced by sadness.” - Carl Jung

The heart is a symbol of the spiritual, emotional, and moral core of a human being. It is not only a poetic reference to the soul, but also a symbol of love. Not surprisingly, this organ is most likely to get affected by an individual’s mental state.

We’ve all been depressed at one time or another and we can all agree that it takes a toll on the body. Along with loss of appetite and sleep, blood pressure also increases, heartbeat speeds up and there is a noticeable rise in insulin and cholesterol levels. When your stress levels are up, your heart is going to be working overtime because of your jacked-up stress hormones, like adrenaline and cortisol.

Fellow Travellers
The exact relationship between depression and cardiovascular health is still a mystery. Recent studies suggest that the two frequently travel together:
  • One out of every three people with heart disease is depressed.
  • Up to 65 per cent of people experience depression after suffering a heart attack. It is more so with the elderly.
  • Depression with obesity forms a constellation of symptoms and often serves as a predictor of and a response to heart disease.
  • The depressed have high levels of stress hormones. This can increase the work of the heart, signal a “fight or flight” reaction and divert the body’s metabolism from the type of tissue repair needed in heart disease.
Affects Recuperation And Recovery
Depression makes recuperation and recovery from a heart attack difficult and slow. It also substantially increases the risk of having another heart attack and the risk of dying within six months. We see similar trends after bypass surgery too. The cardiac outlook worsens as
depression increases.

The brighter side is depression can be controlled, treated and cured through counselling and medication. As the patient begins to recover, the horrors of heart attack recede and with proper guidance and medicine the patient can be normal again. Up to 90 per cent of the time, treatment for depression after a heart attack is effective.

Cardiac Factors In Combating Depression
  • Pharmacological and cognitivebehavioural therapy treatments for depression are relatively well developed and play an important role in reducing the adverse impact of depression.
  • With the advent of selective serotonin reuptake inhibitors (SSRIs) to treat depression, the more medically ill patients can be treated without complicating the
    cardiovascular side effects of the drugs.
  • Exercise, which is a major protective factor against heart disease, is another pathway to check depression as well. Participation in an exercise training programme is comparable to treatment with an antidepressant in the case of older adults diagnosed with major depression.
Why Depression Aggravates Heart Disease?
  • Depressed people are more likely to indulge in heavy smoking and excessive drinking and to forego exercise.
  • When depression sets in, people already diagnosed with heart disease are likely to skip the medication prescribed for them.
  • Mental stress accompanying depression may increase the formation of plaque in the arteries.
  • The state of depression could boost the production of fatty acids and free radicals, which damage the lining of blood vessels.
Dr P K Sahoo is Senior Consultant Interventional Cardiologist, Apollo Hospitals, Bhubaneshwar


    
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