Following is an editorial on the effects of emotions, specifically negative ones, on heart health.

Many Emotions Can Damage the Heart

Most people know that anger is bad for your heart’s health, but loneliness and depression affect your heart, too.

Volatile emotions like anger and hostility are bad for heart health. But studies have shown that some of the quieter emotions can be just as toxic and damaging.

“Study after study has shown that people who feel lonely, depressed, and isolated are many times more likely to get sick and die prematurely – not only of heart disease but from virtually all causes – than those who have a sense of connection, love and community,”

Raising Awareness

Ornish, the founder, president, and director of the nonprofit Preventive Medicine Research Institute in Sausalito, Calif., and the author of Love and Survival, points out that today many people don’t have an extended family they see regularly, or live in a neighborhood with two or three generations of neighbors. Many don’t have a job that promises stability or go to a house of worship every week. “These things affect our survival to a much larger degree than people had once thought,” he says.

 

Unfortunately, says Ornish, “many people think of these as things you do after you’ve done all the ‘important’ stuff,” such as diet and exercise. What winds up happening is people often regard spending time with family and friends as a luxury. “What these studies show us is that this is the important stuff,” Ornish says. “We are touchy, feely creatures, we’re creatures of community, and we ignore these things at our own peril.”

Raising awareness so that people who are lonely and depressed can face these problems is very important, says Ornish. “It’s very hard to get people even to take their medication, if you don’t address these issues. That’s where awareness is the first step in healing. If a physician can spend more time with their patients talking about these issues, these people can begin to make different choices in their lives.”

Depression and the Heart

“The general results of studies are that, for the most part, we believe depression is a risk factor for the development of heart disease,” says Matthew Burg, PhD, associate clinical professor of medicine at Yale University School of Medicine and Columbia School of Medicine.

Burg points out that in people who have already suffered a heart attack that requires surgery to unclog blocked arteries, depression is also associated with poor outcomes, such as an earlier death or subsequent heart attack.

Social isolation and low levels of social support are similarly associated with increased risk for heart disease complications, he says.

Most cardiologists agree these results are important, says Burg. But while cardiologists know what to do about cholesterol and blood pressure, they often don’t know what to do about depression and stress or even how to get patients to reveal how they feel. “It’s not like going to a patient and saying, ‘You have high cholesterol, and here’s the pill,'” says Burg.

Talking About Your Emotions

Not surprisingly, people have an easier time discussing their blood sugar and cholesterol than speaking about their psychological state. “People don’t like being depressed but, in our society, there is a certain stigma about things like depression,” Burg says. “When patients are not as forthcoming about these issues, it makes it that much harder to identify and treat.”

“A person who has suffered a heart attack is likely to say things like, ‘Of course I’m depressed, I just had a heart attack,'” Burg says. “But very often, when we take a closer look, what we find is the symptoms of depression predate the heart attack.

“The depression after a heart attack, which we would call an adjustment problem or adjustment disorder, actually dissipates within a matter of weeks. If the symptoms persist, we’re really talking about a depression independent of the heart disease.” These emotions, when prolonged, “are worth paying attention to, because of the potential effect they’re having on the cardiovascular system.”

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