Anxiety and Cardiac Health
Written by KURA Guest Writer- Doris Lu-Anderson, PhD, E-RYT500, I-CAYT
When our body encounters unfamiliar, stressful, or dangerous situations, we feel tense and uneasy. Our body shifts to the sympathetic nervous system to get ready for a fight or a flight. A certain level of anxiety is healthy and helps us to stay alert. However, if the anxiety lasts around too long — longer than usual, it could become a problem
Anxiety and associated anxiety disorders are common with cardiac patients (Celano et al., 2016; Colber et al., 2020). The relationship between anxiety and heart disease is complex. As with depression, anxiety contributes to poor cardiac rehabilitation outcomes, and it may be involved in the development of the cardiovascular disease. (Colberg et al.).
Having a sudden heart attack is a scary experience for many people. According to Dr. McCann, Professor of Psychiatry and Behavioral Sciences of Johns Hopkins School of Medicine, the experience is similar to post-traumatic stress disorder. She explained that this is a terrifying experience because:
- That is a near-death experience.
- The cardiac patients just go through a life-threatening event.
- Cardiac patients need to avoid the activity or place associated with the heart attack.
- Recurring anxious thoughts may influence having good quality sleep.
- Negative thoughts about an uncertain future may cause a drastically foreshortened outlook of the future.
Common Symptoms of Anxiety
Cognitive symptoms: such as worry, especially worry that is difficult to stop or control, feeling unable to cope, and feeling that things are not real.
Emotional symptoms: such as fear, dread, uneasy anticipation, and irritability.
Physical symptoms: such as weakness, numbness, fatigue, headache, muscle tension or ache, stomach-churning, shortness of breath, blurred vision, dizziness, heart palpitations, trembling and shaking, feelings of paralysis, sweating and pressure in the head or chest (Colberg et al.)
Types of Anxiety Disorders
There are types of anxiety disorders. Dr. McCann stated a few of them that relate more to cardiac recovery:
Trauma- and stressor-related disorders (including post-traumatic stress disorder) (PTSD): Having a frightening incident or sudden life-threatening event such as heart attack may result in this emotional condition. A person who has PTSD has trouble dealing with anything associated with the incident that caused their condition. Additionally, they may experience feelings of jitteriness and detachment.
Obsessive-compulsive and related disorders (OCD): People with OCD will have irrational thoughts and worries about performing the same actions over and over. For example, an individual obsessed with perceived cardiovascular symptoms that have been checked and cleared by a doctor may compulsively research them or find new ones for hours on end.
Panic disorder: This can be associated with cardiac disease or be mistaken for a heart attack. Emotional stress from severe agitation and fear often supplemented by dizziness, chest pains, stomach discomfort, shortness of breath, and rapid heart rate. Cardiac vascular disease (CVD) is the leading cause of death in women and men in the United States. The total number of deaths from cardiovascular disease is higher for men than for women, and the mean age at the manifestation of CVD of women is ten years older than men (Bachmann et al., 2020). They identified that the stressors from cardiovascular disease differ by gender. Family responsibilities and job stress may contribute to this and can manifest in people as fear, anger, social isolation, and a perceived burden to family and friends. American Heart Association’s Go Red for Women and other associations such as National Heart, Lung, and Blood Institute (NHLBI) has campaigned to generate awareness of women’s cardiovascular health.
Anxiety and Cardiac Recovery
Individuals with anxiety disorders have a high degree of fear and uncertainty. It can have a significant impact on cardiac patients who are going through recovery. According to Dr. McCann, anxiety can interfere with:
- Appropriate heart rate
- Sticking to prescribed exercise regimens
- Taking prescribed medications
- Following through with a healthy diet
- Getting a proper amount of quality sleep
- Reconnecting with friends and family
- Confidently resume job career and family responsibilities.
Monkey Mind-Restless Mind
We heard people talk about the “monkey mind” and how they want to calm it down. What is Monkey Mind? According to Buddhist principles, the “monkey mind” is a term that refers to being unsettled, restless, or confused. Cardiac patients may have an unstill mind that is chattering with all their uncertainties and worries. An anxious mind doesn’t help with cardiac recovery.
How to Manage an Anxious Mind?
Cardiac recovery needs teamwork- a group of professionals working together to help cardiac patients recover. Going to see a cardiac doctor is like going to see a dentist for treatment. But when we come home, we still need to brush and floss our teeth regularly to keep up with oral health. Taking care of “monkey mind” is just like that! Therefore, in addition to talking to a cardiac doctor about concerns and seeking psychological help, here are some tips for cardiac patients to take control of the situation and maintain the benefits of their professional treatment:
- Breathing: There are various breathing techniques to calm down the mind, such as Nadi Shodhana (Alternate Nostril Purifying Breath-inhale from left nostril first), Ujjayi breath (oceanside sounding victory breath), Bee Breath (Brahmari)
- Exercise: Get the anxious energy out and/or try some calming exercises (e.g., Tai-chi, Chi-gong) to settle down
- Expressive Arts Therapy (e.g., art therapy, music therapy, sound healing, sand tray, drama therapy)
- Gentle yoga or stretching
- Meditation/Yoga Nidra (Yogic Sleep) or iRest (The modern adaptation of yoga Nidra which was founded by Dr. Richard Miller)
- Nature: Go outdoor and embrace nature!
- Practice gratitude (e.g., write down what you’re grateful for in a journal, write gratitude notes to others, take pictures of things you’re grateful for)
- Eat healthily
We live in a busy world, but it is worthwhile to take a minute and calm down your anxious mind. It is all right to allow ourselves to calm down the monkey mind. Like Louise Hay said, “All is well. Everything is working out for my highest good. Out of this situation, only good will come. I am safe.”
Brachmann, J. M., Forman, D., Gauthier, N., Opotowsky, A., Supervia, M., & Terzi, C. (2020). Special demographic populations. Modifiable CVD risk factors. In American Cardiovascular and Pulmonary Rehabilitation [AACPR](Eds.). Guidelines for cardiac rehabilitation programs (6th ed.) (pp.197–222). Human Kinetics.
Celano, C. M., Daunis, D. J., Lokko, H. N., Campbell, K. A., & Huffman, J. C. (2016). Anxiety disorders and cardiovascular disease. Current Psychiatry Report, 18(11). https://doi.org/10.1007/s11920-016-0739-5
Colberg, S. R., Fletcher, E., Goldstein, C., Gordon, P. J., Hughes, J., Myers, J., Pack, Q. R., & Robinson, K. (2020). Modifiable CVD risk factors. In American Cardiovascular and Pulmonary Rehabilitation [AACPR](Eds.). Guidelines for cardiac rehabilitation programs (6th ed.) (pp.97–148). Human Kinetics.
Hay, L., Khadro, Al., Dane, H. (2014). Loving yourself to great health: Thoughts and food-the ultimate diet. Hay House.
McCann, U. (n.d.). Anxiety and heart disease. Retrieved from https://www.hopkinsmedicine.org/heart_vascular_institute/centers_excellence/women_cardiovascular_health_center/patient_information/health_topics/anxiety_heart_disease.html