Ever since the relapse of my kidney disease I’ve struggled with depression, with the close to twenty pounds I’ve gained because of the medication I have to take and fatigue. This relapse brings back the memory of all recurrences of the disease from the past and that’s a bummer. But I don’t have to worry about sudden death.
Not so for thousands of people who live with the memory of surviving a heart attack. A study reported by Tara Parker-Pope in today’s New York Times sheds light on what many of us in the behavioral health field have known anecdotally for a while. A significant number of people who have experienced a sudden cardiac event develop symptoms of post-traumatic stress disorder (PTSD).
It makes perfect sense. My first job as a newly minted psychologist was at Mt Sinai Medical Center in Manhattan where we studied and treated post-stroke depression. A stroke is another kind of “attack.” The survivors fought hard to recover from the physical effects but often overlooked how the experience was effecting them emotionally.
Both the study I was a part of many years ago and this more recent one out of Columbia University Medical Center, suggest that the presence of PTSD symptoms can contribute to poor disease management, like not taking medication because taking it every day provokes strong negative feelings like anger, sadness, and underneath it all, fear: “I hate that I have to take this pill because it just reminds me of how fragile I am.”
Hypervigilance, can also be a problem. Those of us who live with chronic conditions that go in and out of remission fight with the ghost of hypochondria. Every little twinge, every little pain is like a sudden loud sound for a combat veteran. “Is it happening again?” is a life and death question for heart attack, cancer and stoke survivors.
All this stress, sleep problems, anxiety, without proper diagnosis and treatment, may lead to the very thing cardiac patients wish to avoid, another heart attack. PTSD and depression probably also contributes to slower recovery as we found in our post-stroke depression study.
The good news is that PTSD is treatable with good psychotherapy and if needed, anti-depressant medication. If you or someone you know is having a hard time coping with life after a heart attack, or any life threatening sudden event please reach out to a good therapist. You can always call or email me.
Read more at Carolyn Thomas’s Heart Sisters: Not just for soldiers anymore: Post-Traumatic Stress Disorder after a heart attack.
Photo courtesy Sofia Francesca Photography
Thanks so much for this, Dr. A. I’ve been writing about PTSD and its known links to cardiac events since 2009, when my own was finally diagnosed after I survived a heart attack.
Previous research has suggested that 7-8% of the general population will develop PTSD, but for military veterans, rape victims and, yes, heart attack survivors, this number can go up to an astonishing 30%, as reported by Dr. Susan Ayers in the British Journal of Health Psychology.
In fact, a study published in the Canadian Journal of Cardiology described what many heart attack survivors already know: a heart attack can leave patients “as psychologically traumatized as victims of violence.” More on this at: http://myheartsisters.org/2009/08/25/ptsd/
Thanks also for pointing out here the problem of hypervigilance: it’s hard to describe to those who haven’t experienced this how living with a diagnosis in which every bubble and twinge makes you suddenly clutch your chest and wonder: “Is this something? Is it nothing? Should I call 911?” can be so unspeakably exhausting and terrifying.
regards,
C
Dear Carolyn, Thank you so much for sharing your excellent article ‘Not Just For Soldiers Anymore: Post-Traumatic Stress Disorder after a Heart Attack’ http://myheartsisters.org/2009/08/25/ptsd/ You describe so brilliantly what it is like to live with the PTSD brought on by your heart attack.
As soon as I saw the NYT article this morning my first thought was of you. My second thought was, “Isn’t it interesting how the research eventually catches up to what we already know?”