Mental Health and Cardiovascular Disease

When we think of mental illnesses, we often cast our minds to conditions unseen by the naked eye and are inclined to believe that they are reserved for a minority of the population within society. However, with growing interest and awareness now surrounding and promoting mental health, the more we begin to understand these illnesses, their causes, treatments, and their implications. 

Mental health has surprisingly significant effects on the physiological body, going so far as to being both a direct and indirect cause of heart disease, heart attacks and even strokes. In some of these cases, it’s easier to observe the physical consequences to better understand the mental health conditions that cause them.

The connection between mental health and heart disease

Fortunately, the most widely studied mental health disorders – such as depression – have been linked to heart disease making it relatively easier to treat either or both to manage and reduce the risk of the condition developing further. 

The mental illnesses most likely to have an impact on cardiovascular health include:

• Stress /Burn out
• Anxiety
• Post-Traumatic Shock Disorder (PTSD)
• Depression (and other mood disorders)

Mental health conditions that cause heart disease

Although there is a range of disorders that have the potential to influence the development of heart disease, they share features with one another which has led doctors and researchers to make decisions as to how best to diagnose and treat them. 

Stress / Burn out

It’s one thing to be stressed about an exam or an important meeting, but chronic stress is a medically diagnosable condition. Chronic stress is characterised by prolonged periods of emotional distress and feeling overwhelmed, along with the development of consequential physiological symptoms. Insomnia is an extremely common feature of chronic stress, along with mental fog, low energy, loss of appetite, and bodily aches and pains.

When we’re stressed, our bodies produce hormones and a surge in these hormones lead to high blood pressure or hypertension. High blood pressure demands the heart to beat faster (tachycardia) and narrows the blood vessels. If this is a long-term occurrence, the heart is put under immense stress, potentially leading to heart disease or heart failure.

Although the prognosis is typically long-term, chronic stress can be effectively managed and controlled. Treatments may include medication, natural remedies, and therapy. 

Anxiety

Much like stress, we’ve all been anxious at one point or another in our lives but for those who have been diagnosed with anxiety, an intervention is often necessary, either with medication or therapy. Generalised anxiety disorder (GAD) refers to a condition in which an individual worries constantly and does not cope well with internal stress. It has been known to be hereditary but there is no clear explanation as to why some people have it and others don’t. 

Anxiety has a similar effect on the heart as chronic stress, resulting in high blood pressure and an increased heart rate. Anxiety may also increase the prevalence of heart palpitations, activating fight or flight responses to situations that may lead to panic attacks.

Post-traumatic stress disorder

Post-traumatic stress disorder is a type of anxiety disorder that follows a distressing event, such as war, violence, or a near-death experience. There’s no telling to what degree an event may be traumatising enough to trigger PTSD, as everyone reacts differently to their circumstances. While it’s normal to become upset or feel frightened during and after a traumatic event, persistent flashbacks causing intense feelings of distress after the event has long passed becomes a chronic psychiatric condition. Ironically, even experiencing or surviving a cardiac arrest or a heart attack can cause PTSD.

Much like other mental health conditions known to cause cardiovascular disease, PTSD can be treated with the use of medication, such as SSRIs (used to treat anxiety and depression) and cognitive behavioural therapy, which helps those with the condition to better deal with the negative feelings and emotions attached to the traumatic event.

Depression

Depression is a mood disorder that has a well-known link to cardiovascular disease. To such a degree that many who suffer from heart disease have depression, and those with depression have cardiovascular problems. But why? Neither physical nor mental health is clear-cut and their relationship even less so, but doctors and researchers find that mood disorders have multiple links to cardiovascular health. Not only do mood disorders have a direct causal effect on the body but they also incite behavioural changes that impact physical health.

Depression (and most other mental disorders) are extremely impactful on human behaviour. As an indirect causal factor on heart disease, depression can lead sufferers to engage in less than healthy behaviour, such as eating unhealthily, increasing the likelihood of smoking or drinking, and – due to a lack of energy, feelings of hopelessness, low self-esteem etc. – lack of physical activity or exercise. All significant factors in the development of cardiovascular disease. 

How to manage mental health and heart health

It goes without saying that a lifestyle change is the most accessible “treatment” for those living with either or both mental health and cardiovascular disorders. However, that’s not to say either should be treated with lifestyle changes alone. Medical supervision should always be sought after to diagnose and treat medically (if need be), as well as determine the prognosis of the condition or conditions.

If you have been diagnosed with or believe you may have symptoms indicative of cardiovascular disease, chatting to your GP or a cardiologist is the first step in the right direction. Additionally, if you feel mentally and emotionally overwhelmed and need help from a licensed professional, a doctor or clinic should be able to refer you to a therapist, psychologist, or psychiatrist, who will be able to provide you with the resources needed.  

For more information please contact: 

Dr Mpho Tsikoane, Specialist Psychiatrist

Sunningdale Private Hospital

Tel: 018 4620081