MENTAL HEALTH
SUPPORTING PSYCHOSOCIAL NEEDS AND THE HEART-BRAIN CONNECTION
Dr. Reaz Mahmud Huda
SUPPORTING PSYCHOSOCIAL NEEDS AND THE HEART-BRAIN CONNECTION
Dr. Reaz Mahmud Huda
Once I read an article stating that “for centuries, the mind-body relationship has been postulated. These findings suggest that depression and anxiety are not simply ‘in the mind’. They are real illnesses, like any other physical illnesses, and can negatively impact the entire body, including the cardiovascular system.”1
It has become crucial in our practice that the overlap of symptoms of cardiovascular disease such as palpitations, chest tightness, and shortness of breath that occur in healthy persons, including those due to stress; it makes very difficult for physicians and their patients to assign a causal or related role to mental health. Primary care physicians and cardiologists focus on treating symptoms and risk factors related to cardiovascular diseases, which spare actually little or no time to address feelings and emotions.1 Moreover, social stigma has traditionally existed around mental illness; therefore, patients and families may be hesitant to discuss mental health.1 The purpose of today’s writing is to underscore the importance of mental health and its associations with cardiovascular disease.
The relationship between depression and anxiety and cardiovascular disease is bidirectional.2 In other words, depression and anxiety can increase the risk of developing cardiovascular disease; cardiovascular disease can increase the risk of developing depression and anxiety, and each may lead to a worse outcome.2
Now, what patients can do to reverse those effects are:1
- Exercise:
– Moderate intensity aerobic exercise for at least 30 minutes, on 5 or more days of the week (total of 150 minutes of aerobic exercise per week).
– Brisk walking, cycling, walking on treadmill, jogging, swimming, playing sports, climbing stairs.
- Mindful meditation (including taking brief counselling and psychotherapy):
– Practiced sitting with eyes closed, cross-legged on a cushion, or on a chair, with the back straight.
– Attention is put on the movement of the abdomen when breathing in and out, or on the awareness of the breath as it goes in and out of the nostrils.
– If one becomes distracted from the breath, one passively notices one’s mind has wandered, but in an accepting, nonjudgmental way, and one returns to focusing on breathing.
- Cognitive behavioral therapy (CBT):
– Done with a psychiatrist, psychologist or psychotherapist.
– Excellent for anxiety, stress, and depression that is a grief response, but not much helpful for major depression.
– Meditators start with short periods of 10 minutes or so of meditation practice per day.
- Maximizing social connectivity:
– Be engaged in social activism.
– Create social networking in one or more social media (but try to avoid all distractions that affects your work or daily activities, or feelings like being envious, angry, or depressed).
References:
1.Chaddha A, Robinson EA, Kline-Rogers E, Alexandris-Souphis T, Rubenfire M. Mental Health and Cardiovascular Disease. Am J Med. 2016;129(11):1145-8.
2.Riba M, Wulsin L, Rubenfire M. Psychiatry and Heart Disease: The Mind, Brain, and Heart. Hoboken, NJ: Wiley-Blackwell; 2011.
Dr. Reaz Mahmud Huda MBBS, FCPS (Medicine), FCPS (Cardiology)
Assistant Professor, Department of Cardiology
National Institute of Cardiovascular Diseases (NICVD),
Dhaka, Bangladesh
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