“I’m not depressed!” – and other ways we deny the stigma of mental illness after a heart attack
“This is the most thorough review article I have seen on psychological interventions after heart events,” writes cardiac psychologist Dr. Stephen Parker about a recent UK study on heart patients. And he should know. Dr. Steve is also a heart attack survivor himself who has explored his own profound experiences with the depression and anxiety that commonly accompany any cardiac event.
The study, reported in the British Journal of Cardiology in July 2010, followed over 400 London heart patients for two years – of whom at least half showed symptoms of anxiety or depression when first interviewed. But the study authors described their participants in this way:
“Many of these heart patients were reluctant to accept a diagnosis of anxiety or depression and expressed reservations to the clinical psychologist by rejecting the term ‘depression’ for describing their problems, or by expressing negative views about attending a mental health service for treatment.”
In fact, these ‘negative views’ associated with the stigma of having mental health problems were so strong that all psychological interventions studied were provided to heart patients as part of a scheduled Cardiac Rehabilitation program at St. Thomas’s Hospital in London instead of at a mental health facility. (more…)
Mary Maxwell: “How old age just sort of crept up on me . . .”
“This is the first time I’ve ever been old. And it just sort of crept up on me,” explains 72-year old Mary Maxwell as she delivers the invocation before the annual dinner at an Omaha seniors facility. At first, her presentation starts like a normal little prayer, but it soon takes a hilarious turn when she hijacks the microphone for a more personal chat with God about the topic of growing old. With the laser-like timing of a professional stand-up comic, she talks about common aging issues - like random hair growth. “I remember the time I reached to brush a hair off my lapel,” she deadpans. “And then I realized it was attached to my chin…”
Mary shines a very funny light on the foibles of aging, to the absolute delight of her live audience, as well as over 2 million YouTube viewers so far. Here’s the 7-minute video called “A Reminder That Laughter is The Best Medicine”. It’s from the Caregiver Stress website hosted by Home Instead Senior Care Services. Sit back, enjoy Mary Maxwell, and then forward this link to the people you love. Mary’s unique message and unforgettable humour will be good for their hearts – and their souls.
You can also download a copy of the poem Blessed In Aging that Mary reads at the end of her invocation.
Which one’s right? Eight ways that patients and families can view heart disease
A very interesting phenomenon that I used to observe in bereaved family members during my years working in hospice palliative care is the range of personal grieving styles, and the resulting conflicts over the “right way” to grieve.
Let’s take the example of two grown daughters whose mother has died. One daughter may be emotionally incapacitated and fragile, needing to tearfully tell the story of her mother’s illness and death over and over again to help herself deal with the loss.
But another daughter copes with her own sorrow by trying to make life as “normal” as possible - throwing herself into tasks like organizing the funeral, writing the obituary, going back to work right away, and keeping very busy.
She may feel impatient and frustrated with her emotional sister, urging her: “Pull yourself together! Mum would not want you to be turning into such a weepy mess like this!” The first daughter, meanwhile, might respond in horror: “Look at you! You’ve gone back to work, you’re throwing dinner parties and making vacation plans. Don’t you even care that our mother has died?“
Each sister is convinced that the other is doing it wrong.
The same response to differing coping perspectives can happen in families when heart disease strikes one member. (more…)
My love-hate relationship with my little black box
Every morning, I clip it onto my belt, or tuck it into a hip pocket. I very carefully attach its sticky little electrode pads onto the skin just over my heart, tucking their long black wires under my clothing. Lately, I also have to hold the electrodes in place on my skin with surgical tape because they’re starting to lose their stickiness after weeks of daily wear. I turn on the black box at my waist, and adjust its two knobs to the correct power levels. I feel a prickly little buzz pulsating across my chest.
It’s called Transcutaneous Electrical Nerve Stimulation or TENS, and it involves electrical stimulation used to treat pain. My TENS unit is about the size of a cell phone. You may know the much larger version of this machine if you’ve ever had physiotherapy after a muscle injury or surgery. The only injured muscles it’s working on for me now, however, are those in my heart. Emerging cardiac research is showing that, just as the TENS machine works on improving blood flow and healing for an injured knee or shoulder, it may bring the same benefits to heart patients with chest pain like mine.
But I do have a love-hate relationship with my little black box. (more…)
Is this a “revolution in health care education”?
After my heart attack, while I was deep in the throes of a truly crippling depression, my doctor referred me to a cognitive behavioural therapist for help. She was an extremely perky person, and used to say things to me like: “I have a great idea! Why don’t you sign up for a really interesting night school course at the college?” I remember looking back at her and thinking: “You have absolutely no clue.” If only I’d had the energy, I would have thrown a heavy object right at her head…
I could scarcely motivate myself to even brush my teeth every morning, so how on earth would I manage the registration process for this ‘really interesting course’, never mind actually getting myself out the door to attend night school? That’s the kind of suggestion you might make to a perfectly healthy person, and it told me instantly that this therapist had no real comprehension of how debilitating post-heart attack depression can actually be.
That’s why I was so pleased to learn about a Canadian university’s innovative new mentorship program that - besides teaching health care students using traditional textbooks, labs and lectures – will link health mentors (adult volunteers actually experiencing chronic illness like heart disease) with teams of students from several health care faculties starting this fall. First year students with the Dalhousie University Health Mentors Program (all from the Faculty of Health Professions, Dalhousie Medical School and the Faculty of Dentistry) will meet four times a year with their assigned health mentors to ask questions like:
- What is it like to live with heart disease?
- What are the emotional ups and downs?
- How do you eat well and exercise when you don’t feel well?
- How do you manage pain, shortness of breath, fatigue and other cardiac symptoms?
- How has your life changed? (more…)
