Not just for soldiers anymore: Post-Traumatic Stress Disorder after a heart attack

25 Aug

by Carolyn Thomas    @HeartSisters

When I was at Mayo Clinic last fall, I watched a short film about women and heart disease. A 40-something woman onscreen told the interviewer that ever since her heart attack had happened, she was afraid to go to sleep every night, because now she wasn’t sure that she would ever wake up.

I began to weep when I heard her say this.

For the previous five months since my own heart attack, I’d been somehow compelled to clean the entire apartment every night before bedtime, “just in case”. I emptied trash, recycled  all newspapers, swept and scrubbed and tidied.  I was unknowingly planning that, if this were the night I was going to have another heart attack, the paramedics and the coroner and (worse) my grown kidlets would find me in a nice clean place.  When I finally did fall asleep, I’d have terrifyingly frequent nightmares about having a heart attack on the plane (vividly reliving what had actually happened in May 2008) but this time, when I looked around the plane in my dreams, there were no passengers – and no pilots.  It suddenly struck me on that autumn day at Mayo Clinic that every night since May 6, 2008, I had been essentially preparing for my own death. Night after night, month after month. And I was utterly exhausted.

The only upside: the place had never been so clean.

But it was clear to my physicians that many of my bleak and distressing symptoms were those consistent with Post-Traumatic Stress Disorder (PTSD).

This is a debilitating emotional illness that can develop when you experience or even witness a dangerous, terrifying, or possibly life-threatening stressful event – an event that is outside the range of what’s considered to be a normal human experience.

About 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%.

And now a U.K. study(1) led by Dr. Susan Ayers at the University of Sussex published in the British Journal of Health Psychology confirms that heart attack survivors may have a disturbing incidence of undiagnosed PTSD.  Her research team found that 16% of survivors studied met clinical criteria for acute PTSD, and a further 18% reported moderate to severe symptoms. Dr. Ayers explains:

“Feelings of fear, anxiety and depression are common after a life-threatening cardiac event. The findings of this study suggest that a high proportion of survivors experience very severe distress.  This has the potential to impair recovery, quality of life and threaten future health.”

Montreal Heart Institute researchers found that, one month out, a significant number of heart attack victims show clear symptoms of PTSD such as:

  • frequent nightmares or flashbacks
  • a constant reliving of the fear, helplessness or horror felt when they were having the heart attack and thought they were dying

Dr. Donald Edmondson, assistant professor of behavioural medicine at Columbia University, adds that people who feel more in danger during a medical trauma, or who feel they have less control of their health, also are more likely to experience the disorder.

How are heart attack survivors treated for PTSD?  Like many anxiety disorder treatments, medication and therapy are often the most helpful treatments, the sooner the better, before symptoms worsen. According to Dr. Ayers:

“It is vitally important that heart attack survivors are screened for psychological distress, such as anxiety, depression and PTSD, and offered appropriate treatment if necessary.”

.

More about Post Traumatic Stress Disorder:

This condition has been around forever and known by different names: soldier’s heart, combat fatigue,  shell shock,  gross stress reaction,  post-Vietnam syndrome.  But it wasn’t until 1980 that it was officially added to the bible of mental illness knowledge, the Diagnostic Manual of Mental Disorders (DSM) after Vietnam vets lobbied to have PTSD recognized as a legitimate disorder.

PTSD can also strike both survivors and relief workers at natural or terrorist disasters, and anyone who has either experienced or witnessed this kind of trauma.

New York City’s World Trade Center Health Registry reported that 20% of New Yorkers who lived below Canal Street (close to the World Trade Center) were estimated to suffer from PTSD following the 9/11 terrorist attacks in 2001 compared to 11% of all New York City residents. About 5% of 9/11 trained relief workers were diagnosed with PTSD as a result of just listening to stories from survivors of the attacks. Hardest hit among relief workers were those who were pulled off their regular jobs to perform tasks they were not prepared for – like the city’s sanitation workers who were assigned to help with search and rescue, or relief workers who spent more than 90 days at Ground Zero. Most relief workers showed no further symptoms six months later, but Twin Tower survivors themselves reported suffering PTSD symptoms up to five years after the attacks.

A Harvard Medical School study of survivors of Hurricane Katrina in New Orleans found ‘delayed onset’ PTSD symptoms that actually increased over the first two years following.  The worst-affected Katrina survivors were both close to the epicentre of the tragedy as well as abandoned on their own without help for far too long – both extremely dangerous PTSD risk factors.

For military personnel now serving in the current Middle East war, the PSTD numbers are frightening:

  • one in six soldiers will return suffering from PTSD
  • enlisted soldiers are twice as likely as military officers to report PTSD
  • women soldiers tend to suffer from more severe and debilitating forms of PTSD

And the newly released results of a 60-year study out of the University of Florida have shown that heavy combat exposure at a young age had a detrimental effect on physical health and psychological well-being for about half of the soldiers well into their 80s, These findings were published in the latest issue of the journal Research in Human Development.  But researchers point out that the Ivy League-educated World War II veterans studied for 60 years (all Harvard undergraduates from 1940-44) were probably much better off than today’s veterans because their educational background let them serve in better positions than the average enlisted soldier today.

Complete this assessment to learn if the symptoms you might be having are consistent with a PTSD diagnosis.

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(1) Ayers S, Copland C & Dunmore E (2009). A preliminary study of negative appraisals and dysfunctional coping strategies associated with post-traumatic stress disorder symptoms following myocardial infarction. British Journal of Health Psychology, 14(3), 459-471.

See also:

© 2009 Carolyn Thomas www.myheartsisters.org

Note:  information on this site is not intended as a substitute for expert medical advice. Please consult your physician for specific health information.



6 Responses to “Not just for soldiers anymore: Post-Traumatic Stress Disorder after a heart attack”

  1. Torontonian November 30, 2012 at 11:34 am #

    You are describing exactly my experience. Thank you for this very much. I thought I was going crazy after my heart attack, in a way I was,but thought I was the only one.

    Like

  2. Wiley Kindschuh October 7, 2012 at 8:56 am #

    PTSD can take a very long time to heal. You will need some professional help to manage it.

    Like

  3. Motorola November 20, 2011 at 2:51 pm #

    Thanks for this. Theres so much stigma in our society against mental illness, to admit that you’re having these kinds of bad symptoms (when you should just be happy to have survived your heart attack) is almost too much to expect so you just go bravely and silently on. Carolyn You have helped many survivors Im sure by running this info on PTSD. THANK YOU.

    Like

  4. Olive O. November 13, 2011 at 10:12 am #

    I am reading this post today feeling like you must have been eavesdropping on exactly what I’ve been going through since my heart attack/CABGx2 one year ago. I truly thought I was going crazy, thank you SO MUCH for this thorough and well-researched look at what cardiologists do not seem aware of yet. Its not just about patching us up in the O.R. and moving on to the next patient. Why do doctors not know this? They send us home with a big proud smile on their faces because they have just saved our lives but with not one word of warning at all about mental health issues that wait us once we do get home and back to “normal” life if that is even possible.

    I’m only just now coming out of what I think of as a lost year of my life, close to suicide many days, desperately afraid to talk about any of it and emotionally very ill, I see that now. Why didn’t I read this article one year ago? Why didn’t somebody forward this to my doctors back then?

    Like

Trackbacks/Pingbacks

  1. Explore Whats Next - June 21, 2012

    [...] Read more at Carolyn Thomas’s Heart Sisters: Not just for soldiers anymore: Post-Traumatic Stress Disorder after a heart attack. [...]

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  2. CABGx3 - July 30, 2011

    “Feelings of fear, anxiety and depression are common after a cardiac event. The findings of this study suggest that a high proportion of survivors experience very severe distress.

    Like

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