When being married makes being sick worse

by Carolyn Thomas  ♥ @HeartSisters

Research suggests that being happily married can have a big effect on helping us recover from serious health crises like a heart attack. For men, in fact, marriage doesn’t even have to be particularly happy to increase positive health outcomes. Just the mere state of being married, happily or miserably, apparently leads to better outcomes in males.

But not so for women. Researchers from the University of Utah, for example, tell us that after 15 years of follow-up, researchers found that 83% of happily wedded wives were still alive after their cardiac bypass surgery, versus only 28% of women in unhappy marriages.  They also found that women who report high levels of marital strain also report depression, high blood pressure, high LDL (bad) cholesterol, obesity and other signs of metabolic syndrome - a cluster of known risk factors for cardiovascular disease. And in 2006, the American Journal of Cardiology published a study that found patients with both severe heart disease and poor marriages had a four times higher risk of dying over a four-year period.

So consider for example, how the day-to-day reality described by these heart patients might affect their prognoses:    

VC, age 51: 

“My marriage was really not that great when I got sick. I had been unhappy for a long time and my husband had sent some pretty heavy hints that he could care less if I live or die.

“I woke him up at 3 a.m one morning and told him I was having a lot of chest pain and needed to be taken to the E.R. He got up, took a shower, ate breakfast, then said he was ready to take me. The entire time I was waiting on him, writhing in pain and wondering what the hell he was doing.

“If I get through this alive, I don’t think my marriage will survive. You tell me how much this man loves me or even likes me. I have a 9-year old daughter and a very, very unhappy marriage.”

RT, age 57: 

“I know my husband is put off by having to do things I ask of him. Even after surgery or during one of my really bad days. I’d rather do for myself than to even ask him.

“I care for him mostly, he’s got mild cognitive impairment, diabetes, Hepatitis C, is a recovering alcoholic and was a casual drug user. 

“Lately I’m wondering if I’m going to be able to handle caring for him long term. I just wish there was someone caring for me when I could use help.”

HI, age 48:

“Since 2007, I’ve had bypass surgery, two cardiac stents implanted, cardiac ablation, and Coronary Microvascular Disease. My hubby believes (false beliefs can be as strong as truth) that my illness is a personal rejection of him.

“After years of me waiting on him, taking care of him and everything else, I can no longer do it, so he feels rejected -  like he’s getting a bum deal.

“Of course, in a healthy relationship the hubby would be there for his wife.”

SY, age 55:

“Because I feel less-than-great and activities requiring more than a little puff are exhausting me, I guess I have crossed over to the other side; I’ve had a ‘widow maker’ heart attack and now have congestive heart failure.

“I am having a LOT of problems with my husband, who totally believes that I made myself ill. What a load of codswallop. I can barely lift my head in the morning, and at night I collapse in a dead heap. I am working full-time.  I am terrified, and what is going to happen to me?”

IH, age 59: 

“When I was first told by my doctor that I had a problem with my Aortic valve, I was quite upset.  I was to go grocery shopping after this trip to the doctor’s office, but needless to say I did not go shopping. All my husband said when he found out about my diagnosis was: ‘Well, I guess there will be nothing for supper!’ Now you know why he is my ex . . . “

BZ, age 58:

“I had my sudden, out-of-the-blue heart attack on Mother’s Day 2011. My son asked me ‘What’s wrong, Mom?’  My husband denied I was sick. I wanted to go to the Emergency Care Center near our home. Hubs said: ‘Take a pill and lie down, it’s just anxiety!’  He argued with me and my son all the way to hospital.  Twelve hours later,  I woke up in the intensive care unit after a triple bypass and two stents implanted from having three Spontaneous Coronary Artery Dissections. The cardiologist said if I hadn’t arrived just when I did, I would have died.

“But nothing changed in how my hubs treated me. All week in the hospital, my hubs kept telling me I didn’t have a heart attack. On discharge day, I asked the doctor in front of him if indeed I had a heart attack, and the doctor looked at me with a look of incredulity and said ‘Of course you did!’ Hubs had nothing to say.

“He never went to any follow-up appointments with me. Two months after the heart attack, he ranted at me in front of my best friend about how lazy I was and how he’d had to do everything around the house for the last eight weeks and he was exhausted! 

“PS: It is now over a year later and I live by myself. I choose life on my terms now. I don’t need to take care of a cold, unfeeling man.  And now I feel so much lighter! If they can’t be empathetic when we’re healthy (and we knew this), then they won’t be there for us when we’re sick.”

♥  ♥  ♥ 

My own non-professional advice to these women and any others struggling with both a chronic diagnosis and a toxic relationship:

“Bottom line: this guy is killing you on the installment plan. Get out now while you still have the strength to leave a sizeable boot print on his sorry ass.”

In short, the state of being married is not necessarily a guarantee that women will be supported by their spouses during recuperation from chronic illness.

And what about single, divorced or women who are “between husbands”?  After accounting for a variety of factors, the University of Utah researchers reported no statistically significant differences between outcomes of happily married female heart disease survivors and their unmarried counterparts.

Negative interpersonal behaviours, such as hostility and criticism during conflict in married relationships, have been linked to negative impacts on mental health. In fact, according to a 2003 article in the Journal of Health and Social Behavior, single people tend to have better mental health than those who remain in a tumultuous marriage.

And a 2009 study of married couples conducted at the University of Washington in Seattle found that men are seven times more likely to leave a relationship because of their partner’s serious illness than wives are.

The prognosis, for women particularly, seems directly linked to marriage quality.

Dr. Sheldon Tobe of The Heart & Stroke Foundation adds that even though women are more physically affected by marital relationships than men are, these effects can actually work to our benefit.  His research showed that a happy marriage, for example, could help cancel out the blood pressure-raising effects of a very stressful job:

“We found that women who had a supportive spouse at home were more immune to the effects of job strain. However, people who had less supportive spouses or who experienced stresses from their relationships at home were much more sensitive to the effects of job strain.”

Another report from the American Psychological Association helps to explain this:

“Wives need to feel satisfied in their relationships to reap a heart health dividend, but the payoff for marital bliss is even greater for women than for men. The quality of a relationship weighs heavily on the chance of survival for women. Women in fulfilled relationships have a survival rate of nearly four times that of women in unsatisfying or unhappy marriages.”

♥  ♥  ♥

And speaking of happy marriages . . .   I’d like to wish my favourite daughter Larissa sunshine and blue skies for this Saturday’s picturesque farm wedding as our family and friends celebrate her marriage to her longtime sweetie, Randy.  Big hugs and kisses to both of you from your very happy Mama!

See also:

• Poor Marriage = Poor Heart Health For Women
• Women Heart Attack Survivors Know Their Place
• Marriage Triples our Bypass Surgery Survival Rates – But Only if it’s Happy

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Q:  How has the quality of your marriage affected your own health?

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Tags: congestive heart failure, heart disease and marriage, metabolic syndrome, poor marriages and health