Even heart patients can learn to be optimists


by Carolyn Thomas  @HeartSisters

I’ve been ruminating (something that female heart patients apparently tend to do when feeling depressed) about the writing of Dr. Martin Seligman, professor of psychology at the University of Pennsylvania and author of the excellent book, Learned Optimism. He writes:

“Optimism is not about ignoring what’s real, but becoming aware of your thoughts about why things happen.”

What’s really at the heart of optimism, Dr. Seligman adds, is how you explain negative experiences to yourself. When something bad happens to a pessimist, she’s likely to get into a sort of dark and hopeless mental muttering that has her thinking things like:

“Why me? Ain’t it awful? It’s permanent and everything is ruined and it’s all their fault.”

But the optimist’s explanation?

“It was bad luck, I’ll be able to handle it, I learn from all my experiences.”

With this kind of reasoning, an optimist feels a greater sense of control over her future – and her health.

This is particularly important for heart attack survivors, because we know that the body’s stress hormones like cortisol are particularly damaging to delicate coronary arteries.

Optimism’s negative sibling – pessimism – may lower your resistance to illness, increase your chances of heart disease and even shorten your life, researchers say.

What if ‘grubbing in the garden of gloom’ has been your lifelong habit? You can learn to cultivate a more upbeat attitude, and it’s never too late to start, says Dr. Seligman.

“I’m a born pessimist myself, so I’ve had to learn techniques to help pull me out of the mire.”

Some people face overwhelming adversity and still call themselves optimists. Why?

“When you’re optimistic, you’re also believing: ‘I can make the most of what I have.’ Sometimes you need to redefine your objectives and let go of initial expectations. Then your basic objective is still to make the most of what you have.” 

Research reported in the Journal of Personality and Social Psychology suggests a tendency to idealize our past happiness.(1) This is apparently true for both lottery winners and paraplegic accident victims. Each group, according to this study, shows signs of what’s called adaptation level theory. This theory maintains that lottery winners, for example, tend to contrast ordinary pleasures post-win with that peak experience of winning, thus reducing the value of new expensive pleasures that are now made possible by their winfall. Compared to the control subjects, lottery winners were not happier than the controls and “took significantly less pleasure from a series of mundane events”.  And the paraplegics studied also demonstrated what’s known as a contrast effect by idealizing their past, which did not help their present level of happiness.

Chronically unhappy people also tend to do a running negative commentary on their lives while also blaming others – and they’re often not even aware they’re doing it. Dr. Seligman explains:

“If you’re a real pessimist, odds are you’re fairly depressed. It’s a good bet that undergoing therapy for depression will make you physically healthier and dramatically improve your life.”

Cognitive behavioural therapy, during which you learn to challenge defeatist ways of thinking, can be particularly helpful in this case.

In the normal reaction to an acute emergency, your body’s adrenal glands release the stress hormones adrenaline and cortisol. According to the Harvard Mental Health Letter, your heart speeds up, blood vessels are constricted, and clotting factors in your blood are activated as preparation for a possible injury. This natural response burdens your heart muscle and reduces the supply of blood to your coronary arteries.

“Persistent high levels of these stress hormones can make the heart less sensitive to the signals it uses to adapt its pumping action to changes in the body’s demands. This reduction in heart rate variability raises the risk for serious rhythm disturbances, including ventricular fibrillation, the sometimes deadly rapid and uncoordinated contractions of the lower chambers of the heart.

“Stress hormones also stimulate the production of inflammatory substances and oxygen free radicals, the destructive byproducts of metabolism that can damage the lining of coronary arteries.”

We know that women are diagnosed with depression about twice as often as men are, and depression is strongly linked to heart disease. (See links below). Depressed people are more at risk for developing heart disease, and heart disease patients are more at risk for suffering depression.

The possible reasons given that women are more likely to be diagnosed with depression vary widely – from genetic differences, stress levels and workload pressures to women’s greater willingness to actually recognize their depression symptoms and then seek help compared to men.

But Dr. Susan Nolen-Hoeksema of Stanford University disagrees.

An important clue may lie in the different ways women and men respond to depressing thoughts and situations, Dr. Nolen-Hoeksema suggests. For example, studies have shown that:

  • men tend to take action to distract themselves when depressed
  • women more often analyze and brood over their state – a ruminating process that may deepen pessimistic feelings

Find out more about Dr. Martin Seligman’s work in this short BBC News interview.

See also: 


(1)  Brickman, Coates, Janoff-Bulman et al.  Lottery winners and accident victims: Is happiness relative? Journal of Personality and Social Psychology, Vol 36(8), Aug 1978, 917-927.

4 thoughts on “Even heart patients can learn to be optimists

  1. Pingback: Sick With Optimism
  2. “..Chronically unhappy people do a running negative commentary on their lives while also blaming others – and they’re often not even aware they’re doing it..”.

    AMEN to that. I have a friend who seems more and more obsessed with every little twinge as the years go by. She’s absolutely convinced that each twinge is a signal of some probably fatal diagnosis, spends way too much time visiting doctors and specialists demanding expensive test after test after test (all normal of course!)

    The more she goes on, the more I want to back away, but she seems oblivious to the turn-off effect this “I’m sick – I really AM!” monologue is having on her friends and family.


  3. Useful info here on optimism. But it can be very hard to somehow be positive all the time when also coping with shortness of breath, extreme weakness and ongoing heart failure symptoms day after day with no improvement indeed with more and more decline. Some days it’s all I can do to get myself up and dressed in the morning.This doctor seems to be saying I should pretend none of this is going on and I’m just like my old healthy self used to be.


  4. This is such good advice not only for heart patients but for all of us. It’s just too easy to become so self-absorbed with every little problem and then this can evolve into a self-fulfilling spiral downwards.


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