Four ingredients in the heart patient’s recipe for stress

by Carolyn Thomas

While what stresses you is different from what stresses your neighbour, the recipe for stress is universal. So are the four ingredients in this recipe, according to the Centre for Studies on Human Stress at the University of Montréal.

This Centre, by the way, is a remarkably helpful resource if you’re one of those people who have become so chronically stressed day to day that you no longer think this state of being is even abnormal anymore.

Your body’s natural response to psychological stressors – the release of stress hormones – can lead to poor health outcomes if it becomes chronic.

It struck me that the Centre’s list of four ingredients that reliably elicit this stress response are also those that make a heart disease diagnosis itself so continually stressful.  They include:  

Novelty:Something new you have not experienced before”. This could be having to learn a new computer software program that completely changes your work habits. Or expecting your first baby. Or surviving a heart attack and being diagnosed with heart disease.

Unpredictability: “Something you had no way of knowing would occur.” You have a moody boss with new demands every day. You learn that teachers will go on strike but you have no clue when. Or your ongoing chest pains may be signs of another heart attack – or they may be due to the anxiety of worrying about having another heart attack.

Threat to the ego: “Your competence as a person is called into question.” A new employee keeps asking you why you do things a certain way as if doubting your methods. Your child’s teacher confronts you about how much time you spend helping your child with homework. Or since your heart attack, you feel less competent at work, or are not able to return to work.

Sense of Control: “You feel you have little or no control over the situation.” You are in a hurry to get to an important meeting and you get caught in traffic.  The airline loses your checked luggage containing your bridesmaid’s dress for a family wedding this weekend. Or in spite of being a young,  fit non-smoker with no cardiac risk factors, you are diagnosed with heart disease, a condition that suddenly limits your participation in many of your favourite daily activities.

We do not develop stress-related problems like depression or heart disease simply by being exposed to stressors like these alone, according to the Centre for Studies on Human Stress:

“Being in situations that involve one or more of these four ingredients of stress causes the release of stress hormones. But the mere act of anticipating stressful situations can be worse than actually being in one because you can ruminate about it endlessly in advance, the whole time secreting stress hormones.”

This familiar example is given to illustrate how anticipating a stressful event can hurt us:

“At your weekly Tuesday staff meetings, one co-worker gets on your case every chance he/she gets. Knowing this, on Monday afternoon you start anticipating this stressor. You then may start thinking about it on Monday morning, then on Sunday night….”

For heart patients, anticipation of stressful events can include ongoing distressing symptoms, going back to the hospital for more cardiac tests, having to make appointments with a new specialist to treat new symptoms, or even hosting a special occasion family event in your home.

Find out more about deconstructing stress from the Centre for Studies on Human Stress.

Q: How do you cope when you’re feeling chronically stressed?

NOTE FROM CAROLYN:   I wrote more about how stress affects cardiac care in my book, A Woman’s Guide to Living with Heart Disease”.  You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press. (Use their code HTWN to save 20% off the list price).

See also:

Women’s Heart Disease and Chronic Stress

Do You Think Too Much? How Ruminating Hurts Your Heart

How Flexible Hours Can Lower Your Blood Pressure

Got A Minute? Try This Mini-Relaxation For Your Heart Health

A Heart Patient’s Guide To The Three Stages of Chronic Stress

In Praise Of Slowness: How ‘La Dolce Vita’ Can Help Your Heart

Is Family Stress Hurting Your Heart?

Poor Marriage = Poor Heart Health for Women


8 thoughts on “Four ingredients in the heart patient’s recipe for stress

  1. Pingback: Clinical Hearts
  2. “…But the mere act of anticipating stressful situations can be worse than actually being in one…” Very true for me. I’m a worrier, just thinking of what those stress hormones are doing to my coronary arteries now is enough to bring on more stress. A vicious cycle.


  3. These four stress “ingredients” are absolutely present during and after a cardiac event. 100% bang on. Thx Carolyn.


    1. Thanks 4M – I too was struck by how ‘bang on’ these four items were for heart patients, too.


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  5. Wow! You’ve done it again. You’ve just described my life.

    My workplace implemented a new computer system this year that has even the very tech savvy of us frustrated and I have to deal with it, use it, explain it to students everyday. But because I have approx. 200 more students than I should, I have no time to bring myself up to speed.

    My department merged with another that has a completely different and less people friendly culture. My new counterpart has half the number of students, wants to be my boss, has a sharp tongue, is confrontational and a bully. She questioned my professionalism because I don’t jump when she says jump. Our bosses supported me and begged me not to resign, offered me a raise, but didn’t tell her to knock it off.

    I started worrying on Sunday about the 3 two-hour meetings a week I had to have with her. Whether it was me or another she was attacking, it was horrible.

    Funny thing is it started showing up in my health. Imagine that. The cardiac rehab nurses begged me to find a way to reduce the stress for the reasons you outline, so this heart sister said goodbye to the extra stressors. I made good on that threat and 6 months later resigned.

    I wish I lived in a country where I could count on a healthcare system; luckily I can be covered by my husband’s, but what about all those that can’t?


    1. That IS an amazingly coincidental list of similar scenarios, isn’t it? 🙂 Congrats, my Heart Sister, on resigning from that toxic job. When even your rehab nurses start pointing out the bleedin’ obvious, you know it’s time to take action to preserve your emotional and physical health! And I’m also glad you’re covered by your hubby’s insurance – I’ve heard horror stories from American heart patients who are not so lucky.


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