Since returning from my 2008 WomenHeart Science & Leadership training at Mayo Clinic, I’ve spent a lot of time meeting, listening to, speaking with, writing for and hearing from countless other heart patients. Once the dust settles immediately following a cardiac diagnosis – that time my heart sister Jodi Jackson engagingly calls “post-heart attack stun“ – I’ve observed that a recurring theme among so many of the freshly-diagnosed is a sense of anger at what has just hit them.
Here’s a fairly typical example.
A woman I met recently had spent decades making good health an important priority in her life, and then – WHAM! – a heart attack, out of the blue. Her subsequent anger is hardly surprising: “How could this have happened to ME, of all people? I’ve been doing everything right! I never saw this coming! And now you’re telling me that I’m stuck with this chronic and progressive medical condition for the rest of my life?!?”
Here’s how the Glasgow National Health Service helped to explain this common reaction:
“Some people feel angry that they have had heart problems. They may feel they have ‘done all the right things’ and that their heart condition is unfair. Thoughts of ‘why me? why now?’ are common as we begin to realise things we thought would never happen to us, DO happen.
“Sometimes being angry with others – or at yourself – is a way of covering up underlying fear and anxiety.”
Sometimes, by the way, “being angry with others” can extend to people you don’t even know.
I went through a period like this in the early days after my Dad, a non-smoker, died at age 62 of metastatic lung cancer. For a time after his death, I became really annoyed at old people. All old people. Any old people. I’d watch them with barely concealed outrage while they shuffled slowly across the street. Why were these useless old folks still alive when my own fit and active father was dead?
Sometimes our anger is simply misdirected. We’re angry because of this new diagnosis, and we’re reminded how ticked off we are every time we have to take those pills we’re expected to take every day for the rest of our natural lives, or modify our diet, or interrupt our lives for cardiac rehab classes and medical appointments.
And what if part of you now feels guilty for past behaviours that you believe may have contributed to your current condition? Sometimes heart disease survivors can feel upset or angry at themselves, especially if they – or somebody they care about – suspects that their lifestyle choices might be at least partly responsible for what’s just happened.
Whether they’re mad at others or mad at themselves, no wonder heart patients can feel so ticked off. Surviving a cardiac event can seriously affect careers (as happened to me), finances, personal relationships, quality of life, basic daily decisions, and even one’s sense of self.
As I’ve written previously, something you’ve taken completely for granted so far (that your heart would simply continue to beat regularly and pump blood like the owner’s manual says it’s supposed to do) has suddenly and catastrophically let you down – which means you may feel like you can no longer trust the heart that has betrayed you like this.
And there’s something else: unlike cancer patients, for example, who fear the external enemy that has somehow invaded their bodies, heart patients fear the threat that actually lives within.
The American Heart Association warns that extremes of emotions can affect at least two important aspects of life after a cardiac event:
- our recovery from that event
- our risk of having a future heart issue.
That’s why the AHA says it’s important to understand those feelings, recognize problems and get help when needed. For example:
” Many heart patients feel angry and upset about what’s happened to them. But frequent or extreme anger can cause your blood pressure and heart rate to rise, and make your heart work harder. Sometimes anger also causes angina (chest pain) because vessels narrow, reducing blood flow and oxygen to the heart muscle.”
Anger can be a problem if you find that you often:
- lose your temper
- feel rage at people who are in your way in daily situations, such as at work, in traffic or waiting in line
- feel that people around you aren’t skilled or useful
- don’t trust the people around you
Jenni Prokopy, who blogs at Chronic Babe, has written about emotions, including anger – which she describes as “completely normal” – among those living with a serious health condition. I liked her wise take on how to manage that anger:
“Diagnosis of a chronic illness is one of the most stressful life events we can imagine. Even 17 years since my own diagnosis, I can still get pissed off and bummed out. But my solution is coming back to the concept of acceptance, recognizing that illness is part of my life and isn’t going anywhere.
“But if we fight our illness when we’re angry at ourselves and at our body for being sick, we’re fighting facts, we’re fighting with ourselves, fighting things we don’t have control over. Getting angry at our illness causes self-harm. And don’t we already have enough pain and suffering without causing ourselves more though anger at our situation?”
“Because I’m not perfect (no one is!), I still get angry, but the trick is to try to spot it early on and pause that process. One way I do that is to make a list of behaviours that show up when I’m feeling grief or anger, and then watch for those behaviours as signs I’m headed to a dark place.
“Rely on your team! Your friends, family, your manicurist, your mailman, anybody who will hear you out and not let you host an enormous pity party. It’s fine to talk through feelings of anger, but then you need to get back to a happier place.”
Social worker Stephanie Best had some other good suggestions in her Psych Central column to help patients manage those angry feelings, and most of these focus on challenging the way the chronically ill may think about their reality:
- When you’re angry, you tend to believe you’ve been wronged in some way. You know this is happening if you find yourself accusing others with the words “you always…” or “you never…”
- Remind yourself that acting out your anger in hurtful ways runs the risk of turning away the very people who might be most able to help you.
- Talk to those close to you using words and a tone that is more likely to get you the results you want. For example: “I know you are really busy, but could you please ______?”
- Exercise! Take a walk or do some simple stretches to relax your muscles.
- Remind yourself that frustration and powerlessness are a part of daily life for everyone – whether they live with a chronic illness or not. Stop thinking of yourself as a poor victim.
If it starts to feel like your anger is out of control, or if your anger is affecting your relationships with others and/or your health (blood pressure, sleep, diet), consider seeking professional counseling to help you through this.
Please don’t let the short-term anger that’s so common after a serious diagnosis morph into a toxic longterm way of life.
Q: What has helped you manage angry feelings about your diagnosis?
NOTE FROM CAROLYN: I wrote much more about coping with life after a cardiac diagnosis in my book “A Woman’s Guide to Living with Heart Disease“. You can ask for it at bookstores (please support your local independent bookseller!) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher Johns Hopkins University Press (if you use their code HTWN , you can save 30% off the list price).