Once your heart has been repaired, allow time for healing the mind, says Dr Sharon Frewen, a clinical psychologist specialising in cardiac rehabilitation, who believes patients who have suffered a heart attack should attend at least one session with a psychologist in this field.
“After surgery, experiencing depression and anxiety is normal,” she says.
What psychological effects can be expected?
After major cardiac surgery – or a heart attack – it is absolutely normal for patients to experience a shift in mood characterised by emotions such as depression, anxiety, anger, fear and frustration.
These can manifest immediately after surgery and continue for three to four months, or longer if left untreated. In some patients, who initially feel physically well after surgery but fail to manage their emotional reactions, these issues can persist until treated.
Why the psychological fallout?
There are several factors:
- Having undergone a life-threatening experience and having to face one’s mortality.
- A loss of trust in one’s body.
- A sense of ‘why did this happen to me?’ or ‘life isn’t fair’.
- A feeling of loss of control.
How to heal body and mind
Dr Frewen suggests that the best healthy-mind, healthy-body regime involves avoiding the behaviour patterns that precipitated heart disease in the first place. “People underestimate the impact of stress on heart disease,” she says. “Returning to bad habits can put your recovery at risk.”
She believes therapy is also essential. “Patients should be referred for psychological help as a matter of course post-op, as importantly as taking your meds is. Unlike overseas, in South Africa patients are left to figure out that they need help. Frequently, individuals feel lost and helpless and do not know that they are depressed and that they can be helped.”
On the physical side, Dr Hewitson says the single most important behaviour change necessary for improved cardiac health is to stop smoking, as it causes the arteries to narrow and aggravates the effects of any obstructions. And, adds Dr Frewen, if smoking is being used to deal with stress, the patient will need to find a new way of coping.
- [This is an edited version of an article by Jacqui Zurcher, as published in HEART Magazine, August 2006. The current edition is on sale now.]