Dr. Phil McGraw and Dr. John Whyte
This is the first in an exclusive series of columns by Dr. Phil McGraw and Dr. John Whyte on issues involving mental and physical health.
Chronic depression, loneliness and grief are breaking our hearts – literally.
New research reveals that poor mental and emotional health puts Americans at much greater risk of heart disease, the leading cause of death for men and women across almost all racial and ethnic groups.
It’s no exaggeration to say that when it comes to preventing heart disease, managing our emotional and mental health is just as important as managing our cholesterol and blood pressure. Yet most people – and even many doctors – don’t fully understand the relationship between feelings and physical health.
Today, we have a better understanding than ever of how heart disease develops. Studies show that genetics account for about a quarter of an individual’s risk profile, while lifestyle accounts for the remaining three-quarters. That’s good news, because it means that for most of us, healthy choices can significantly lower the chance of developing heart problems.
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Of course, diet and exercise matter. But learning to recognize and manage stress and depression also should be a part of risk reduction efforts.
Table of Contents
Serotonin and dopamine levels affect health of your heart
Depression wreaks havoc on the body’s natural chemical balance by lowering levels of serotonin and dopamine, the “happy hormones.” These hormones regulate sleep, mood, motivation and other functions. That means they also play a huge role in heart health, because those are part of that major lifestyle influence.
For every mood, emotion and thought you have, there is a corresponding physiological event. If you doubt the one-to-one relationship, test it yourself. Close your eyes and think about biting down into a really crisp, crunchy dill pickle. Imagine the dill vinegar smell as it permeates your mouth and you chew it. What happened? We bet you began to salivate. No one touched you or gave you anything. You just had a thought.
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More to the point, researchers have found that when a person with low serotonin experiences emotional duress, the body produces more inflammatory compounds such as interleukin-1. When you experienced thoughts of the dill pickle, your body produced saliva. But in the case of stress, it can lead to plaque buildup in arteries, the formation of blockages and other dangerous cardiac conditions. Serotonin also helps regulate heart rate and rhythm, blood clotting and other critical heart functions.
‘Broken heart syndrome’ is real. What the American Heart Association found
Study after study confirms the negative impact of depression on heart health. The American Heart Association found that people with clinical depression have a greater than 30% chance of developing atrial fibrillation – a chronic condition that causes abnormal heart rhythms – compared with nondepressed people. And a review of more than 22 studies, which together looked at more than 500,000 subjects, found that people with depression were at increased risk of heart disease.
Meanwhile, profound grief and sadness can cause Takotsubo cardiomyopathy, also known as “broken heart syndrome.” In the wake of a personal tragedy, the body releases a surge of stress hormones, which strain the heart and alter the shape of the left ventricle.
Chronic stress also increases our risk of illness. Stress causes our blood pressure and adrenaline levels to rise. That’s a good thing when we need to jump out of the way of an oncoming bus or brace for a fall. But constantly elevated blood pressure makes our arteries less elastic.
The reduction in blood and oxygen flow can result in heart failure. Blood pressure medication can help, but so can reducing our stress levels. Research confirms that physical and mental relaxation for five to 10 minutes a few times a day can have a stress reducing effect. Actions as simple as deep breathing or imagining pleasant scenery can have a significant impact.
Left unmanaged, even a single acute stressful event can increase the risk of heart disease. For example, one study found that the rate of heart attacks in New Orleans nearly tripled in the years immediately following Hurricane Katrina. For many people, stress levels went off the charts during the pandemic and could have lingering effects on physical health.
Of course, we all experience sadness and stress at times, which is completely normal. But clinical depression and chronic stress are different. Too many of us are uncomfortable talking about mental health and emotional well-being. Yet their adverse impact on physical health can be direct and dangerous.
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Know the signs of depression, stress
Diagnosis is the first step toward reducing risk. That’s why it’s important for folks to talk with their doctors about screening for depression or stress. The patient health questionnaire and perceived stress questionnaire (available online and in many doctor’s offices) can help people determine whether they’re suffering without even knowing it.
Some people never realized they were highly stressed or depressed until they weren’t! Maybe they finally escaped a toxic, emotionally damaging situation they had lived with for so long they just thought it normal. Or perhaps during counseling for marital or parenting issues, their chronic stress or depression was discovered. But by then damage may have been done.
Trying to self-diagnose can be fraught with danger – but recognizing basic red flags can be important. Changes in grooming habits, loss of interest in previously enjoyed activities or decreased social interactions, changes in appetite and changes in sleep patterns can all be signs of depression, anxiety and chronic stress. So can prolonged periods of anxiety, sadness or hopelessness.
The good news is that in addition to medication, there are many ways to effectively manage depression and stress. Yoga, for example, can release endorphins and calm the body. Talking with a loved one or mental health professional can relieve anxiety. Numerous studies have shown that regular meditation can improve the well-being of people of all ages. Simple things, such as prioritizing quality time with friends, can have a profound impact on our emotional health.
The connection between our emotions and our hearts isn’t just figurative. People really can die of a broken heart.
Dr. Phil McGraw, one of the most well-known mental health professionals in the world, is the host of one of daytime TV’s top-rated program, “Dr. Phil.” Dr. John Whyte is chief medical officer of WebMD.