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Dealing with the emotional side of coronary artery disease

Bill Sylvester knew most of his life his heart could give him trouble one day. His family’s history of heart disease goes back at least three generations. His mother, three uncles and two grandparents all died of the disease before the age of 65.

Sylvester, a 63-year-old manufacturer of custom baseball bat in Big Bear, CA, did everything he could to outwit his genes. He did not smoke or drink. He exercised and ate a low-fat diet.

But eventually Sylvester noticed heartburn-like symptoms in his chest, especially during uphill walks with his wife and dogs. Over time, it spread to his neck and arms. In 2015, doctors discovered three partially blocked veins and diagnosed him with coronary artery disease.

A life-changing diagnosis

Coronary heart disease is the most common type of heart disease. With this condition, sticky plaque builds up in your veins and can cause chest pain, shortness of breath and even a heart attack. Some people respond to the diagnosis with panic, anger or numbness, says Naomi Torres-Mackie, PhD, a clinical psychologist at Lenox Hill Hospital in New York City and head of research at The Mental Health Coalition.

Still others “go into exaggeration mode and dive head first into their worries, working day and night to address them at the expense of their own rest and well-being,” she says.

Sylvester has lived in fear of a heart attack since his teens. That fear increased when a friend died of a heart attack in the middle of a bike ride.

“He was kind of like me. He did not smoke, he did not drink, he exercised, his weight was good. ” Sylvester thought he might as well die a sudden death.

Sylvester’s anxiety is not uncommon. About 1 in 3 people with heart disease have depression and anxiety. Poor mental health in turn makes it more difficult to cure heart disease.

It helps to be as kind to yourself as you would be to a friend. Give yourself the same pep talk, support and encouragement you would offer your loved ones.

Sometimes you may need professional help if your sadness, anger, anxiety or other emotions persist for more than a few weeks, or if you have had thoughts of suicide.

How to manage your emotions

Ironically, Sylvester was finally relieved of his constant worry about a sudden fatal heart attack when his doctor confirmed that he actually had coronary heart disease.

The diagnosis, he says, means “I no longer live year after year and wonder if I have heart disease and if I am going to die suddenly of a heart attack.”

Once you have come to terms with your illness, it may help to trust your immediate family and friends. If you want to keep your CAD diagnosis private, that’s fine. But sharing the news with others gives them a chance to provide valuable support.

You can also connect with a community, whether online or in person, of people who understand exactly what you’re into. Look for support groups that focus on coronary heart disease in particular or heart disease in general. You’ll find them on social media or through organizations like the American Heart Association. Find a group that helps you alleviate your anxiety and learn about new therapies and other useful information.

A counselor can also help you process your feelings about this new diagnosis. One study found that for 1 in 3 people who also had a type of therapy called metacognitive therapy during their cardiac rehabilitation, which helps you control negative thoughts, saw their anxiety and depression improve for up to a year.

Finally, take care of yourself both mentally and physically. And remember the parts of your life beyond your heart problems.

“Take time to look at these other parts of yourself so that it does not feel like your diagnosis or medical condition is becoming your whole life,” Torres-Mackie says. “It may be a scary new chapter, but you’re still the person you were before the diagnosis.”

For Sylvester, learning as much as he could about his illness helped him resist the emotional toll of living with a serious condition.

“It’s much less stress and anxiety to know what my condition is and the knowledge that the artery is now open again with the help of a stent and that I can resume normal activities,” he says.

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