Grief, depression and heart disease

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The impact of grief and depression on patients with a new diagnosis of heart disease, and on their loved ones who are caretakers, might vary, but it is likely to affect most on some level. It could be experienced as just a slight sadness for the loss of the carefree years when you could eat what you wanted freely, with little consciousness of the health consequences, but heart disease can also increase the risk of depression. This article from the University of Iowa explores the relationship between depression and heart disease, noting that “A balanced diet will make you feel better, improve the health of your heart, and decrease your risk of heart disease.”

Grief, at some level, follows loss, and dealing with heart disease can mean a profound loss of freedom. The groundbreaking classic, “On Death and Dying,” by Elisabeth Kübler-Ross, was one of the most influential books of the 20th century in the psychological community. In it, Dr. Kübler-Ross explored the following five stages of grief: denial, anger, bargaining, depression and acceptance.

Besides a loss of food freedom, a newly diagnosed patient has a temporary loss of physical stamina (which can last for months, depending on the treatment), a loss of personal freedom during the hospitalization, and perhaps a loss of the opportunity to achieve some immediate or long term goals and dreams.

For example, even the simple 10-pound weight restriction that lasts for several months after open heart surgery can trigger several reactions:

  • Denial: refusing to follow doctor’s instructions;
  • Bargaining: looking up the weight of everything from water (26 pounds for a 24 pack of 16 ounce water bottles) to a grandbaby (usually well in excess of the limit) or pet; trying to convince their caretaker that pushing, dragging or pulling is not the same as lifting (it is; see your doctor’s instructions);
  • Anger: arguing with their caretaker over what things weigh or whether the restriction “should” still be in effect; and
  • Depression: not wanting to do anything at all, because it seems like everything hurts and nothing is allowed.

According to Dr. Kübler-Ross, some iteration of each of these stages, short or long, precedes the final stage of acceptance that is necessary to move on with life.

As with the other challenges of this new lifestyle, both patient and caretaker need to be aware of what is going on when these reactions pop up, and need tools and strategies for facing them.

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