Dealing With the Emotional Side of Coronary Artery Disease

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

Sylvester, a 63-year-old custom baseball bat maker in Big Bear, CA, did everything he could to outsmart his genes. He didn’t smoke or drink. He exercised and ate a low-fat diet.

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

A Life-Changing Diagnosis

Coronary artery disease is the most common type of heart disease. With this condition, sticky plaque builds up in your arteries and can cause chest pain, shortness of breath, and even a heart attack. Some people react 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 overdrive mode and dive headfirst into their concerns, working day and night to address it at the expense of their own rest and well-being,” she says.

Sylvester had lived in fear of a heart attack since he was a teenager. That fear escalated when a friend died of a heart attack in the middle of a bike ride.

“He was sort of like me. He didn’t smoke, he didn’t drink, he exercised, his weight was good.” Sylvester thought he, too, might die a sudden death.

Sylvester’s anxiety is not unusual. About 1 in 3 people with heart disease have depression and anxiety. Poor mental health in turn makes it harder to heal from heart disease.

It helps to be as kind to yourself as you would 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 linger more than a couple of weeks, or if you’ve had thoughts of suicide.

How to Manage Your Emotions

Ironically, Sylvester finally gained relief from his constant worry about a sudden fatal heart attack when his doctor confirmed that he in fact had coronary artery disease.

The diagnosis, he says, means “I no longer live year after year wondering if I have heart disease or if I am suddenly going to drop dead from a heart attack.”

Once you come to terms with your illness, it may help to confide in close family and friends. If you want to keep your CAD diagnosis private, that’s OK. But sharing the news with others gives them a chance to offer valuable support.

You also can connect with a community, either online or in person, of people who understand exactly what you’re going through. Look for support groups that focus on coronary artery disease in particular or heart disease in general. You’ll find them on social media or through organizations such as the American Heart Association. Find a group that helps ease your anxiety and to 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 during their cardiac rehab also had a type of therapy called metacognitive therapy, 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 trouble.

“Take time to tend to these other parts of yourself so that it doesn’t feel like your diagnosis or medical condition becomes your entire life,” Torres-Mackie says. “This might 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 disease helped buffer him from the emotional toll of living with a serious condition.

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