Post-Traumatic Stress Disorder, Heart Attacks & Other Medical Traumas

Ever since the relapse of my kidney disease I’ve struggled with depression, with the close to twenty pounds I’ve gained because of the medication I have to take and fatigue. This relapse brings back the memory of all recurrences of the disease from the past and that’s a bummer. But I don’t have to worry about sudden death.

Not so for thousands of people who live with the memory of surviving a heart attack. A study reported by Tara Parker-Pope in today’s New York Times sheds light on what many of us in the behavioral health field have known anecdotally for a while. A significant number of people who have experienced a sudden cardiac event develop symptoms of post-traumatic stress disorder (PTSD).

It makes perfect sense. My first job as a newly minted psychologist was at Mt Sinai Medical Center in Manhattan where we studied and treated post-stroke depression. A stroke is another kind of “attack.” The survivors fought hard to recover from the physical effects but often overlooked how the experience was effecting them emotionally.

Both the study I was a part of many years ago and this more recent one out of Columbia University Medical Center, suggest that the presence of PTSD symptoms can contribute to poor disease management, like  not taking medication because taking it every day provokes strong negative feelings like anger, sadness, and underneath it all, fear: “I hate that I have to take this pill because it just reminds me of how fragile I am.”

Hypervigilance, can also be a problem. Those of us who live with chronic conditions that go in and out of remission fight with the ghost of hypochondria. Every little twinge, every little pain is like a sudden loud sound for a combat veteran. “Is it happening again?”  is a life and death question for heart attack, cancer and stoke survivors.

All this stress, sleep problems, anxiety, without proper diagnosis and treatment, may lead to the very thing cardiac patients wish to avoid, another heart attack. PTSD and depression probably also contributes to slower recovery as we found in our post-stroke depression study.

The good news is that PTSD is treatable with good psychotherapy and if needed, anti-depressant medication. If you or someone you know is having a hard time coping with life after a heart attack, or any life threatening sudden event please reach out to a good therapist. You can always call or email me.

Read more at Carolyn Thomas’s Heart Sisters: Not just for soldiers anymore: Post-Traumatic Stress Disorder after a heart attack.

Photo courtesy Sofia Francesca Photography

A Crazy New Age Idea: Always Be Positive

“I think this is one of the most toxic New Age ideas: that all patients should keep a positive attitude. What a crazy, crazy idea that is! It is much healthier, much more healing, to allow yourself to feel whatever it is that comes up in you, and to allow yourself to express it. Allow yourself to work with the anxiety, the depression, the grief.”

~Dr. Michael Lerner

My friend Carolyn Thomas, a heart attack survivor and founder of Heart Sisters, wrote this great article, A Heart Patient’s Positive Attitude: A “crazy, crazy idea”?

It’s about how we can be our greatest enemy by insisting on staying “positive” when the world is literally crashing down around us. She does me the honor of being among the professionals and experts she quotes. Read it! You’ll laugh and cry and laugh again – it’s that good.

Side bar! You have got to see this video Carolyn sites, starring Elizabeth Banks (whom I’ve adored ever since Seabiscuit.) “Just a Little Heart Attack,” sponsored by Go Red for Women.

Impress Yourself!

Photo by Stephen O’Bryan,

Today I was ho-humming along, feeling blah and uninspired. I knew I needed to write but the mojo wasn’t there. My muse had left the building. Then I stumbled upon this brilliant photograph by my friend and business coach Stephen O’Bryan. It was exactly what I needed today!

Here’s what Steve’s friend, Jason, commented about the photo: “…this is beautiful, in a lot of ways. The colors are SUPERB but again, it’s the story. Someone painted around this. I mean I’m sure it’s there on a white clapboard wall and then someone comes along with the job or desire to paint it blue, but they come to this and they leave it alone …. Why ? … Did they add the “yourself”?  It’s an amazing bit of storytelling.”

What is your story? How do you impress yourself? It’s a challenge but if you take the time to think about it I bet you could come up with at least two or three things you’ve done or are doing that are impressive! How about getting out of bed and taking a shower! Hey! That’s impressive for some of us, believe it! We can be our own inspiration!

Depression: What is it? What does it feel like? How is it treated?

The statistics on depression are depressing. About 5% of the world’s population suffers from depression at some time. In the US depression is the leading disability for people between 15 and 45 years of age. Chances are good that you or someone close to you has experienced depression first hand. There are so many myths and misconceptions around depression it is refreshing to watch this program, Charlie Rose Brain Series: Depression, where intelligent people explain what depression in all it’s forms looks like, can feel like and how it can be treated.

What I appreciate about this program is that these experts, the people who study depression as well as those who have experienced the worst kind of major depression first hand, all state that psychotherapy alone, or with medication, is a powerful treatment for depression. Too many physicians out there are very quick to treat their depressed patients with Zoloft, Wellbutrin or whatever, and do not bother to make a referral to a good therapist. Offering drugs alone may be depriving their patients of the most effective way to not just get them out of depression but to help them stay out. Depression, like anxiety, can relapse. Good psychotherapy provides people with psychological, emotional and behavioral tools that can be used as needed.

Medication is good. Psychotherapy is good. In combination, for some of the worse, most stubborn depression, they can be the needed one two punch.

Click here to view the program’s video. It is an hour long show well worth your time.

First Hide All the Mirrors: Chronic Illness & Appearance

I am vain. Generally I like how I look. Not beautiful, I am grateful to my mother (who was beautiful) for giving me a decent face. That face is now quite puffy and I can no longer fit into much of my wardrobe. I waver between extreme self-consciousness and forgetting about it until I look in a mirror or worse see a photo or video of my puffed-out, hollow-eyed self. The longer I live with the puffy face and body the more it’s become the new normal. Sometimes that just depresses me. Sometimes that helps with acceptance.

Illness and its treatment can alter your appearance until we don’t recognize who that person in the mirror is any more. It can make you gain or lose too much weight, drain your complexion, cause dark circles under your eyes, make your hair thin out or fall out completely… We feel we look old before our time. Make-up is a girl’s best friend but you can’t hide everything under concealer and blush. All of it can do a number on our self-esteem because we are attached to how we look. That’s not being vain, that’s being human!

What helps with acceptance? A huge thing for me is how kind and supportive people are. Family, friends and clients let me know the change in my appearance doesn’t matter to them. In the last few months I have heard several versions of “I know you are going through a hard time, I see it, but you are still beautiful.” Even when I am not in the mood to believe it, I feel their sincerity, the kindness. Allowing it to sink in makes me feel all warm and good inside.

How do you handle the changes in your appearance as a result of illness or treatment? Please share your wisdom or frustration! It’s all good!

Side bar!  A friend who knows how my puffy face makes me feel bad told me about Ashley Judd. She went through some very public criticism for her puffy face, the result of having to take steroids for an illness! She is very articulate about how the change in appearance can be criticized by society and how cruel that is towards all women!

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