Sunday, 17 July 2016

How to keep your brain cool by managing your emotions/Stress levels to save your heart By Dr. RGS Asthana, Senior Member, IEEE

 How to keep your brain cool by managing your emotions/Stress levels to save your heart

By

Dr. RGS Asthana, Senior Member, IEEE

 



Prelude
Are your heart and brain completely separated from each other? The answer to this question is no.  One may argue that heart and brain are located in different regions of the body, and also their study comes under separate disciplines referred to as cardiology and neurology respectively.  But, in fact, these organs are very much connected and whenever your emotions adversely affect your brain, not only your heart but whole body is also affected. 
Let’s take an example where some people are reported to have heart attack when say, India loses a World cup cricket match. Similarly, one may have heart attack due to the shock (equivalent to very high level of stress) such as the death of a loved one, a break-up, or constant anxiety. The main reason is the emotional attachment; one has with Cricket or with the person which causes very high level of stress on some. This emotional stress may trigger adverse effect such as weakening of heart, particularly, on those suffering from heart disease. 
Intense emotion is a major risk factor for heart attack and stroke, specifically, in the initial hours after the emotion occurs.  Precaution includes steps like physical exercise, not smoking, and a healthier diet, it's just as important, therefore, to take care of your emotional health as well.
Effect of stress on a susceptible heart  
There are mainly two kinds of stress that impact your brain. Stress known as ‘eustress’ or good stress; helps you in getting things done as it assists you in focusing your attention.  Bad stress (distress) may lead to lethargy and even cause cardiovascular disease (CVD).
CVD is a class of disease that involves the heart or blood vessels. CVD, in fact, CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). The heart of patients with CAD may be deprived of oxygen due to stress. This deprivation is called myocardial ischemia and can occur in as many as 30% to 50% [1] of all patients with CAD. Please note that emotional stress further aggravates the CAD.    

Effect of stress on a heart with no disease

Stress/Emotions do have a big effect on your heart even if you have a healthy heart. Even in people with no prior heart disease, major depression doubles [2] the risk of dying from heart-related causes.
“ For every affection of the mind that is attended with either pain or pleasure, hope or fear, is the cause of an agitation whose influence extends to the heart, and there induces change from the natural constitution, in the temperature, the pulse and the rest”  - Dr. William Harvey, 1962

Cardiac psychology: Tending to your emotions for your heart’s sake

The term “Psychosocial” [also see Figure 1] broadly categorizes factors which are:
·        Psychological   – e.g., anxiety and/or depression.
·        Psychosocial – e.g., work stress, discrimination and/or emotional support.
·        Social-structural – e.g., socioeconomic status, social integration and/or neighborhood effects.
may trigger acute Cardic Events      
may necessitate medical intervent
 Figure 1  Phycho-social Stress and Cardiac problem
             
It is important to control your worry and stress [3] on top priority and ideally as soon as possible. This is so as there is elevated risk in case one has CAD/CVD. Estimated incidence of major depression in the US is 14%, but it goes up to 30% in cardiac patients. Depressed mood could also be due to combination of other symptoms such as weight change, sleep disturbance, insomnia, fatigue, feelings of guilt, worthlessness, and/or hopelessness.
It is, therefore, not only advisable to worry less and feel better but also because less worry keeps your brain cool and leads to reduced stress for your heart.  A new emotion-based approach to heart’s health, called cardiac psychology, is receiving increasing interest now a day. It helps you to change your brain in the positive direction and get a healthier heart in the process. Here are a few methods to follow:
·         Get professional help. 
Never ignore stress, anxiety, depression, excessive worry, or bouts of anger that engulf your life. Go to your doctor as early as possible and ensure you get right professional help to overcome your problem and protect your brain as well your heart.
·         Treatment using cardiac psychology techniques. 
The link between the mind and body including heart [4] has been studied over the centuries in many fields, such as medicine and psychology. Aside from more traditional psychiatric treatment and exercise, educational training, stress management, biofeedback, counseling sessions, and relaxation techniques should all be considered before or after a heart-related event.
Newer treatment such as acceptance and commitment therapy has shown some potential. It’s always advisable to familiarize yourself with the research effort in development and validation of the CVD Acceptance and Action Questionnaire (CVD-AAQ) for an Italian sample of cardiac patients [5].
·         Exercise. 
One of the major symptoms of aging includes a decline in cognitive functions, particularly, in the areas of executive function, processing speed and episodic memory. These age-related declines are further aggravated by CVD as well as also by the related causes such as hypertension, diabetes, obesity and raised total cholesterol.
Physical exercise in the right amounts can help achieve cool brain and a healthier heart. Various types of aerobic exercise, including jogging, swimming, cycling, walking, gardening and dancing help in reducing anxiety and depression [4, 6] and also help in improving self-esteem as these activities not only increase body temperature but also increase blood circulation in the brain,  thus, improving brain’s ability to react to stress.
The Surya Namaskar (see appendix ‘D’ [4]) is supposed to be a complete exercise by itself provided one is fit enough to do it properly. It can, generally, be practiced before any yoga routine. It helps warm up almost 95% of our muscles. It comprises of flowing series of 12 yoga postures [Steps] and brings great flexibility to the spine and limbs besides regulating breath and thus cooling your brain. It could be just the wake-up call you need.
Epilogue
Terrorism, such as, the attacks on the World Trade Center (WTC) on September 11, 2001, result in higher stress-related disorders, especially in those persons in close proximity where such an event occurs.  For example, after the September 11 terrorist attacks, heart attacks and abnormal heart rhythms surged more than 35 percent in Brooklyn area during the ensuing two months [7].  The events in Brooklyn are an extreme example of exposure to stress, but they show the close relationship between the heart and mind.
For many of us, stressful situations and anger are common in life. Many of us can control or suppress their feelings, but others find it difficult to control them. If you struggle with stress, anger, anxiety, worry, depressions, or problems with self-esteem, you need to seek immediate professional help — or preferably visit a cardiologist as you are in the high risk category. A consultation with a psychiatrist may also be very helpful. Together, you can find which therapy might best help you protect your psychological state, your brain as well as your heart.

References

[1] Heart-Brain Interactions in Mental Stress Induced Myocardial Ischemia by Robert Soufer, M.D., Hitender Jain, M.D., and Andrew J. Yoon, M.D. see abstract at

[4]. Chapter 4, 7, 8, 10 and Appendices on exercises entitled. ‘Exercises of mind’, ‘The mind-body connection’, ‘Relaxation Techniques’, ‘How to keep your heart Healthy’ and Appendix ‘D’ and ‘E’ respectively in book entitled, “Live Active and Healthy,” by Dr. Geeta Asthana, Dr. RGS Asthana and Dr. Naresh K. Sinha., Confluence International, pp. 224, ISBN 978-81-86425-90-9, pages 224, 2014.”

[5] “Development and initial validation of the Cardiovascular Disease Acceptance and Action  Questionnaire (CVD-AAQ) in an Italian sample of cardiac patients,” seehttp://journal.frontiersin.org/article/10.3389/fpsyg.2014.01284/full

[6] “Effects of exercise on anxiety, depression and mood,” see http://europepmc.org/abstract/med/15518309

[7]  ”Lose Your Temper and Risk Your Heart Health, ”  By T. Jared Bunch, MD,  Published Mar 13, 2014

http://www.everydayhealth.com/columns/jared-bunch-rhythm-of-life/lose-temper-heart-health-risk/



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