Heart disease, even mild, is associated with major depression and cognitive issues. Doctors & nurses who've worked in both cancer wards and cardiac hospitals universally agree that terminal cancer patients tend to be rays of sunshine compared to even mild heart disease patients, with their gloomy, Eeyore-like dispositions, short tempers & generally downbeat personalities. This has long befuddled scientists, who often speak vaguely about the "rhythm of life," "two-way relationships" between the heart and brain as well as posing the question as "Well gee, how could depression cause heart disease?"
But in my feeble non-expert brain, the association probably works the other way around: clogged arteries and small blood vessels caked with calcium deposits due to atherosclerosis impede the flow of blood--and thus oxygen and vital nutrients--to the brain, resulting in the hideous symptoms we refer to as depression: fatigue, malaise, pessimism, dysphoria, suicidal thoughts, hopelessness, etc. There's also a well-established link between inflammation and certain types of depression thanks to drugs like interferon, which almost universally causes severe depression in hepatitis patients via its effect on cytokines: an immune cell that mediates inflammation. Foods high in sugar and saturated/trans fat (among other additives & unhealthy ingredients) are known to induce inflammation throughout the body.
Finally, the brain has a sort of "clean-up" system known as the glymphatic system that helps remove debris when working properly. It's comprised of cerebrospinal fluid and works similarly to the lymphatic system which doesn't extend to the brain. It removes both excess proteins as well as wastes like lactate & carbon dioxide that are thought to contribute to the development of Alzheimer's disease over time when the glymphatic system is not working properly. What keeps it working properly you ask? Exercise, deep sleep & a diet high in polyunsaturated fats to name a few things.
All these things taken together likely account for the low mood, slowed thinking and general lack of vitality in heart disease patients if I had to guess. The heart is the body's central pump within the cardiovascular system, but we can't overlook the other part: the VASCULAR system. This is made up of arteries, veins and small blood vessels that snake their way through every part of our bodies and brains, taking blood (i.e. oxygen and other vital nutrients) to and from them. When this vital highway of life gets blocked by atherosclerotic plaques, our organs suffer. This includes our brain, which is the largest and most complex organ of all. Many people with heart disease also have high blood pressure and/or high blood glucose, both of which add to the destruction of the vascular system. Eventually dementia, strokes & other neurological events occur. This is no different than fatty liver leading to cirrhosis (scarring) or blindness caused by uncontrolled high blood sugar in that it's an organ (the brain) being damaged by ongoing conditions in the body (atherosclerosis/heart disease).
Close to Home
The type of depression from which my family suffers
Depression, bipolar disorder and other mood disorders are more than just a foul mood or a sign of childhood trauma--they're a biological warning that all is not right in the body. And this is exactly what we've seen time and again in my family.
One side of my family is entirely saturated with mental illness: mood disorders of both types (bipolar/unipolar) as well as every anxiety disorder you can imagine, from OCD to specific phobias, social & generalized anxiety. Not one person unaffected regardless of age or economic background. The rich private school Christian kids are as bad off as the children of drug addict deadbeats raised by their grannies, mentally speaking. All have been hospitalized in psych wards at some point (most more than once), many have attempted suicide or have addictions on top of their primary diagnoses. It's a mess.
I include myself in this "mess". The ancestor farthest back that I'm aware of slit her throat (unsuccessfully) in the midst of a paranoid panic. Why? She thought her husband, an alcoholic abuser, was cheating. These were my grandmother's parents. How these mental cases escaped Freeman's frontal lobe ice pick is a mystery to me--probably poverty. People, especially women, were lobotomized for much less in those days. (See: Rosemary Kennedy). My mother was offered electroconvulsive therapy while in the psych ward as a teen, but thankfully turned it down.
As an interesting aside, everyone on that side of the family died of cardiovascular casues--nearly all strokes. I recall barrelling down the highway at 80 mph one day in the back of my (bipolar) grandma's car, her hands shaking due to the stress/anxiety of caring for her demented older husband as she said out of nowhere "I'm sure I'll die of a stroke. All my brothers died of strokes." Fuck, could you wait until we're parked to say that, G? I tried to have the "stress kills" talk with her to no avail. Like clockwork, she had a massive stroke--actually her 2nd--her 1st happened when I was 12 only a couple years after she attempted to take her own life in a rather bold and batshit manner. In any case, she didn't recover from this second one and ended up in the nursing home.
The most recent mental-illness-goes-neurological case in my family is my 50-something underweight, non-drug using cousin. He's struggled with... some form of mental illness his whole life, taking no responsibility for his own misery and making it impossible to empathize, treating everyone in his orbit like absolute dirt. Son he totally ignores? Check. Mom he verbally abused & uses for $$$? Double check. He currently receives home healthcare and disability, something he used to mock others for--mostly poor people and minorities because he's a racist bum. He's so disabled from repeated strokes he can't put on his own blood pressure cuff. His stroke happened less than a year after his mother, my aunt, had a stroke and drove herself to the hospital with her entire left side numb. 🤦🏻♀ They couldn't get her blood pressure down for 2 days afterward in the hospital which is a predictor of poor outcomes generally.
Again, these particular family members aren't morbidly obese or drug abusers. (Other family members do and are). Speaking of which, as I write this another family member is awaiting open-heart surgery after brushing off his convulsion-inducing chest pain as "stomach issues". For months. Last time I saw him he was convinced he had prostate cancer. Did I mention he DOES drink and smoke lots of pot? He's also bipolar, has way too much $$$ and a grandson who looks up to him too damn much who's gonna inherit it all when he goes. THAT little boy reminds me of a young Kurt Cobain, both in the looks department and in his hyperkinetic, sensitive nature that's headed for a hard crash in the very near future. He's 12 and asked his grandma if she could "let him out on the highway so a car could hit him" out of nowhere one day when I was with them.
Confusing Symptoms with Disease Process
As for whether a person can "think" themselves into having 99% clogged arteries or a major aneurysm, I'm not ruling it out entirely. The mind is a powerful thing. We already know the effect emotional stress has on every cell of the body, and we have a term for the phenomenon in which a fake sugar pill produces noticeable symptom improvement in clinical trials--the placebo effect.
That can't be good for the old Thinker. 🧠
But a more likely scenario is that it's something depressed people are doing/not doing that's leading to these outcomes. Like loneliness/isolation, self-medicating with a personal smorgasbord of drugs--both licit and otherwise--alcohol, tobacco, food not fit for a hog trough & topping it all off with a dangerous lack of sleep and a lifestyle so sedentary it'd make Al Bundy look like an Olympic athlete. Then when they do have worrying symptoms like pain radiating up one arm + nausea + fainting & busting face on the concrete (hi mom), they ignore it, opting to "stay home and take some more pills" for the symptoms rather than address the underlying disease process (most likely heart disease). They live like this precisely BECAUSE THEIR JUDGMENT IS AFFECTED BY THE LACK OF CIRCULATION TO THEIR BRAINS.
Yeah, maybe it's not such a 2-way relationship at all. Maybe the brain insufficiency caused by a heart smothered in fat and a body full of calcified arteries/veins is the sole cause in this scenario. And maybe theres's a bit of an underlying genetic component to the heart disease, but it's mostly caused by our shitty American diet/lifestyle. Nobody's saying a low mood improves or has no effect on disease outcomes, that'd be delusional. But likewise, nobody ever cured their terminal cancer with positive thinking in the absence of evidnece-based treatments (radiation, chemo, surgery). Further, insinuating that suffering from the highly heritable/genetic brain disorder of depression/bipolar disorder subtly puts the onus on the patient to "try harder" or have a more positive outlook. If only they'd think positive, they'd catch fewer illnesses & be healthier! Less heart disease, less missed days of work!
Except that's impossible because you can't "think positive" when your brain is starved for nutrients, oxygen and neurotransmitters. The "positive thinking" is to make those around you feel better because nobody likes a sad-sack. Once again, y'all are confusing the chicken with the egg... the symptoms with the disease itself. Negative thinking/pessimism is a SYMPTOM, not a cause of depression.
Magical thinking has no place in medicine or the "soft science" that is psychiatry & I'm tired of pretending it does. This is also where the separation between "mental health" and "physical health" becomes dangerous. The brain is not separate from the body and it's negligent to treat symptoms of brain dysfunction as if they all arise from a combination of past trauma, lack of coping skills and Zoloft deficiency. That may be the case in situational depression, but when a person has felt under the weather mentally for decades, there's something deeper going on.
Me? So far the only cardiovascular issue I have is high cholesterol, and I was able to lower it 33 points in 3 months just by giving up butter. 🤦🏻♀ I may go on statins at some point but am putting it off as long as possible because I already take a mountain of pills every day. And I won't list my mental diagnoses here because this is already long enough. One sibling (OCD, autism) is on meds for weight loss, high cholesterol AND blood pressure and is younger than me, so there's definitely a lifestyle factor. And my other sibling (bipolar, anxiety) took a GLP1 drug for a while. My dad (???) also takes a GLP1/blood pressure meds and my mom (bipolar, personality disorder?) from whom all this illness stems has been on cholesterol meds for decades & should be on GLP1's but refuses to see adequate medical care.
.jpg)
.jpg)
No comments:
Post a Comment