1. Stress Management&Emotional Reactions toHeart DiseaseCarolyn Kienitz M.S.W.,R.S.W.

2. Emotions & the Heart in Everyday Language Heart ache Downhearted Soft hearted Disheartened Light hearted Fainthearted Chickenhearted Change of heart Sick at heart Learned by heart Heart of stone Right to the heart of. Tender hearted Heart of Gold Broken hearted Bleeding Heart 3. What is stress? Stress is when lifes demands seem morethan you can handle. The most importantcomponent of our stress response is often notthe actual stressful event, but how weevaluate the situation mentally. 4. Its not stress that kills us;It is our reaction to it. Hans Selye 5. Fight or Flight It is what allows us to respond to danger andact to save our own life or that of another 6. Stress Responseour reaction to real or imagineddanger 7. Fight or Flight Response The flight or fight response is a series of biochemicalchanges that prepare you to deal with threat ordanger. Without this response we could not havesurvived. Today the dangers in our lives are notalways as concrete as a tiger jumping out of thewoods at us, but the fight or flight response stillserves us well. Whether it is a car cutting us off onthe highway or running to rescue a child fromdanger, our bodies need to be able to respondquickly. 8. Fight or Flight what happens? Any problem, imagined or real, can cause thecerebral cortex (the thinking part of the brain) to sendan alarm to the hypothalamus (the main switch forthe stress response). The hypothalamus stimulatesthe sympathetic nervous system, which make aseries of changes in your body. Your heart rate,breathing rate, muscle tension, metabolism and bloodpressure all increase. Your hands and feet get coldas blood is directed away from your hands and feet tothe heart and larger muscles that can help you fightor run. Your pupils dilate to sharpen your vision andyour hearing becomes more acute. 9. Fight or Flight - continued Unfortunately when the fight or flight becomeschronic, there can be long term negative effects. Youradrenal glands start to secrete corticoid which inhibitsdigestion, reproduction, growth, tissue repair;decreases the response of your immune andinflammatory systems, and over time can negativelyaffect the cardiovascular system. 10. IN OTHER WORDS Heart rate increases Blood pressure can become elevated Blood flow changes more to heart andlarger muscles The hands and feet become cooler 11. And more . Our skin pales (white as a ghost) The blood clotting mechanisms increase andour blood becomes thicker Blood sugar elevates Digestion slows down or stops 12. And even more. Sleep problems? Do you feel like exercising? Urges to double up ie cigarettes or alcohol Harder to diet or quit smoking. 13. So the question is..Are you stressed? 14. Symptoms of Stress Appetite change Rapid, shallow breathing Headaches Teeth grinding Whirling mind Forgetfulness Poor concentration 15. Symptoms of Stress Anger Irritability Mood swings Crying Lowered sex drive Increased use of alcohol or cigarettes Insomnia And so on 16. And if your answer is yes What if there are no simple answers? 17. Dr. Herbert Bensen Working at Harvard Medical School Researching ways to combat High BloodPressure 18. Relaxation Response Breathing becomes slower and deeper Heart rate slows down Artery walls relax, BP lowers Hands and feet warm Muscles relax 19. Relaxation response continued Over time BP lowers and stays there Immune system seems to get a boost People still get stressed but dont stay thatway as long Endorphins are released 20. Meditation Meditation focuses on calming the mind.1) Concentrative meditation focuses your attention on something specific such as your breath2) Mindfulness meditation describes a state of mind where you are aware but detached from everything you are experiencing 21. Benefits of Meditation Reduced anxiety More relaxed body Improved sleeping patterns Lower blood pressure and reduced pulse rate Lower levels of stress hormones in the blood Improved circulation Improved quality of life in those who suffer fromchronic pain 22. Tai Chi Has been shown to improve blood pressure, stress reduction, balance, postural stability and fall prevention Other studies demonstrate pain reduction in osteoarthritis and improved physical function Improved sleep Some evidence that Tai Chi may improve immune function Appears to improve cardio vascular fitness 23. Yoga Provides stress reduction Can reduce blood pressure Recommended as helpful for sufferers of arthritis Study subjects demonstrated fewer angina attacksand improved exercise capacity Helps with weight loss Improves sleep 24. Other forms of relaxation Read a book Garden Woodwork Listen to music Sing Play an instrument Knit or sew Walk Play with a child 25. Pet Therapy The act of petting a dog can lower blood pressure People with dogs go for more walks 26. Laughter is the Best Medicine The arrival of a good clown exercises more beneficialinfluence upon the health of a town than twentyasses laden with medicine.Thomas Sydenham, 17th century 27. Humor and Health Muscle Relaxation Reduction in Stress hormones Enhances Immune System Reduces Perception of Pain Provides Cardiac Exercise Reduces Blood Pressure (women more than men) Respiration similar to deep breathing 28. Common emotional reactionsto cardiac disease Denial Anxiety Anger Grief Depression 29. Common Emotional Reactions Denial 30. Common Emotional Reaction Anxiety 31. Common Emotional Reactions Anger The Hostile Personality is independent risk factor forHeart Disease 32. Common Emotional reactions Grief 33. Depression In a healthy population, major depressioncould be found in 4 - 6% of males, 18% offemales Add a cardiac diagnosis to that populationand the instances of major depression canjump to 20% or more (1) 34. Why should this concern us? Depression is an awful experience and affects thewhole family Depressed people are less likely to return to workand are hospitalized more often Depression has been shown to increase the risk offurther cardiac events, including death by 25% 35. Symptoms of Depression Persistent sad, anxious, or empty mood Feelings of hopelessness, pessimism Loss of interest, pleasure in activities that were once enjoyedincluding sex Decreased energy, fatigue, being slowed down Difficulty concentrating, remembering, making decisions Insomnia, or oversleeping Appetite and/or weight changes Thoughts of death or suicide or suicide attempts Restlessness, irritability, loss of sense of humor If five or more of these symptoms are present every day for at least twoweeks and interfere with routine daily activities, seek an evaluation fordepression 36. Fortunately: Depression is treatable Antidepressants have been proven safe in cardiacpopulation When depression is treated research is indicatingthat risk factors can return to normal Not everyone needs an antidepressant 37. Treatment Options Talk therapy Cognitive Behavioral Therapy Antidepressants Exercise Time Cardiac Rehabilitation Program 38. Exercise as a Treatment for Depression Must be aerobic 2 - 3 times per week 20 - 30 minutes at a time (more is better) At a rate that you can still talk but hard enough thatyou could not sing If you are older and out of shape you will seeresults faster No side effects and fewer relapses 39. Dr. Bensons Breathing Exercise Deep slow gentle breaths In through the nose Hold it Breathe out though pursed lips Your tummy should expand when you breath in 40. The EndHave a good day