Is it possible to separate the heart from the mind? The answer is “no,” according to specialists who met at the 39th Congress of the State of Rio de Janeiro Society of Cardiology (SOCERJ), an event held virtually in May. During a conference on mental health, physicians and psychologists recalled that long-term data have suggested that people who are under stress are more likely to present with cardiovascular events. Takotsubo cardiomyopathy (TCM) is an extreme example of this.
Several different articles in the scientific literature show how negative emotions affect physical health. According to one of the presenters, Gustavo Barbirato, MD, cardiologist and member of the Department of Spirituality and Cardiovascular Medicine (DEMCA) of the Brazilian Society of Cardiology (SBC), a study performed during the 2006 World Cup in Germany, and published in the New England Journal of Medicine in early 2008, showed for example that viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event.
Path to improved health
Sometimes it can be hard to start a conversation with your doctor about your mental health. Here are some tips that can help you before, during, and after your appointment.
Before your appointment:
- Set reasonable goals for the appointment. Diagnosing and treating mental illness takes time. If you set a goal of having your symptoms go away immediately, you will likely be disappointed. Instead, set a few reasonable goals. These could include explaining your symptoms to your doctor, learning a possible diagnosis, and coming up with a treatment plan.
- Write down important information. Take some time before your appointment to write down what you’d like to talk about. This will help you make sure you don’t forget anything when you’re in the doctor’s office. Some things you can write down include:
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- Your symptoms. These could be physical, mental, emotional, or behavioral changes that you’ve noticed in your life.
- How your mood affects your everyday life.
- Key personal information, such as traumatic events in your past, or current stressful situations you are facing.
- Your medical information, such as other physical or mental conditions you currently have. Also write down all medicines you are taking, including over-the-counter medicine and herbal supplements.
- Questions you want to ask your doctor.
You can use this Start the Conversation Checklist as a starting point. Just print it off, fill it out before your appointment, and take it with you. You can give it to your doctor to read or use it as a reference when you’re talking about your symptoms.
During your appointment:
- State your concerns plainly. It’s important to tell your doctor all of your symptoms. But before you get into that, tell him or her what you think may be wrong. Use clear statements such as “I think I may be depressed” or “I am having trouble with anxiety.” This will help guide them and let them know what direction to go in.
- Be as open and honest with your doctor as possible. He or she can’t help you if they don’t know everything that is going on. It can be hard to open up about your feelings, especially with someone you don’t know very well. But your doctor is trained to deal with sensitive issues. They will be supportive and professional, and you won’t tell them anything they haven’t heard before.
- Refer to your notes. It’s common to forget half of what you were going to say once you get in the doctor’s office. That’s why it’s important to write things down beforehand. If you use the notes you’ve prepared ahead of time, you won’t have to worry about forgetting important details.
- Understand the diagnosis process. There is no simple blood test or scan that can tell you if you have depression, anxiety, bipolar disorder, or another mental illness. Sometimes it can be challenging for your doctor to be able to name the specific condition you have. Plus, you may have a combination of conditions that are causing your symptoms. For example, depression and anxiety often occur together. Bipolar disorder shares some symptoms with depression. And depressive illnesses often occur with physical conditions such as heart disease, diabetes, or cancer. Your doctor may ask you questions that seem unrelated to mental illness. This is all in an effort to make sure they get the diagnosis right.
- Bring someone with you. If you need support, invite a friend or family member to go to your appointment with you. They can help you understand and remember what the doctor tells you. They also may be able to tell the doctor about the changes they’ve noticed in you.
After your appointment
- Follow through with treatment. After you’ve shared your concerns and your doctor has given his or her diagnosis, together you will come up with a treatment plan. This may include talk therapy, medicine, lifestyle changes, or a referral to a specialist. It is your job to follow through with the treatment. Schedule appointments with a specialist or a therapist. Get your prescription filled and take the medicine as directed. Give the lifestyle changes a try, even if you don’t feel like it.
- Follow up with your doctor. Your doctor will want to see you again in a few weeks to see if the treatment is working. It is important that you schedule a follow-up visit and go to the appointment, whether you are feeling better or not. If you aren’t feeling better, your doctor may have other ideas on ways to treat you. This could include changing your medicine, adding another medicine, or recommending other courses of action.
- Be patient. It is important that you are patient with yourself and with your doctor through this process. You might have to try different medicines or a combination of medicines. You might need talk therapy and a mix of self-care strategies. It can take time to find the right treatment plan for you. Just don’t give up. You will feel better as long as you keep trying to find a solution.
