The heart health and depression connection
February was Heart Month. Of course, the 14th was also Valentine’s Day, and this year I posted on a social media about the new meaning of the holiday following my sudden heart attack last summer.
The response was overwhelming, largely because my focus wasn’t so much the event itself — a valve replacement — but on the often misunderstood aftermath.
Heart disease and depression make excellent bedfellows. People with coronary artery disease are at greater risk of clinical depression, while depression itself increases the risk of heart disease. It’s the classic chicken-and-egg scenario. And while my diagnosis was a little bit different, the result — chest cracked open on the operating table — was much the same.
I was lucky, skirting serious mental health aftereffects by benefiting from family and peer support, excellent postoperative care and a flexible work schedule. Many don’t enjoy these privileges.
Generally speaking, people in the lowest income bracket are three to four times more likely to report poor mental health than those in the highest.
But even with financial security and a tightly-woven safety net, my experience in the realm of the ill was a wake-up call. Given my role as board chairman of the Mental Health Commission of Canada, I knew that the stealth companions of anxiety and depression could well accompany me on discharge day. As I recovered at home, my family kept a keen eye on my appetite, sleep patterns and ability to concentrate — usually the first casualties of a mental health problem.
But for men in particular, the signs and symptoms of depression can easily be conflated with a normal reaction following a life-altering medical event. Irritability and anger can be chalked up as reasonable in the wake of open heart surgery. In the earliest days after my own operation, I was frustrated by my limitations, irritable at my perceived vulnerability, and itching to “get back to normal.”
But it’s when these symptoms persist, untreated, that they begin to spiral into something far more concerning. Stigma still shrouds mental illness — especially among many men who conflate mental health problems with weakness. This silent suffering means men in Canada account for 75 per cent of completed suicides. And more than half of all suicides involve my peers, people aged 45 or older.
But no one is immune from mental health problems.
According to MHCC research, one in five people will experience a mental illness in any given year. By the tender age of 40, that number jumps to one in two.
Yet, despite its prevalence, the Centre for Addiction and Mental Health cites that 75 per cent of people in this country say they wouldn’t feel comfortable revealing a mental illness to a colleague or an employer. Respondents to that same survey said they would be three times more likely to disclose a physical illness, like cardiovascular disease or cancer.
Imagine then, in addition to managing a serious illness, adding to that the fear of losing one’s job or being treated with judgement or disdain.
Compare that to my experience. When I was unwell, my colleagues rallied around me, and, equally importantly, around my family. I received cards and well-wishes, casseroles and kindnesses. These gestures were anything but small. They buoyed my sprits and shored up my confidence, and were as integral to my recovery as pain medication, healthy food and plenty of rest.
We simply cannot afford to allow our friends and colleagues living with a mental illness feel they must endure it in isolation. They are worthy of the care and concern I was so fortunate to receive.
In good news, that same CAMH survey reports that 76 per cent of respondents would — themselves — be completely supportive of a colleague who disclosed a mental illness.
That tells me we are harder on ourselves than we would be on a friend or neighbour. We judge ourselves more harshly than we would a colleague. So, even if it’s not easy, we must turn our compassion inward.
In the last few months, I’ve learned to celebrate smaller wins. To feel good about setting boundaries, rather than pushing limits. And to reframe asking for support as an unsung superpower.
Our stories and our scars — whether physical or mental — are at the heart of the human condition. By sharing mine, I hope others can draw the strength to do the same.