The Cardiac Behavioral Medicine service was created with the understanding that the mind and body (the heart, in particular) influence each other.  The most obvious example of this mind-body connection can be seen in the risk factors for heart disease, most of which can be reduced by altering our behaviors (e.g., increasing exercise, eating a heart-healthy diet and quitting smoking). Our lifestyle behaviors directly influence our heart health. Changing long-standing behaviors, however, can be difficult. Barriers to change often include limited motivation, reduced confidence from prior attempts at change, stress, emotions, minimal support, limited time and resources, and only a vague plan about how to proceed.

Our emotions and personality also can impact our cardiac health. Depression, stress, anxiety, hostility and limited support can increase an individual’s risk of developing a heart condition and can worsen the outcome after a cardiac event. For example, some medical studies have found that depressed individuals are 2-4 times more likely to develop heart disease than non-depressed persons. Our physiological reaction to stress also can cause wear and tear on the cardiovascular system, ultimately impacting blood pressure, inflammation, coronary artery disease, cardiac events, and arrhythmias. In sum, our emotional health and our lifestyle behaviors influence our heart health.

The reverse also is true -- heart health can impact our emotions and stress levels. A diagnosis of heart failure can trigger symptoms of depression, anxiety, fear, or stress. Medical studies have repeatedly found that heart failure patients with depressed symptoms are more likely to have poorer medical outcomes. Changes in sleep, appetite, concentration and diminished interest in pleasurable activities may suggest depression or emotional distress. Some patients with heart failure become sensitive to noticing physical sensations in their body, particularly patients with an implantable cardiac defibrillator. This heightened awareness of body sensations can sometimes lead to anxiety or panic. Avoidance of certain people, activities or situations due to anxiety or fear of another discharge, suggests that the anxiety is debilitating and likely warrants medical attention. Identifying and treating the emotional consequences of a cardiac event are important for optimizing the quality of a person’s life and to help maintain the best heart health possible. Reducing emotional distress also can make it easier to adapt a healthier lifestyle and follow doctors’ recommendations. Therefore, please discuss any changes in mood or stress with your cardiology team.     

Cardiac treatment is most successful when it focuses on the physical, emotional, and behavioral health of the patient. Northwestern Memorial Hospital’s Center for Heart Failure at the Bluhm Cardiovascular Institute offers Cardiac Behavioral Medicine services which include comprehensive care in the evaluation and treatment of heart failure by addressing the emotional and behavioral components. Cardiac Behavioral Medicine helps patients and their families adjust to a diagnosis of heart failure and provides support for patients who require invasive treatments or cardiac surgery, including transplant. Patients are educated about the role of emotions and stress in their cardiac health. They are taught new ways of relaxing and coping so that their heart is not harmed by daily stress and hassles. Lifestyle behavior changes are tackled in a supportive setting to help patients achieve their goals of quitting smoking, losing weight or adhering to a new exercise regimen.

Kim R. Lebowitz, PhD, director of Cardiac Behavioral Medicine and Gail M. Osterman, PhD specialize in helping cardiovascular patients adjust to a diagnosis and become more resilient throughout the course of treatment. Their techniques include strategies that facilitate behavior change, improve coping strategies, minimize stress, aid with extended hospitalizations and prepare for an upcoming procedure or surgery.

Cardiac Behavioral Medicine is helpful for a variety of presenting issues, including stress, depression, anxiety, panic, fear of physical symptoms, perfectionistic tendencies, adjustment to a medical diagnosis, coping with a chronic illness, relaxation training, smoking cessation, hypnosis, behavior changes and preparation for an upcoming surgery or procedure, including a mechanical assist device or heart transplant. Various support groups also are available throughout the year.  

Contact

To schedule an evaluation or inquire about services regarding Cardiac Behavioral Medicine through the Bluhm Cardiovascular Institute, please call 312-695-4965.