Emotional Feelings After a Heart Attack

Regardless of age, sex, or financial status everyone will experience certain emotional phases after a heart attack. These emotional phases are:

Phase 1: Shock and Disbelief
This phase is usually a short one where you experience a numb feeling. You may respond to the heart attack by denial and anxiety.

Phase 2: Developing Awareness
The initial shock has worn thin and after the first evening, you may feel better and begin to deny you had a heart attack.
Later you may be preoccupied with your fears of further problems or fear of death. These thoughts often lead to depression.
There may be some regression as you are treated like a child - - fed, washed, and helped with all bodily functions - - you may become dependent. As you progress you become more adolescent, torn between dependency and independency.

Phase 3: Resolution
The last phase begins at perhaps the most difficult time - - discharge from the hospital. You will have to face the consequences of your heart attack. Depression, fear, hostility, anxiety and denial are experienced in various intensities.

A heart attack affects the mental component of a personality as well as the physical. To cope with the variety of feeling you may experience can be more difficult than talking medicine, restricting diet, or even surgery.

The mental implications and adjustment cannot be undermined. You must be able to understand and cope with feelings of depression, anxiety, anger, tension, denial, shock, helplessness, lack of control with respect to self direction, lack of confidence and self-esteem, fear of the future and death.

It is normal to experience the above feelings to a degree and your moods will vary during the first several months of recovery. However, if there feelings were prolonged, it would affect a successful recovery period and professional help should be sought.

If you have some of the following characteristics:

• Melancholy
• Difficult sleeping and early awakening
• Inability to concentrate
• Feelings of helplessness or pessimism
• Listlessness and disinterest
• Short verbal responses
• Withdrawal (by sleeping more than usual, keeping curtains drawn).
• Loss of appetite or overeating
• Uncontrolled crying or easy tearfulness

A certain amount of depression is natural and normal after a major illness as it represents an acceptance of the situation and, hopefully, an attempt to come to terms with it.

1. Regular exercise on the advice of your specialist. Generally you begin with walking short distances.
2. Relaxation: hobbies, meditation, recreational, vacation, social activities.

If you have some of the following characteristics: 

• Excessive talking
• Restlessness — can't sit still
• Insomnia — can't sleep
• Inability to concentrate
• Sweating of the palms
• Rapid heart beat

1. Accomplish specific tasks
2. A full expression of your emotions, such as:
   • "I'm very, very scared about returning to work."
   • "I'm not the man or woman I was."
3. Know your illness - - ask questions of the various medical staff involved in your case. Make a list of concerns and don't worry about how silly they may sound. Anxiety feeds on the Unknown!

Denial is a dense mechanism used to reduce anxiety by reducing the threat. It is normal, necessary and healthy. When it is prolonged it becomes a problem.

Here are some statements indicative of denial:

• "Well, doctors do make mistakes."
• "It's really indigestion."
• "It's not possible."
• "This couldn't happen to me."

Here are some behaviors that suggest denial after discharge:

1. You start to smoke again.
2. You over-exercise to prove yourself.
3. You maintain the same pace of activity as pre-admission.
4. You continue to indulge yourself in a high cholesterol diet.
5. You become over-involved in other people's problems to avoid your own.

You must believe that the trauma has happened and adhere to restrictions.

1. Listen to medical advice.
2. Listen to your body (signs of fatigue to tiredness).
3. THOUGH THE MEDICAL STAFF INVOLVED REPEAT THE FACTS TO YOU, IT IS UP TO YOU TO BELIEVE.

All hospitalized patients experience regression because you are dependent on the medical staff. To move from dependence to independence, after discharge can be difficult both for the family and the patient. Sometimes extreme dependency is based on subconscious motivation as some people may have long been looking for an excuse to avoid responsibilities of life.

Some family members treat their loved one as if he or she were a cardiac cripple or invalid which can be very harmful in the recovery period.

1. Understand that mental factors rather then physical factors are causing the behaviour.
2. Encourage activity and gradually your self-confidence and esteem will become stronger. Independence will grow as you feel more competent with your tasks.
3. Take part in the decision-making with respect to household issues and personal care, ie. select you menus, meal preparation, schedule for exercise.

Angina or shortness of breath are important issues during hospitalization. After discharge minor aches and pains may be magnified by your anxiety.

1. Knowing the signs of angina and heart attacks are important.
2. Know how to use Nitroglycerin properly and do not be afraid to use your nitroglycerin as directed.
3. When angina persists, even though nitroglycerin relives the angina, see your doctor. Remember, angina is a warning sign your heart is not receiving enough blood and oxygen.

It is common to feel exhausted. If you find yourself expressing the following:

"I felt great in the hospital. I thought I'd be able to do anything after discharge. When I was home the first week I could barely walk the length of the house without feeling exhausted."

After a heart attack, people feel weak and tired. Weakness is not a sign of problems.

1. Stop and rest; if you feel tired in the middles of an activity. However, the ideal is to stop before feelings tired.
2. Check with your doctor if you feel exhausted all the time. He can determine whether it's a mental of physical factor.

It is normal for you and your family to feel angry. However, it is healthy to express it within certain limits.

Some of the following statements are common:

• "It's my fault, if I had stopped smoking this would not have happened."
• "I blame ________ for what happened to me."
• "My wife resents the fact that I'm ill and we have to undergo all these changes."
• "Nobody's going to tell me what to do."

1. To defuse it you must get to the root of the cause:
   • Were you a hostile person before the heart attack?
   • Were you passive/aggressive for years?
2. Have you informal time for discussion with family members so that all are aware of feelings.
3. Use hospital staff to discuss your concerns and feelings; ie. social worker, cardiac rehab nurse, etc.
4. Write or record how you feel in a log.
5. Take time for fresh air and smell the flowers.

Most cardiac patients have been extremely time urgent and active so it is difficult to slow down immediately after a heart attack.

Two main fears, are fear of death and fear of living with impending death. To suffer or to be completely debilitated is a concern also to some patients.

1. Understand that with any trauma you are reminded of your morality and you must come to terms with it.
2. If death is a concern that affects your spiritual unfulfillment, speak with a spiritual leader of your faith.
3. Believe in your doctor. He is not God; however, if you believe he and the other medical staff are giving you the best care, you can feel reassured.
4. Knowledge of cardiopulmonary resuscitation (CPR) can help, and some family members may be more confident with this knowledge.

Disclaimer
Reviewed by Alberta clinical experts. Brought to you by HealthLink Alberta. Copyright.
This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. For more health advice call Capital Health Link at 780-408-LINK (5465) 24 hours a day, seven days a week. In Alberta, call Toll-free: 1-866-408-LINK (5465)