Amit had a heart attack during a business meeting. Never in a million years did he believe that he would have a heart attack at the early age of 33. After months of cardiac rehab, physiotherapy and nutrition counselling, he was finally ready to lead a normal life. However, he found himself having nightmares and flashbacks about the event – feeling helpless in hospital, feeling angry at himself and the world for this unfair situation, worrying about his family, feeling depressed about the changes in lifestyle that he had to make… But most of all, he was afraid of having another heart attack. Every ache and pain in his body made him think that he was having another heart attack. This made him anxious and worried, after which he stopped doing anything that might raise his heart rate, including exercise. While he was careful about what he ate and how he lived, he was now living in fear, just waiting for it to happen again. Through counselling, Amit was able to come to terms with his heart attack and let go of his anxieties. He now leads a happy and healthy life.

A heart attack most commonly occurs when blood flow to a part of the heart is blocked. It is a shocking and traumatic event and many survivors may feel helpless, anxious and depressed. Some survivors actually develop post-traumatic stress disorder (PTSD)! How a survivor reacts may depend on factors such as whether it was a recurrent event, whether he had any warning signs, the nature of stressful events at the time, his personality, and his usual coping styles. Despite these different factors, there are some common psychological reactions to having had a heart attack.

1. A survivor might feel numb or go into shock. This is the mind’s way of protecting him by allowing the trauma to be felt very slowly. The event may seem unreal, like a dream or something that has not really happened. Only with time will this numbness and shock give way to the realisation of having had an attack.

2. He might feel helpless that there is nothing he could have done and is powerless to stop it from happening again. This may lead to anxiety and depression, which may in turn lead to feelings of sadness and grief for losing the feeling of being healthy. He may then begin to display resistance to any life changes that need to be made.

3. A survivor may feel guilt for causing distress to people close to him, anger about the unfairness and senselessness of it all, shame for being helpless, emotional or needing others’ help and regret for all the things that he has not done and might never be able to do.

4. Relationships may begin to change with close family members while they try to find a middle ground between coddling the survivor and encouraging him to do too much. A survivor may feel afraid of being left alone or of having to leave loved ones.

5. Perhaps the most important psychological effect of having a heart attack is the fear that it might happen again at any time. This may put a survivor on alert for tell-tale signs and he may take action to stop doing anything that would make his heart beat faster such as being active or doing exercise that may actually be good for the heart.

6. Awareness of body sensations may increase and any ache and pain may be misconstrued as an onslaught of another heart attack. In a way, this could be helpful as it allows a person to take better care of his body and be more responsive to what his body needs. However, some survivors may misinterpret normal bodily sensations as an indication of having another heart attack. This can lead to anxiety, which can then exacerbate the physical sensations, which in turn can reinforce the idea that something is wrong with the person’s heart. The problem can be made worse if a person then starts to avoid certain activities because of this fear or spends too much time checking and focusing on his body.

There are a few things that a survivor can do to break from this cycle. He can –

• Ask a cardiologist to explain angina pains and indications of a heart attack. This may help ease his worrying
• Remember that thinking that he is having a heart attack does not mean that he is really having a heart attack
• Look after his body as best as he can by reducing his own risk factors. This will help him to know that he is doing everything he can to prevent another heart attack
• Use relaxation to calm symptoms of anxiety
• Talk to a counselling psychologist or a psychiatrist about any worries

Simply surviving a heart attack is just the beginning of a long process of recovery. Identifying and understanding a survivor’s own reaction to having had a heart attack can be an important first step. Being patient with oneself, discussing one’s feelings with family or friends and arranging for counselling may help. The important thing to know is that such feelings of numbness, fear, helplessness, sadness, guilt, shame or anger are normal and understandable reactions that could follow a heart attack. This knowledge could save a survivor from unnecessary anxiety and go a long way to healing his heart and mind.

If you have been going through something similar, our professionally qualified counsellors at TalkItOver will be more than happy to help you.

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About Shireen Stephen

Dr. Shireen Stephen has a Ph.D. in Health and Counselling Psychology and Masters in Applied Psychology. Over the last 7 years, she has worked in the capacity of a research scholar, counsellor and lecturer. Some of her areas of expertise are research, coping with lifestyle changes and relationship counselling. To this end, she has conducted numerous online workshop modules on choosing the right life partner. She has worked almost exclusively with employees of the BPO industry by helping them understand and cope with the various unique health effects of working at odd hours. She uses a problem focused and action oriented approach to dealing with problems and her primary therapy orientation is using Cognitive Behaviour Therapy techniques. She strongly advocates positive psychology and holds the humanistic view that each individual has the potential for self-actualization and possesses the necessary tools to lead a satisfying life.