Recovering from Heart Attack & changing habits -- when already depressed
October 6, 2019 5:30 PM Subscribe
I’m looking for recommendations on resources for someone (youngish) recovering from a heart attack. Books, blogs, videos, podcasts... whatever. NOT looking for cookbooks. I need resources that can help me think through some big mental roadblocks, and get through to some better practices for living.
45 year old male, three weeks ago had a blockage in the LAD. Stent inserted. Recovery seems to be going fairly well, and now I’m back at work after 2 weeks off. I’m not struggling very much dietarily -- have successfully eliminated butter, red meat, beer, etc.; and greatly increased vegetables -- and am dutifully taking the various medications proscribed. The metoprolol seems to be the worst of the bunch, but I can see its value.
Doc said I should watch out for being depressed. “Thanks no thanks, Doc ; I already am”. I’ve struggled with depression my entire adult life. Already medicated, already therapized. With the exception of some increased mental fogginess and decreased memory and other capacities, I would say that nothing I’m experiencing depression-wise is new or different from what I’d regularly experience prior to the heart attack. Anyway I mention it because the depression and struggles with it, and/or side effects of the medications I’ve taken, are probably a significant factor in some of the poor habits that led me to not have had much success in getting my [absurdly high] cholesterol down.... And hence led to this heart attack.
I have had -- well before the heart attack -- a particular sensitivity to feeling ‘incapable’ or “under-resourced”, physically or otherwise. It really is a trigger for me, to feel like I can’t do things, or won’t be able to do them well or respond effectively if they go sideways. This is a BIG part of why I used to have some pretty unhealthy eating habits. I’d prophylactically overeat in order to make ensure I would not be caught off-guard by upcoming challenging situations.
I’m overwhelmed by information. One day: “Eat this, don’t eat that” then the next you read the opposite. “Take this medication, to keep you alive” then you read up on the side effects or interactions and I think, “Well this very well may be the think that kills me instead”.
Now I feel like I’m a cog in the medical-industrial complex machinery. Prior to the heart attack, for the past 2-3 years, I already had been feeling like I was just a cog in a machine, with ever decreasing capabilities (mental and physical) to make a change for myself, to get out of that machine. I’m fully aware that my mindset is a HUGE part of that, and that that needs to change.
I’m seeing a therapist weekly. He’s very much into mindfulness and MBSR. I am not opposed to these approaches, and I can see how they can help someone like me, but I feel like I need something in addition.
Sorry for the meandering and somewhat aimless post. I am guessing/hoping that anyone who has bothered to read this far has had experience themselves in this area, and is not someone to just recommend a cookbook by Gundry or Amen or Oz. I’m looking for... something else? Some sort of higher-level guidance on how to think about thinking-about how to recover from a heart attack, and make significant changes in ones’ lifestyle (diet) especially when struggling with pre-existing conditions -- both emotional and physical -- that make change difficult?
Thank you.
45 year old male, three weeks ago had a blockage in the LAD. Stent inserted. Recovery seems to be going fairly well, and now I’m back at work after 2 weeks off. I’m not struggling very much dietarily -- have successfully eliminated butter, red meat, beer, etc.; and greatly increased vegetables -- and am dutifully taking the various medications proscribed. The metoprolol seems to be the worst of the bunch, but I can see its value.
Doc said I should watch out for being depressed. “Thanks no thanks, Doc ; I already am”. I’ve struggled with depression my entire adult life. Already medicated, already therapized. With the exception of some increased mental fogginess and decreased memory and other capacities, I would say that nothing I’m experiencing depression-wise is new or different from what I’d regularly experience prior to the heart attack. Anyway I mention it because the depression and struggles with it, and/or side effects of the medications I’ve taken, are probably a significant factor in some of the poor habits that led me to not have had much success in getting my [absurdly high] cholesterol down.... And hence led to this heart attack.
I have had -- well before the heart attack -- a particular sensitivity to feeling ‘incapable’ or “under-resourced”, physically or otherwise. It really is a trigger for me, to feel like I can’t do things, or won’t be able to do them well or respond effectively if they go sideways. This is a BIG part of why I used to have some pretty unhealthy eating habits. I’d prophylactically overeat in order to make ensure I would not be caught off-guard by upcoming challenging situations.
I’m overwhelmed by information. One day: “Eat this, don’t eat that” then the next you read the opposite. “Take this medication, to keep you alive” then you read up on the side effects or interactions and I think, “Well this very well may be the think that kills me instead”.
Now I feel like I’m a cog in the medical-industrial complex machinery. Prior to the heart attack, for the past 2-3 years, I already had been feeling like I was just a cog in a machine, with ever decreasing capabilities (mental and physical) to make a change for myself, to get out of that machine. I’m fully aware that my mindset is a HUGE part of that, and that that needs to change.
I’m seeing a therapist weekly. He’s very much into mindfulness and MBSR. I am not opposed to these approaches, and I can see how they can help someone like me, but I feel like I need something in addition.
Sorry for the meandering and somewhat aimless post. I am guessing/hoping that anyone who has bothered to read this far has had experience themselves in this area, and is not someone to just recommend a cookbook by Gundry or Amen or Oz. I’m looking for... something else? Some sort of higher-level guidance on how to think about thinking-about how to recover from a heart attack, and make significant changes in ones’ lifestyle (diet) especially when struggling with pre-existing conditions -- both emotional and physical -- that make change difficult?
Thank you.
Best answer: I really have no simple or even complex answer--At age 77 I have dealt with several significant health related issues (doing just fine BTW). Whatever you decide to do--diet, life style, cardiac rehab, daily habits etc--start small, stay focused, make a/few commitment(s) to doing it and do it today/tomorrow. All the reading, thinking, talking, analyzing, listening will not do one iota for you until you do what you have committed to do--today, tomorrow and as long as it takes. I can assure you there is no magic answer, no secret, no perfect solution but there are things you can do--in the presence of conflicting and apparently reliable information trust the middle road AND then do it. Jeez, --I sound like a Nike Ad. Wishing you the very best as you move ahead.
posted by rmhsinc at 6:19 PM on October 6, 2019 [2 favorites]
posted by rmhsinc at 6:19 PM on October 6, 2019 [2 favorites]
Therapy should be for *you*, and a good therapist is "into" whatever fits with a particular client, and if they can't be "into" that, they refer out. It sounds like this therapist may be a bit of a one trick pony and is foisting mindfulness on you because of his or her preferences. Ironically, they don't sound like they are being very mindful of your reaction. If I were you I'd look for a new therapist. The modality should be secondary to the relationship, but "eclectic" or "humanistic" are good descriptors to look for in a therapist. They should have more than one concept in their toolbox!
You say you don't want cookbook recommendations, but I can't tell if that means you also don't want any kind of dietary advice. You mention that your high cholesterol lead to your heart attack, but that may not be the case at all. The current research also suggests that avoiding dietary cholesterol is not necessarily going to help you reduce your chances of another heart attack, especially if you replace whole animal foods with processed sugary crap. If part of your extra depression is due to giving up foods you are used to/enjoy, know that you may not have to. (I am not a dietician, but am very well read on the topic).
Originally I added some reference links related what I've said above, but then I read again that you feel "overwhelmed by information" (if you want refs, let me know). Bottom line: If I were you, and I wanted to not have another heart attack, avoiding butter and beef would not even be on my list. Reducing sugar and refined flours would. Adding vegetables might be. Exercise as tolerated would be. Social support would be. Additional supplements (such as ubiquinol) might be.
posted by nirblegee at 6:31 PM on October 6, 2019 [2 favorites]
You say you don't want cookbook recommendations, but I can't tell if that means you also don't want any kind of dietary advice. You mention that your high cholesterol lead to your heart attack, but that may not be the case at all. The current research also suggests that avoiding dietary cholesterol is not necessarily going to help you reduce your chances of another heart attack, especially if you replace whole animal foods with processed sugary crap. If part of your extra depression is due to giving up foods you are used to/enjoy, know that you may not have to. (I am not a dietician, but am very well read on the topic).
Originally I added some reference links related what I've said above, but then I read again that you feel "overwhelmed by information" (if you want refs, let me know). Bottom line: If I were you, and I wanted to not have another heart attack, avoiding butter and beef would not even be on my list. Reducing sugar and refined flours would. Adding vegetables might be. Exercise as tolerated would be. Social support would be. Additional supplements (such as ubiquinol) might be.
posted by nirblegee at 6:31 PM on October 6, 2019 [2 favorites]
If I were in your situation, I might find something to distract me and to make me interact with a professional or quasi-professional about something I may want to learn or improve.
When I motor through bad times, I find it helpful to seek out professionals who aren't doctors or therapists - like trainers, physical therapists, massage therapists, nutritionists, golf instructors, music teachers, and so on.
(Just one or two not all at once). I've picked something to work on and find someone who wants to meet once or twice a week for, say, 8 weeks.
Regularly getting input from someone who cares about my progress, but who is not a doctor or mental health professional, really has helped me from time to time.
Hoping you find ways to have fun with your life changes!
I sometimes start with a new endeavor because I'm feeling anxious or down, but end up feeling better.
posted by rw at 9:49 PM on October 6, 2019 [2 favorites]
When I motor through bad times, I find it helpful to seek out professionals who aren't doctors or therapists - like trainers, physical therapists, massage therapists, nutritionists, golf instructors, music teachers, and so on.
(Just one or two not all at once). I've picked something to work on and find someone who wants to meet once or twice a week for, say, 8 weeks.
Regularly getting input from someone who cares about my progress, but who is not a doctor or mental health professional, really has helped me from time to time.
Hoping you find ways to have fun with your life changes!
I sometimes start with a new endeavor because I'm feeling anxious or down, but end up feeling better.
posted by rw at 9:49 PM on October 6, 2019 [2 favorites]
Best answer: At your age, I too had a blockage of the LAD and got me two stents. I never actually had a heart attack, but when they opened the blockage, they said it was 97% and when I asked why I was alive, they responded with something along the lines of just lucky I guess.
I was not a healthy eater, but I was physically active at the time. I work(ed) in a very stressful job as a trader.
My doctor also told me that heart attack victims often become depressed especially at such a young age. He told me to go to therapy. I would tell you to follow that advice from your doctor, but it sounds moot as you already are both depressed and seeing a professional. Stick with it. Bring up the heart issue with your therapist.
I struggled mightily changing my eating habits and generally getting into a better state of health. Actually, 3 or 4 years later, I had 2 more stents put it. I now regularly pass my treadmill stress tests with flying colors.
The one thing I did do from the beginning was take all the medications prescribed EVERY SINGLE DAY. I was just at my cardiologist last week and when I told him I only missed my meds 2 times in over a decade, he gave me an attaboy. I too take Metoprolol. Plavix. Crestor, baby aspirin and one other that slips my mind at the moment. I too read the side effects and was not impressed. Either taking them would kill me or not taking them as I saw it. I just decided that my odds were better taking them, side effects be damned. I think the only side effects I have are some initial weight gain and sluggishness. Exercise really worked on both of them. And when I say exercise, initially, it was walking. Started at a mile a day and worked up to 5 miles a day 5 days a week. Now I play hockey, basketball, bike and do anything I want or can.
I tried all sorts of diets, meal plans, eating schedules, etc. None were particularly effective. I could do Atkins and did, and did lose weight, but it was not sustainable. I read dozens of books, listened to dozens of people tell me all sorts of different things, only one thing worked for me.
Here is the punchline: The only thing that worked for me was trusting my medical professionals and seeing a registered dietician who was willing to work with me to make very specific meal plans for weeks or even a month at a time. Then all I needed was will power. I tracked everything I ate for months and started to learn what to eat and what to avoid. What made me bloated, what helped with cholesterol, etc. My dietician served as both a food advisor and in some ways a therapist who was very patient talking me through my eating struggles.
Forget idiots like me on the internet, forget, your friends or family, listen to a trained professional. I asked my cardiologist to recommend to me three dieticians. She did. I settled on the second one I saw.
Good luck. Take it one day at a time. Slowly develop good habits. Listen to the pros.
posted by AugustWest at 10:15 PM on October 6, 2019 [7 favorites]
I was not a healthy eater, but I was physically active at the time. I work(ed) in a very stressful job as a trader.
My doctor also told me that heart attack victims often become depressed especially at such a young age. He told me to go to therapy. I would tell you to follow that advice from your doctor, but it sounds moot as you already are both depressed and seeing a professional. Stick with it. Bring up the heart issue with your therapist.
I struggled mightily changing my eating habits and generally getting into a better state of health. Actually, 3 or 4 years later, I had 2 more stents put it. I now regularly pass my treadmill stress tests with flying colors.
The one thing I did do from the beginning was take all the medications prescribed EVERY SINGLE DAY. I was just at my cardiologist last week and when I told him I only missed my meds 2 times in over a decade, he gave me an attaboy. I too take Metoprolol. Plavix. Crestor, baby aspirin and one other that slips my mind at the moment. I too read the side effects and was not impressed. Either taking them would kill me or not taking them as I saw it. I just decided that my odds were better taking them, side effects be damned. I think the only side effects I have are some initial weight gain and sluggishness. Exercise really worked on both of them. And when I say exercise, initially, it was walking. Started at a mile a day and worked up to 5 miles a day 5 days a week. Now I play hockey, basketball, bike and do anything I want or can.
I tried all sorts of diets, meal plans, eating schedules, etc. None were particularly effective. I could do Atkins and did, and did lose weight, but it was not sustainable. I read dozens of books, listened to dozens of people tell me all sorts of different things, only one thing worked for me.
Here is the punchline: The only thing that worked for me was trusting my medical professionals and seeing a registered dietician who was willing to work with me to make very specific meal plans for weeks or even a month at a time. Then all I needed was will power. I tracked everything I ate for months and started to learn what to eat and what to avoid. What made me bloated, what helped with cholesterol, etc. My dietician served as both a food advisor and in some ways a therapist who was very patient talking me through my eating struggles.
Forget idiots like me on the internet, forget, your friends or family, listen to a trained professional. I asked my cardiologist to recommend to me three dieticians. She did. I settled on the second one I saw.
Good luck. Take it one day at a time. Slowly develop good habits. Listen to the pros.
posted by AugustWest at 10:15 PM on October 6, 2019 [7 favorites]
Does the idea of going vegan appeal to you at all? I ask because it would be great for your health, but if you also happen to be into helping animals and the environment it would give you a sense of purpose. You would also become part of a community, both of which I think would really help your mindset.
Finally, I survived a similarly serious adverse health event a number of years ago (not a heart attack) and as a non-depressed person my overwhelming emotional responses were fear (which wasn't that helpful) and also gratitude to be alive experiencing all the small pleasures that I almost didn't live to enjoy. Tiny things like seeing a butterfly on a flower or hearing a new song I liked on the radio. This doesn't seem to have happened for you (perhaps it doesn't for heart attack victims and also we're all different) but I wonder if keeping a gratitude journal could help?
posted by hazyjane at 11:27 PM on October 6, 2019 [1 favorite]
Finally, I survived a similarly serious adverse health event a number of years ago (not a heart attack) and as a non-depressed person my overwhelming emotional responses were fear (which wasn't that helpful) and also gratitude to be alive experiencing all the small pleasures that I almost didn't live to enjoy. Tiny things like seeing a butterfly on a flower or hearing a new song I liked on the radio. This doesn't seem to have happened for you (perhaps it doesn't for heart attack victims and also we're all different) but I wonder if keeping a gratitude journal could help?
posted by hazyjane at 11:27 PM on October 6, 2019 [1 favorite]
The following comes from a place of compassion, I promise.
1. For the love of God, find a different therapist. Mindfullness is not going to help you deal with the prophylactic eating that got you here, nor is it going to help you deal with the issues you ate prophylactlyic in response to. This seems like the single biggest thing you can do for yourself.
2. Why are you not on an anti-depressant? You don't mention one.
3. Take your meds and don't read about the possible side effects. This is literally not data you need right now. You need to get to a steady state and then you can make changes later.
4. Conflicting dietary advice is enraging and I completely understand that. (I mean, just reading this thread is already annoying.) Figure out the goal. Is it to lower cholesterol? Then just focus on a diet that has been shown to lower cholesterol and stick to it. I honestly feel like this is like choosing a religion -- you just pick something and commit.
posted by DarlingBri at 6:03 AM on October 7, 2019
1. For the love of God, find a different therapist. Mindfullness is not going to help you deal with the prophylactic eating that got you here, nor is it going to help you deal with the issues you ate prophylactlyic in response to. This seems like the single biggest thing you can do for yourself.
2. Why are you not on an anti-depressant? You don't mention one.
3. Take your meds and don't read about the possible side effects. This is literally not data you need right now. You need to get to a steady state and then you can make changes later.
4. Conflicting dietary advice is enraging and I completely understand that. (I mean, just reading this thread is already annoying.) Figure out the goal. Is it to lower cholesterol? Then just focus on a diet that has been shown to lower cholesterol and stick to it. I honestly feel like this is like choosing a religion -- you just pick something and commit.
posted by DarlingBri at 6:03 AM on October 7, 2019
I had a stroke forty years ago.
You don't mention daily exercise. If your docs approve this is something you should be doing that may help your state of mind. Regular exercise will, if nothing else, put you in better physical shape, which may make you feel better about yourself; it also burns calories. Ask your primary doc what is ok for you to do now. I belong to a community center gym that has a shallowish indoor pool, it's shallow enough for adults to walk laps, but deep enough to swim laps. Walking is another simple form of exercise that you can do.
Taking an art class may also help. I took some pottery classes when I was recuperating, had never done any kind of art class before. It took serious focus, which took my mind away from my problems. Find something that appeals and make time for it.
Don't be too hard on yourself. Full healing takes time.
posted by mareli at 7:08 AM on October 7, 2019 [1 favorite]
You don't mention daily exercise. If your docs approve this is something you should be doing that may help your state of mind. Regular exercise will, if nothing else, put you in better physical shape, which may make you feel better about yourself; it also burns calories. Ask your primary doc what is ok for you to do now. I belong to a community center gym that has a shallowish indoor pool, it's shallow enough for adults to walk laps, but deep enough to swim laps. Walking is another simple form of exercise that you can do.
Taking an art class may also help. I took some pottery classes when I was recuperating, had never done any kind of art class before. It took serious focus, which took my mind away from my problems. Find something that appeals and make time for it.
Don't be too hard on yourself. Full healing takes time.
posted by mareli at 7:08 AM on October 7, 2019 [1 favorite]
I am 39. At 36 I was diagnosed with congestive heart failure. It sucks. You have to allow yourself to recognize and acknowledge that your situation sucks, but not ruminate on it. It's been almost 3 years and I still get down and angry about having heart failure. It's allowed. The important thing is to do your sulking and then get on with your life.
Also realize that you can change up your meds (with your doc) if need be. If one is making you super sluggish and tired, try another one. There are lots of beta blockers.
Find a new therapist who will work with you in a style you can deal with. I fucking hate CBT, but when I found someone who was into ACT, I did a lot better.
It's only been 3 weeks since a major life altering event happened to you. You're still processing it and still overwhelmed by how much your life will change. It will get easier, and you will reach a new normal.
Do you have family or friends who support you? Just having someone cheering you on and caring is so helpful.
posted by misanthropicsarah at 8:47 AM on October 7, 2019 [2 favorites]
Also realize that you can change up your meds (with your doc) if need be. If one is making you super sluggish and tired, try another one. There are lots of beta blockers.
Find a new therapist who will work with you in a style you can deal with. I fucking hate CBT, but when I found someone who was into ACT, I did a lot better.
It's only been 3 weeks since a major life altering event happened to you. You're still processing it and still overwhelmed by how much your life will change. It will get easier, and you will reach a new normal.
Do you have family or friends who support you? Just having someone cheering you on and caring is so helpful.
posted by misanthropicsarah at 8:47 AM on October 7, 2019 [2 favorites]
I had a LAD 100% blockage due to a plaque rupture and had a stent placed. I found I was depressed too, which I attributed to my belief that this was avoidable had I taken better care of myself sooner.
I was placed on a high dosage of statins which led to brain fog once dosage was dropped the fog went away.
I was also put on a beta blocker and ace inhibitor. These caused a dizzying effect when I started would stand or turn quickly, that effect went away quickly once body adjusted to the meds.
Keeping active is important. Find an activity that you enjoy and will stick with.
posted by tman99 at 9:41 AM on October 7, 2019 [2 favorites]
I was placed on a high dosage of statins which led to brain fog once dosage was dropped the fog went away.
I was also put on a beta blocker and ace inhibitor. These caused a dizzying effect when I started would stand or turn quickly, that effect went away quickly once body adjusted to the meds.
Keeping active is important. Find an activity that you enjoy and will stick with.
posted by tman99 at 9:41 AM on October 7, 2019 [2 favorites]
This thread is closed to new comments.
posted by FencingGal at 5:46 PM on October 6, 2019 [5 favorites]