Post-traumatic stress disorder is not limited to troops on the battlefield; it can also affect patients with heart disease as well as those with other medical conditions, according to this month's issue of the Harvard Heart Letter.
"The same kinds of things we associate with soldiers can be associated with so many other things," Patrick Skerrett, editor of the Harvard Heart Letter, told Reuters Health, including heart attacks and heart disease.
Coined during the Vietnam War, the term post-traumatic stress disorder (PTSD) is often used to describe the condition affecting soldiers returning home from war, for example, or that affecting individuals who have witnessed horrors such as the attack on the World Trade Center.
Yet, the Harvard Heart Letter asserts, individuals can also experience symptoms of PTSD after being diagnosed with cancer or some other serious illness, after undergoing some type of major surgery, or after experiencing heart trouble.
"After a heart attack, we have so many good ways to save people and get them on the road to recovery," Skerrett said. But for some people, as their bodies recover, their emotions, their souls, their minds may not.
Symptoms of PTSD include re-experiencing, by which sufferers relive the trauma they experienced through flashbacks or nightmares; avoidance, whereby affected individuals stay away from certain people, places, activities, or other reminders of the trauma; and arousal, as affected individuals are constantly on the alert for any signs of danger, have trouble sleeping or concentrating, and are easily startled.
10 percent survivors experience PTSD
Research shows that up to 10 percent of individuals who survive heart attack experience PTSD.
PTSD has also been found among people who have experienced stroke, major heart surgery, including transplant, and in those who have had a defibrillator implanted. And, in addition to its psychological and emotional effects, PTSD may slow down recovery from these conditions, or even worsen heart disease.
In some cases, for example, heart attack patients may stop taking prescribed medications to avoid reminders of the trauma.
Betrayal of the body
The thing unique to heart-related PTSD is that the trauma is from the inside, rather than being due to some outward event, according to the Harvard Heart Letter.
"The knowledge that your body betrayed you once, and could very well do it again, has some heart attack survivors walking on eggshells," Dr. Leonard Doerfler, of Assumption College in Worcester, Massachusetts, who has conducted much research on the topic, told the Harvard Heart Letter.
Still, while feeling anxious or down after experiencing heart attack or some other traumatic event is normal, those who experience daytime flashbacks, heightened arousal or other symptoms should talk with their doctor about being evaluated for PTSD, according to the letter.
"You're not crazy," Skerrett says to those who have such symptoms after experiencing heart trouble. "There can be some long-term emotional or psychological consequences of having a heart attack," he said, adding that cancer patients may also experience similar symptoms.