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Get the social support you need if you have coronary artery disease

Annoyed by constant indigestion and other lingering symptoms, Marybeth Neyhard of Broomall, Pa., Went to see a doctor in July 2017, who quickly got disturbing test results.

A scan of her coronary arteries showed she had several major blockages, and instead of going on vacation to London with her husband, she headed to an operating room, where she ended up having bypass surgery. ’emergency.

Neyhard, the oldest of six siblings and a married mother of three grown children, woke up to find she had plenty of company. “My whole family was around me,” she says. Neighbors rushed in with wishes and meals, and friends near and far checked in to see how she was doing.

And when she spotted a sign in the hospital elevator for a monthly women’s support group at the Lankenau Heart Institute, she decided to go to the next meeting.

“I’m not the type to be afraid to reach out,” says Neyhard, who is determined to do everything in his power to avoid a second surgery. “I don’t want to be a repeat offender.

Maintaining connections – and forming new ones – is an essential part of cardiac rehabilitation for patients like Neyhard, says Yale professor Matthew Burg, PhD, a clinical psychologist who studies how stress and emotional factors affect cardiovascular disease. .

Years of scientific studies have shown a clear trend. “Social support is good, and not having it is bad,” says Burg. For people who don’t feel like they have someone to turn to or to rely on, the risk of adverse events can double, he says.

Here’s what you need to know about social support, why it’s so important to your heart, and how to make sure you have people to help you through your tough times.

Why social support affects your heart

For decades, scientists have understood that mind and body are connected, says Kim Feingold, PhD, founder and director of behavioral cardiac medicine at Northwestern’s Bluhm Cardiovascular Institute. These links appear with many medical conditions, but are especially pronounced with patients with heart disease.

“It’s the disease [where] it is very evident that the way we behave, think and feel has an impact on our physical health, ”says Feingold. Not only do things like depression, anxiety, stress, and social isolation not feel good, but they are also linked to other health issues.

Social support plays a role in each of these factors. “We are social animals. It’s in our DNA, ”says Burg. That’s why we take great comfort in knowing that there are people who can help nearby – it can help them know that if something goes wrong, everything will be fine, he says. When we don’t have that assurance, it’s stressful.

“The question is: How does this stress get into your skin? Says Kevin Larkin, PhD, who heads the Behavioral Physiology Lab in the Department of Psychology at the University of West Virginia. The answer: by the head.

When you feel stressed, your brain absorbs this information and sends signals to the rest of your body. Research shows that these reactions, including the resulting inflammation, likely contribute to heart problems and other health issues.

What counts as social support?

The term “social support” is difficult to define because it means so many things.

As Burg notes, sometimes you need very practical assistance: “If my car breaks down, is there someone I can call? Are there people who can shop for me? “

The emotional needs are just as urgent, Feingold says. She emphasizes the importance of laughing, sharing stories and being able to solve problems.

And when it comes to changing lifestyle behaviors – like quitting smoking or getting back in shape – it may require a different kind of support. “If you find a partner to exercise with, you’re more likely to achieve your goals,” says Feingold.

In some cases, a spouse may provide all or all of these types of support. But not always, says Burg, who has seen married patients consistently score low on a social support scale. He says it’s common for wives to excel as caregivers when their husbands have heart problems, and the opposite is true when the tables are turned. “Man does not mobilize to help or change expectations,” he says.

Of course, many men are good at providing social support. In any partnership, one person may feel more supported than the other or be better at social support, not just in husband-wife relationships.

Neyhard has encountered similar situations among members of his support group, as well as women whose families refuse to put heart-healthy food in the fridge or on the dinner table. “Maybe they’re okay with it initially, but they’re not about to change their diet because she has to,” she says.

So it can be important to expand beyond your existing networks to get the full range of support you need.

Request social support

When clinical psychologist Valerie Hoover meets people with heart disease, she encourages them to ask themselves if they can get more support than they think.

“If they say, ‘I don’t have anyone to turn to’, I ask them to generate a list of everyone they know – friends, family, neighbors – and if they go to that person,” explains Hoover, PhD. , clinical assistant professor of cardiovascular medicine at Stanford University.

“There are usually different ‘Aha’ times for patients. When they sit down and write this list, they are amazed at the number of people in their life.

The next step is to probe how comfortable they are to ask for this support.

“A lot of people have this idea that it says something negative about them, or that it’s weak to ask for help,” says Hoover. She tries to make them see things differently. She asks them to think about times when people have turned to them for help in the past and how rewarding that has been.

When it’s time to ask for help, Hoover encourages them to be as specific as possible. (For example, rather than asking your partner to do more at home, you might come up with a concrete task to do, such as cooking dinner.) And, she says, it’s important to follow through on that request with gratitude. and appreciation.

Build a support network

Some people may write their list of social links and find it quite short. The two most common situations, says Burg, are people who have never formed many relationships and those who have had social circles that have since collapsed.

“Maybe there’s an older woman whose husband has passed away, her friends have moved south, and her children live remotely,” Burg says. For someone with this profile – or someone who has a hard time trusting others – it can be stressful to tell them to just go out and make friends. And this stress, he points out, is not good for their hearts either.

Feingold’s tip: Take your time and find ways to make connections that work for you.

“Cultivating social support is practical and possible, but it’s a process,” she says.

One way to start is to seek out common interests, perhaps through a hobby, book club, or place of worship. “Challenging yourself to step out of your comfort zone can seem awkward at first,” she says. But these types of groups not only offer potential friends, but also a chance to establish new routines and motivation to leave the house every day.

Heart patient support groups have the added benefit of bringing together people who have faced similar challenges. “They can build relationships and exchange resources,” says Feingold. “They understand each other in a way that others cannot.”

This was true for Neyhard. Her support group gives her the opportunity to discuss topics that she normally prefers to avoid.

“When I go to lunch with my friends, I’m not going to talk about my food choices,” she says. But with her support group, she doesn’t hesitate to ask questions and share recipes. “It gives me an outlet to talk about all this health stuff without ruining the party.”

How the pandemic has disrupted social support

Social distancing and cutting back on many in-person activities over the past 2 years have had obvious consequences.

“High blood pressure and stress-related disorders flourish in this environment,” says Larkin. He is particularly concerned about the long-term effects on students, who have missed the opportunity to form relationships that often last for decades and provide a framework for making and keeping friends into adulthood.

For many older people, the pandemic has made it difficult to maintain existing bonds and form new ones.

Feingold sees a silver lining: Online support groups have improved access for people who had not been able to attend in person before. Attendance is on the rise in the group led by Larkin. She attributes this to easier logistics. “They don’t have to drive downtown, find a parking space and drive home,” she says.

Searching for online help can work very well, Hoover acknowledges. But what matters most is the level of support you end up getting.

“Like a Facebook post is not a conversation,” she says. Your heart needs more than that.


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