Healing the mind after heart attack

Free online program offers support to heart attack survivors dealing with anxiety and depression
Mother and daughter sitting talking

Luke Schneider was contemplating topics for his clinical psychology research project when a close family member had a heart attack. 

“He told me that he went to a cardiac rehabilitation service and was struck by how much focus was on exercise and eating healthy,” recalls Luke, a PhD candidate at the University of Regina. “He went in hoping to talk with somebody about the depression and anxiety he was experiencing. Their answer to him was, ‘Go talk to your GP.’”  

Digging deeper, Luke soon discovered that many Canadians shared similar stories. 

“I realized that national guidelines in Canada emphasize psychological treatments and supports to help people manage stress and anxiety after a heart attack. But there is a lack of access to evidence-based treatments. That’s what got me on this road.” 

The mind-heart connection

Depression and anxiety are common for heart attack survivors — yet many people don’t seek treatment. 

In 2016, Luke developed the Cardiac Wellbeing Course for his doctoral dissertation to address the gap of limited mental health supports for cardiac patients. 

The free, eight-week online pilot program is available to people across Canada who have experienced angina or heart attack within the last two years.

When you get nervous or stressed, part of the anxiety response is to speed up the heart, Luke says. For someone who has had a heart attack, those physical symptoms can be extremely upsetting and trigger a chain of thoughts. “Does this mean I’m having another heart attack? Should I go to the hospital? Should I take extra medication?” 

Participants in the Cardiac Wellbeing Course learn stress reduction techniques, like breathing exercises, to relieve anxiety in these moments. They also receive cognitive behavioural therapy (CBT), a form of therapy that teaches evidence-based, practical strategies to deal with depression and anxiety.

Traditionally, cardiac rehabilitation programs focus on group-based  classes. Wait times to enroll in these programs are generally long and group settings can deter people who feel embarrassed about sharing their mental health struggles. 

To overcome these barriers, the Cardiac Wellbeing Course takes an individualized approach. Patients don’t need a referral to join the program and receive weekly check-ins from a  mental health professional by phone or email.   

Luke Schneider

From a prevention point of view, these things shouldn’t wait until they become big problems.

Luke Schneider Cardiac Wellbeing Course creator 

Living with anxiety 

When Ron Thompson underwent coronary bypass grafting surgery in July 2016, he expected to be back on his feet within a few days. That’s not what happened, says the 69-year-old Moose Jaw resident. 

“Before the operation I wasn’t told about all the difficulties that would arise. I think that was part of the problem, I didn’t expect the physical symptoms to be as bad as they were. I was anxious about getting through it all.” 

Ron’s recovery plan included a 12-week cardiac rehabilitation program that focused primarily on physical rehab; it included only one three-hour session on the emotional changes and symptoms he might experience. 

With few supports, Ron's anxiety attacks worsened. He'd startle from bed at night soaked in sweat, heart racing and unable to catch his breath. 

When a nurse told him about the Cardiac Wellbeing Course, Ron enrolled right away. He found that the weekly phone calls and breathing exercises eased his anxiety and helped him work through his feelings of uncertainty. 

“Sometimes it’s difficult to talk about things but it’s important. You learn that you’re not the only one in that situation; many people have the same thoughts after a heart operation.”   

The program is under evaluation until August 2018, but early results are promising enough that the program may be extended. After eight weeks, participants who enrolled with symptoms of mild- to moderate depression or anxiety reported minimal symptoms at the end of the program. Many also increased their physical activity levels. Anxiety, depression and physical activity levels for  people placed on a waiting list for a similar period of time remained the same. 

Looking ahead, Luke hopes to expand the program to reach more people. 

“People have a hard time with labels like depression and anxiety. I really want to emphasize to people that if you’re feeling a little stressed, of if you’re feeling a little down or anxious, you can be part of this course,” Luke says. 

“From a prevention point of view, these things shouldn’t wait until they become big problems. If there’s an inclination on someone’s part to get a little bit better and learn some stress management techniques, this course will benefit them.”