Our aching hearts

"Don't go breaking my heart," intones Sir Elton. While the King checks into Heartbreak Hotel, the Chairman of the Board warns us to "Be Careful, It's My Heart."

If you think this kind of thing only happens to the big boys, consider this. I am still heartsick, after all these years, over the breakup of the Monkees.

Who knew that the almighty heart could be so emotionally fragile? It is, after all, the powerhouse of our bodies.

And if you think all of that song and dance about the heart being plagued by our emotions is just a bunch of poetic hooey, consider the following.

A large-scale review of studies has found a risk of coronary artery disease as much as four times greater in depressed people as compared to nondepressives.

For those who have survived a heart attack, the greatest predictor of death within 18 months is major depression.

Middle-aged men who are troubled by depression or anxiety are three times more likely to have a fatal stroke than their less troubled brothers.

Women are not exempt. One study found that post-menopausal women who were mildly depressed had 50 percent greater risk of succumbing to a heart-related death than nondepressed women.

There is a lot more, but I assume you get the picture.

Why does the mind have such sway over the heart?

There are several explanations that have been put forth.

Remember the Type -A personality? That's the label warring spouses are fond of hurling at each other. It has been postulated that these personalities -- hostile, impatient, defensive and insecure -- are the ones most primed for heart disease. Certainly anger has been indicted as a definite risk factor.

As anyone who has been there knows, depression is stressful. And when we are stressed, the heart does its job by taking on the extra burden. It pumps harder and speeds up. Depressed people tend to be in a chronic state of arousal, which means constantly high rates of the stress hormone cortisol, more inflammation and the bad free radicals.

On a practical level, depressed people have been known to ignore their health.

What can we do to bring the mind into a heart-healthy state? Here are some suggestions:

* If you relate to the driven Type-A personality, then it's time to consider meditation, yoga or some other stress-relieving relaxation regimen.

* If you know you have a heartsick family history, then dedicate yourself to a different value system. Eat differently, think differently, move your body differently. And most of all, handle stress differently. How about giving up smoking and road rage for starters?

* If you have a family history of depression heart disease and depression, you need to get really serious about prevention. Know the risk factors -- high blood pressure, high cholesterol, high triglycerides are three -- and get them checked regularly.

* Get intimate and/or spiritual. Some recent research points to these two as powerful heart-healthy tools. For example, men who have regular social interactions with other men or have a solid religious faith will reduce their mortality risk by a whopping factor of seven.

* Exercise. As anyone knows who has tried it, one hour at the local gym is good for both the heart and the troubled mind.

* And most of all, if you are depressed, get proper treatment from a competent mental health specialist.

Next week, I will explore treatment options for depression.

Dr. Michael O.L. Seabaugh, a Cape Girardeau native, is a clinical psychologist who lives and works in Santa Barbara, Calif. Contact him at mseabaugh@semissourian.com.