Link Between Mental Health and Physical Health May Be Changing

Though months have passed, we might never forget the heart-wrenching story of Joe Garcia, the grieving husband who, hours after placing flowers at a memorial to his wife, Irma, reportedly died of a heart attack. Garcia’s wife was one of two teachers killed in the mass shooting at Robb Elementary School in Uvalde, Texas. The story of his death would resonate around the world, as both news headlines and family members attributed his death to a broken heart. What medical science now knows is that it is a description of a condition that is now more than symbolic.

The clinical name for broken heart syndrome is Takotsubo cardiomyopathy. According to the Cleveland Clinic, it is a disorder with similar symptoms to a heart attack. Its cause is not completely known. “It may happen because of a sudden surge in adrenaline and other stress molecules in your body, possibly due to triggers like severe emotional stress.”

Reports USA Today, a 2021 study shows that cases of broken heart syndrome have increased in recent years and that “a growing body of medical research” suggests the “likelihood has increased during the COVID-19 pandemic.”

Dr. Ilan Wittstein is a cardiologist and professor at Johns Hopkins University School of Medicine who co-wrote a study of the syndrome in 2005. “If you think about the heart as a pump that has to pump blood to the rest of the body, if the heart muscle suddenly weakens, it can create a situation where blood isn’t getting to the vital organs, and a person can die,” he explains to USA Today.

It wasn’t all that long ago when medical professionals viewed the brain as isolated from the rest of the body. Many still do. Western medicine treated the brain and the body as separate domains. As more research is being devoted to examining the link between physical and mental health, a closer direct connection is being made.

For example, Harvard Health research recently demonstrated at a conference of the American College of Cardiology that the roughly 52,000 patients across the United States who had depression after a heart attack were 50% more likely to suffer a stroke compared with those who did not develop depression.

The study also found that “heart attack survivors with depression also had higher rates of high blood pressure, diabetes, heart failure, chronic obstructive pulmonary disease (COPD), and coronary artery disease, compared with those who didn’t develop depression,” reports Harvard Health. The study has yet to be peer reviewed but is consistent with evidence from earlier studies on the association between depression and stroke after heart attack.

As reported by the New York Times, as experimental drugs prove ineffective, new dementia prevention methods are shifting from the prescribed to behavioral. Says Dr. Julio Rojas, a neurologist at the University of California, San Francisco, this represents “a drastic change in concept.”

“Public health experts and researchers argue that it is past time to turn our attention to a different approach,” the Times’ Paula Span reports. “(By) focusing on eliminating a dozen or so already known risk factors, like untreated high blood pressure, hearing loss and smoking, rather than on an exorbitantly priced, whiz-bang new drug.”

This shift in approach was apparent in a new study of vision impairment published in JAMA Neurology. Using data from the Health and Retirement Study, researchers estimated that nearly 100,000 dementia cases could have been prevented through healthy vision. “Though that’s a fairly small percentage, it represents a comparatively easy fix.” writes Span. “That’s because eye exams, eyeglass prescriptions and cataract surgery are relatively inexpensive and accessible interventions.” This is according to Dr. Joshua Ehrlich, an ophthalmologist and population health researcher at the University of Michigan and the study’s lead author. He also states that the link between dementia and hearing loss as an important factor has already been well-established.

Why would hearing and vision loss contribute to cognitive decline? As explained by Rojas, co-author of an editorial in JAMA Neurology, “A neural system maintains its function through stimulation from sensory organs.” Without that stimulation, “there will be a dying out of neurons, a rearrangement of the brain,” he says. “Hearing and vision loss could also affect cognition by limiting older adults’ participation in physical and social activity.”

As dementia cases are climbing along with an aging world population, eye and hearing exams, exercise, weight control, stopping smoking, blood pressure medications and diabetes care represent modifiable risk factors worth addressing. “These are things people can do in the communities where they live,” says Ehrlich.

It is easily understood how grief can throw off the body and impact gastrointestinal health. Connie Chang and Juli Fraga of Time magazine cite one story of a woman who, following the death of her mother, didn’t eat for days. Stress can trigger the “fight-or-flight response … when the body is warding off danger, it’s not focused on digestion or eating,” they write.

“It’s challenging to solely examine bereavement, because grief includes other emotions such as anger, sadness, and denial,” they say. “When these feelings linger, they can contribute to mental health concerns like anxiety and depression. These conditions’ ebbs and flows have been linked to the bacteria residing in the gut.”

Karina Alvina, a neuroscientist at the University of Florida, explains that the biggest mindset change for the medical community “was the realization that the brain not only instructs the body to move and breathe, but that signals from the gut as well as other organs and tissues can also alter how the brain functions.”

“Overall, grief is a full-body experience,” they write.

For traditional medicine to admit that health disorders can have both a physical and psychological element signals an important step forward in modern medicine.