Tuesday, February 15, 2011

In Honour of Valentine's Day ..

Happy belated Valentine's Day to everyone out there! I am a day late in this post due to some unforeseen Valentine's Day events: editing articles for today's Markham Stouffville Hospital Health Fair, which I was honoured to be a part of. I know, I know .. it sound pathetic spending Valentine's Day engrossed in medical data! I may be pathetic .. but at least I'm pathetic and smart! :)

Considering V-day, let's talk about the heart. So, it's interesting to note that there is an undeniable correlation between depression and heart disease! When we talk mortality, depression ALONE doubles mortality risk; heart disease ALONE increases risk by two thirds. It is interesting to note, as Scientific America Mind (Jan-Feb 2011) did by summarizing a study, that, on any given day, individuals with both depression and heart disease were approximately five times more likely to die than their peers!

This peaked my curiosity so I began researching the mechanism of action of this lethal pair. Early research shows that individuals that suffer from depression are at greater risk for developing a heart condition, including arteriosclerosis, arrhythmias and MI (myocardial infarction or heart attack). As I delved a little deeper, I found that the physiological explanation to why depression leads to and can worsen heart disease is still unclear. An article called Biological Mechanisms in the Relationship Between Depression and Heart Disease reviews the scientific data and the theories associated with this correlation: it is plausible that people who have had a cardiac incident can become depressed which negatively impact lifestyle and increase their chances of another cardiac incident. On the other hand, people that are depressed already, may not be indulging in healthy eating and exercise which could contribute to them acquiring heart conditions. This, although relevant, is simply a contributing factor. The situation is seemingly more complicated that just lifestyle: depression is associated with dysregulation of the HPA axis (hypothalamic-pituitary-adrenal axis). Studies indicated that the feedback loop of this axis is impaired in depressed individuals resulting in an increase in glucocorticoid production. This causes a cascade of events that lead to an increase in corticotropoid releasing hormone which acts in the brain to increase your stress response. More circulating norepinephrine and epinephrine act to increase heart rate and contractility which can predispose individuals to heart disease and increase their risk of cardiac incident. I could continue with the pathophysiology of it all (the research study is 17 pages long) but I will spare you!

Considering the unfortunate circumstance of living in dark, cold Canada in the month of February and knowing that there is an nice, tidy association with heart disease and depression, what is a girl like me to do?!

According to TCM (Traditional Chinese Medicine) there is a distinctive heart-mind connection. Balancing the heart-mind connection usually involves cooling the body with foods that are simple and nourishing: unrefined grains like wheat (germ) and brown rice will "cool" the heart and provide your body with much needed magnesium (a natural muscle relaxant that slightly dilates blood vessels) and B vitamins which mitigate stress. Mind-body techniques such as listening to uplifting music will induce a happier state of mind consequently interrupting the negative cascade of endocrine dominoes which eventually lead to heart pathology. Increasing serotonin by ingesting l-tryptophan-rich miso soup on a nightly basis will help you balance mood and avoid the winter blues that lead to seasonal depression. And if all this fails, pack up and move to a sunny, hot destination spot and fall in love over and over again to keep the positive endorphins flowing ... or just run a marathon daily, which will produce the same endorphin rush (despite the eventual need for bilateral knee replacement surgery). Regardless of which you choose, make sure you have fun doing it!

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