The expression “thinking with your head, not your heart” implies the two are disconnected, but research has found the two have more connections than you think.

Unraveling these connections and finding ways to help heart patients cope has been the research focus of Jeff Huffman, MD, director of the Cardiac Psychiatry Research Program at Massachusetts General Hospital.

What is Cardiac Psychiatry?

Cardiac psychiatry, also called behavioral cardiology, is the study of psychiatry as it relates to patients with heart conditions. It explores the connections between mental health, behavior, and medical health in patients who have suffered from an acute cardiac event, heart disease, or other chronic conditions.

The field is relatively new but Huffman has always had a feeling the two were connected.

A psychiatrist by training, Huffman was always interested in cardiology in medical school. He was intrigued by people with heart disease because of the evidence that mental health plays a significant role in cardiac recovery.

Cardiac Psychiatry Research at Mass General

Research by Huffman and others has shown depression and anxiety are risk factors for poor cardiac outcomes and death, even independent of traditional cardiac risk factors like high blood pressure, smoking or diabetes.

When patients experience heart issues, they can have a hard time staying positive and adjusting to a new heart-conscious lifestyle, Huffman says.

One day Dr. Huffman was in a bookstore and happened to see a book about the impact of being happier, The How of Happiness. He decided to contact the author, Sonja Lyubomirsky. Together, they created the PEACE program, which stands for Positive Emotions after Acute Coronary Events.

Researchers from the Cardiac Psychiatry team recruit people who have recently suffered from a heart attack, stroke or other acute cardiac events to participate in the PEACE program. The program focuses on highlighting strengths and successes to help patients maintain optimism and feel motivated to reach their recovery goals.

"If we can help people's mental health, their frame of mind, we believe it can help their hearts," Huffman says.

Another program, called Total Health, includes people who have both an established mood or anxiety disorder and a chronic health condition.

The study utilizes a collaborative care model in which each person is assigned a nurse who helps the patient manage their physical and mental health. This nurse is also in constant contact with a cardiologist, who monitors the patient’s heart health and intervenes when necessary.

The goal is to incorporate mental health care into cardiac care and to determine if this combination leads to an improvement in quality of life and other positive outcomes during and after treatment.

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