The Link between Heart Disease & Depression – An Eastern and Western Perspective

One of the most rewarding aspects of practicing an ancient form of medicine in our modern times is to bear witness to the many modern studies which increasingly help to shed some light on the wisdom of these practices.  Lately there has been much press on various studies that are proving the mind body connection.  The American Heart Association recently published a study that showed a high correlation between women experiencing depression with the likelihood of suffering from heart disease.  The research study looked at more than 3,000 adults with suspected heart disease for 3 years and revealed that women 55 and younger with moderate to severe depression were twice more likely to suffer a heart attack or require an artery opening procedure.  http://newsroom.heart.org/news/depression-linked-to-higher-heart-disease-death-risk-in-younger-women

THE CHINESE MEDICAL PERSPECTIVE — THE HEART AND SPIRIT

Traditional Chinese Medicine has an explanation for this.  In Chinese Medicine the physiological processes ruled by any given organ encompasses more than its basic biomedical function as understood in the West. While the heart’s main function is to pump oxygen-rich blood through the body, from an Eastern medicine perspective it not only regulates blood circulation but also governs consciousness, mental clarity, memory, our thought processes, and emotional well-being.

Ancient Eastern texts describe the heart as housing the “Shen.”  The “Shen,” according to Chinese medicine, is described as psyche, mind, or spirit.  In other words, “it
 is the residence of the mind.”

I recently read a book on Western herbal medicine (Guido Mase’s “The Wild Medicine Solution”).  In a section devoted to understanding the potent effects of aromatic herbs, the author goes into a detailed review of studies and the science around heart rate variability (HRV).  HRV is the variation in the time interval between heartbeats.  Apparently, much of this variability depends on how much activity is occurring along the vagus nerve.  The vagus nerve is a key component of the parasympathetic branch of the autonomic nervous system, regulating the homeostasis (or “resting state”) of the majority of the body’s internal organ systems that operate on a largely subconscious level, such as the heart, lungs, eyes, adrenal glands, and digestive tract.  It is the messenger of the “rest-and-digest” side of our nervous system.  The nerve that records our responses to external stress and internal tension.

Thus the “tone” of this nerve tells us a lot about the body’s internal state of tension.  In the context of psycho-physiological research, vagal tone represents an index for the functional state of the entire parasympathetic nervous system. The greater, more regular, and more frequent shifts in heart rate (HR) due to the greater amount of “tone” signals healthier parasympathetic functioning.  Greater variability also indicates better adaptability and ability to modulate internal tensions.

[Indeed studies have shown that poor HRV often indicates an imbalance and dysfunction of the vagus nerve signaling leading to nervous system problems and that people with poor HRV are more likely to have high blood pressure. (1998 Research – Singh et al., “Reduce HT Rate Variability & Neurological Onset Hypertension.”)]

In sum what this all seems to indicate is that the nerves and heart participate in a feedback loop.  As the nervous system experiences stress, as it retreats from relaxation, the heart hardens.  The cardiovascular system is less able to endure and respond to stress.

Clinical research and physicians who deal with behavioral & emotional disruptions (such as anxiety & depression) have indeed observed connections between emotional states and HRV and heart disease and HRV.

If these links exist it is further evidence of how the mind and the body, in particular our emotional processing centers and our cardiovascular system are intimately linked and not separate entities.

Traditional Eastern medical practitioners seem to have intuitively understood this.  Indeed, Traditional Chinese medical doctors have a long tradition of diagnostics, most notably the pulse reading, to gauge the internal state of tension and balance between the internal organs, the mind and the patient’s external environment.

ACUPUNCTURE AND THE HEART

Modern scientific research have found that many of the effects of acupuncture can be attributed to its ability to modulate parasympathetic/sympathetic nerve activity.  Modern research has shown that acupuncture can improve the health of patients who experience severe heart problems by dramatically reducing the activity in the sympathetic nervous system that regulates heartbeat and blood pressure.

A study conducted through the Los Angeles School of Medicine suggests that acupuncture can be used “successfully with long-range results in improving hypertension, and it may also be beneficial in lowering sympathetic nerve activity.”

Overactivation of the sympathetic nervous system is common with patients who suffer from heart problems. Over time, this may cause the heart to work harder, forcing blood to flow through blood vessels that are constricted due to heightened nerve activity.

The study showed that sympathetic nerve activation was significantly reduced in those individuals who received acupuncture care compared to those who only received a placebo. (Middlkauff HR. Acupuncture in the treatment of heart failure. Cardiol Rev. 2004 May-Jun; 12(3):171-3.)

ACUPUNCTURE AND DEPRESSION

Since Eastern medical traditions have always recognized the body-mind-spirit continuum we can explain how minding Heart health has a side effect of minding the health of your spirit and vice versa.  In TCM the element of the Heart is Fire and the predominant nature is Fire Yang energy, which unlike the darker & calmer Yin, is related to excitement, assertiveness, and exuberance. The Fire element brings warmth, passion, joy and activity into our lives. When we lack fire, we lack emotional warmth, passion and joy. This leads to inactivity and depression.  An imbalance in this energy can manifest as excess or deficiency. Thus while joy and contentment might represent a balanced Fire energy, an imbalance can manifest as agitation, nervousness, anxiety, insomnia when in excess, or as depression and lethargy when deficient.

This is why from a Chinese Medicine perspective, treating a Heart imbalance can mean not only addressing heart-related physical ailments but also addressing the psycho-emotional components as well.