The following is an excerpt from Kidding Ourselves: The Hidden Power of Self-Deception by Joseph T. Hallinan [Crown, $25.00].
For decades, researchers have documented a strong connection between heart attacks and hopelessness. Once people come to believe, for whatever reason, that life is no longer worth living, that belief tends to become a self-fulfilling prophecy. One major study in the United States found that having a severe sense of hopelessness doubled the risk of a fatal heart attack. Moreover, the study found, hopelessness and heart attacks weren’t merely correlated; one actually appeared to cause the other. A study of Dutch men reached a similar conclusion: those who felt overwhelmed by their problems and wanted to “give up” faced an increased risk of heart attack.
Very often, these heart attacks are triggered by extreme emotional shock, such as the death of a spouse, or, even worse, the loss of a child. In 2004, for instance, Karen Unruh-Wahrer, a respiratory therapist from Tucson, Arizona, got the news every parent dreads: her son, twenty-five-year-old army specialist Robert Oliver Unruh, had been killed by enemy fire in Iraq. Friends reported that she could not stop crying. Hours after viewing his body, she collapsed in her kitchen and died. She was just forty-five years old. Her boss at the hospital where she worked said that although coroners identified cardiac arrest as the cause of death, Ms. Unruh-Wahrer did not have a history of heart disease, and family members believe she died of a broken heart.
This is not hyperbole.
Recent studies in Denmark and the United States have shown that mothers of children who have died face a much higher risk of dying themselves in the years immediately following the child’s death. In the United States, in the two years following the death of a child, the odds of the mother dying increased to more than three times those of mothers whose children survived. After two years, the difference narrowed, but it was still 22 percent higher for grieving mothers. A similar trend has been found among those who lose their spouses; several studies of men and women in the year or so following the death of a spouse show higher than expected death rates, with much of the increase due to heart disease.
“When I’m asked, can you die of a broken heart, I say... absolutely, yes, you can,” says Dr. Ilan Wittstein, a cardiologist at Johns Hopkins School of Medicine.
In a 2005 article in the New England Journal of Medicine, Dr. Wittstein and his colleagues described nineteen cases of patients who had no coronary disease but were nevertheless admitted to Johns Hopkins with chest pain or heart failure brought on by acute emotional distress. They labeled the condition “stress cardiomyopathy,” but it has since come to be known by a more popular name: broken heart syndrome. It can be triggered by a wide variety of emotions, but one of the most powerful is grief. Since the publication of Dr. Wittstein’s article, the condition has been diagnosed in thousands of patients around the world and has been written about in hundreds of journal articles.
For reasons that aren’t clear, nearly 80 percent of its victims are postmenopausal women. Although its exact incidence is not known, the condition is likely to be far more common than generally thought. About 1 percent of men and 7 percent of women diagnosed with heart attacks are estimated to have stress cardiomyopathy instead. The confusion is understandable. The symptoms of both conditions are nearly identical: chest pain, weakness, shortness of breath. But there is one big difference. Hearts attacks are caused by a blockage—a chunk of plaque breaks loose from a vessel wall and clogs the vessel, shutting off blood supply to the heart. But in stress cardiomyopathy, there are no signs of blocked arteries.
So how does a broken heart kill? No one knows. Dr. Wittstein’s suspect is stress hormones -- powerful chemicals such as adrenaline that are released into the bloodstream when we experience fear, anger, and other emotions. In small doses, these hormones work wonders, often allowing us to perform superhuman feats, like lifting cars off of people. But a surge of hormones can also do more harm than good. And Dr. Wittstein’s patients showed extremely high levels of stress hormones -- in some cases up to thirty times the levels seen in normal patients. Calcium also rushes into the heart cells to allow the heart to contract more vigorously and squeeze more strongly. When a storm of adrenaline hits, too much calcium floods the cells, and the heart becomes overwhelmed. The heart muscle isn’t damaged, as it is in a heart attack; it is instead stunned, and the stunning can be enough to kill.
Reprinted from the book KIDDING OURSELVES by Joseph T. Hallinan. Copyright 2014 by Joseph T. Hallinan. Published by Crown, a division of Penguin Random House, Inc.