How Depression and Anxiety Effect Heart Disease

In the blog entry, I'm already Great, I talk about how I experienced heart palpitations while working in a stressful environment. I'd heard the saying "stress kills", but never did I take it as seriously as I did the day my heart started racing and would not stop. I seriously thought I was dying. Here I am, a cardiac nurse, who didn't even know that you could actually die from being stressed out. My cardiologist told me I needed to quit my job, which I did nearly immediately. I wasn't about to let my job kill me. I have things to do.

Stress, in the form of depression and anxiety, can lead to several cardiac complications. It increases the risk for atherosclerosis, which is a build-up of cholesterol plaque in the walls of arteries causing obstruction of blood flow. Depression and anxiety cause an increase in unhealthy lifestyle choices, like smoking, eating junk food, and lack of adherence to treatment regimens (like taking your medicine, or making it to appointments). Stress increases cortisol levels, which leads to increased blood pressure and blood glucose levels. Increased blood glucose has been shown to increase the risk for cardiovascular disease. Anxiety increases the resting heart rate, causing the heart muscle to work overtime. The increased levels of serotonin, which is linked to depression, can increase platelet adhesions, which can lead to blood clots. If you are someone who already lives with diabetes, hypertension, or high cholesterol, you can see how depression and anxiety can further complicate these disease processes.

So what do we do about this? We can start by identifying the source of our stress, depression, or anxiety, and eliminating it. If leaving your job, or other toxic situation, doesn't seem to be an option at the moment, start working on a plan to make the move possible. If your source of anxiety or depression is a result of a loss, then finding healthy ways to work through the grieving process can assist you with healing from the inside out. If you need help getting started, talking with your primary care provider or visiting a counselor would be the first steps to take in this journey.

We should make healthy choices, but we all know that can be difficult. This is usually because we take the "all or nothing" approach. For instance, trying to quit smoking “cold turkey” or deciding to drink only juice as a way to lose weight. That is set up for a huge let-down, and typically the old habits are revisited when stressful situations arise. Start by gradually changing one habit at a time, replacing it with a healthier behavior, to make the transition smoother. 

Physical activity, like Zumba or jogging, or relaxation techniques, such as deep breathing and meditation, are found to relieve stress and anxiety. Practicing yoga is one way to incorporate exercise and breathing techniques into one activity. You can join a yoga class, or find an online yogi that suits your ability so that you can practice at your own pace in the privacy of your own home.

And of course, always seek out professional advice. Again, talk with your primary care provider about your mental and physical health and find a counselor to assist with positive coping mechanisms. 

For more information about how stress can impact your heart, visit this link!

N. Scott, MSN RN

That time I “got read” by a complete stranger

So I only learned the term “getting read” recently when I discovered a podcast called The Read, which I enjoyed for all its mindless banter. They tickled me. At the end of each episode the host and hostess basically picked a topic that made their teeth itch, and would tell the irritating or insulting person or people about how awful they were. Nobody was safe. Random flight attendants. Celebrities. Anyone could get it. And I would listen and laugh because I thought it was funny.

I also liked to listen to another podcast that discussed political issues, hosted by two comedians, one of which would make fun of himself regularly for continuing to be single… which, by the way, is totally okay. He would joke about how his mother would comment on him not having a girlfriend. I’m not sure, but he probably even used this as material in his stand up acts. And so one day, I made a comment regarding his lack of a girlfriend on Twitter. And do you know what happened?

I got read on their next podcast. OMG. Picture it. So I’m sitting there, listening to the podcast like normal (because I was a faithful listener), and the insulted comedian starts talking about how people are rude on Twitter and how this one person (me!) made a joke about him not having a girlfriend. I was just sitting there thinking, “Holy shit, that’s me!” He says the joke wasn’t funny. (Well, I’m not the comedian, so….) The other comedian says that although it’s a joke, I’m not in on the joke (but y’all keep telling the joke), and I have no right to comment on said comedian’s single life (okay, point taken). He says he can make jokes about the insulted comedian because he’s his friend (alrighty then). Then the insulted comedian goes on to say how he’s educated and successful and doing pretty well for himself even though he’s single… as if having a woman is synonymous with success. At any rate, he was pissed, and I was sorry. So I apologized via Twitter. I never listened to their podcast again, so I have no idea if he ever read my apology or said anything about it. As a matter of fact, I didn’t even finish the rest of that episode. They said something about not coming back for a third season. I may or may not have single-handedly ended a whole podcast by telling one bad joke about a comedian that started the joke about himself in the first place. Who knew I had that much power?

And then I realized how those people must feel when they get read on The Read. I stopped listening to them too.

That wasn’t the first or last time I’ve gotten told about myself. It was certainly the first time I got told off on the air. And it was humiliating. I wish I could say that’s the only time I was put in my place in 2017, but it wasn’t. I had several more embarrassing moments where I was talked to as if I was a child, all while approaching 40. Each time I apologized for my missteps and tried my best to remember not to make the same mistake again. It’s uncomfortable to listen to someone talk about your behavior as if you intentionally did whatever it was they didn’t like. But I try to remember that their feelings are valid in that moment. I would like to think that I'm a kindhearted person, who would never want anyone to feel uncomfortable because of something I said or did. So of course, having to listen to my faults in that manner is hurtful, and often feels degrading.

My counselor and I have discussed better coping mechanisms for situations such as these. When I am emotionally uncomfortable, I tend to restrict (anorexic habits), and isolate. It’s like punishing myself for making mistakes. It’s like a mental version of sending myself to bed without dinner; remember when that used to be a punishment? The thing is, we can’t help but make mistakes. We are only human. Learning to accept that with a Type-A personality has proven to be very difficult for me. I’m already my harshest critic, so having others criticize me is like validation that I am as undeserving and mediocre as I already think I am.

I’ve learned (and relearned) some good lessons in 2017.

Like, don’t joke about someone else’s issues, even if they've joked about them first. Don’t assume someone knows what you’re talking about in a text message. Demand face-to-face business meetings, or face-to-face discussions about anything of importance for that matter. End conversations before they become toxic. Say what you mean. Mean what you say. And always, always be honest. I also learned to be more patient with others, to always speak to people with respect, and communicate in a manner that motivates people and gives them a sense of appreciation. There’s never a reason to talk to someone as if they are less than, and it will never be my intention to do so.

Being read by a complete stranger was humbling, even more so than being read by someone that I know. Mostly because this person knows nothing about me, so my first impression was all he had to go from. His impression of me was taken at face value, with no knowledge of what I do for a living, or that I have children or a husband, or that I’ve taught several hundred nursing students how to be awesome nurses. He doesn’t know that I love community service and that I’ve thrown myself into helping women of color through yoga. He doesn’t know that I’m actually a great mentor to many. He only knew that what I said insulted him. And that’s all that actually matters. He also doesn’t know that his comments changed how I interact with others via social media and in public. I’m reminded not to take people at face value; to remember that we are all humans, with stories, who have flaws, and that we should all be working to make each other better people. 

~ ND

I'm already "Great"

“You’re going to be great someday, “ she said. I was sitting across the desk from this blonde-haired, hazel-eyed woman. We were practically the same age, but I was aware that I looked probably 10 years younger than her. No lie. I wondered if she noticed it too. I wonder if she realized that I would never age as quickly as she did.  We both had our Master’s Degrees. We both taught on a collegiate level in a bachelor of nursing program. We were both mothers, married nearly the same length of time. She was no better than me.

“Someday.” I tossed those words around inside my head. “I’m great right now though.” I was confused. What the hell did she even mean? Bitch. But I sat there, smiling, and said, “Yeah, I understand.” I didn’t understand. I knew, though, that she thought I was somehow beneath her. And for whatever reason, it didn’t bother me not one little bit. Well, maybe just a touch. Lies. It bothered me a lot.

I think back on the significance of that moment and how familiar that situation was. I’m not the best at sticking up for myself and I remember sitting there thinking I should say something. But I didn’t. I never did. Like that time this white man asked me, “How did YOU get this job?” while I stood in the hospital room with my white student. I was a nursing instructor and the man had just mistaken me for the student, and my student for the teacher. Most semesters I was the only person of color in the classes I taught and people often confused me for one of the students. They would ask me when I was graduating, and I would say, “I’ve already finished school. Twice.” The students would then say, “She’s the teacher!” They got a kick out of it. The patients and family members, doctors and nurses would all apologize and try to sell me some story about how I looked so young or whatever. Same story all the time. But this man was rude. He looked at me with a half smile on his lips that did not reach his eyes, knowing that what he’d said had cut right through me. “How did I get this job?” I looked at him, smiled with all the sweetness I could possibly muster and said, “I applied for it.” I lifted my shoulders and rolled my eyes playfully. “Imagine that.” My student giggled. But it wasn’t always so easy to let these microaggressions go. Sometimes I was tired and my frustration could be read all over my face. Being constantly mistaken for a CNA or a student when I worked so hard to get as far as I had gotten, honestly, was insulting. I mean, I had on a nametag for crying out loud. Nicole Scott, MSN RN - Instructor. I would bring my concerns to coworkers, who would say, “You just look young. Take it as a compliment.”

Yeah. Okay.

“Explain why they never confuse the much older Black CNA for a nurse? Or any of the white nurses for CNAs.” Nobody ever had an answer for me. “Yeah, that’s what I thought.” I don’t have anything against CNAs. As a matter of fact, I learned more about nursing from the first CNA that I worked with than I did with my first nurse preceptor. As she showed me how to do a proper bed bath without soaking the entire bed, she said, “You’re doing a great job,” and to my patient, she said, “You’re lucky to have her”. I was fresh out of school and thought, “Wow, that was nice of her!” I kept that in mind when I had to deal with patients, family members, and coworkers who thought I was somehow unworthy of respect. “I’m doing a great job. They’re lucky to have me as their nurse.” I was already great, but it would take me awhile to figure this out.

A couple of years went by and I was working in the clinical education department at the hospital, teaching new graduates and seasoned nurses how to be better nurses.  I watched as every idea that I came up with was stolen and claimed as someone else’s. Nobody ever seemed to believe that I was the originator of any of the innovative changes that were taking place. The campaign to change the location of the hand hygiene stations the in patients’ rooms, the designing of the simulation lab, the implementation of the nurse internship program; all ideas that I had proposed. I watched as my manager told a prominent woman in the community, a large financial donor, how she single-handedly designed the simulation lab. I rode quietly in the elevator as she talked about how she discovered the rarely used space in the hospital and petitioned for this space. The truth was, this idea was already in the making when she became the manager. I sat in on her interview. I was there before her. I eventually got tired of being overlooked. I started having palpitations. Each morning when I would get to work, I would begin coughing uncontrollably, my heart skipping beats and leaping up into my throat. One day I couldn’t take it anymore. “I’m going to see a cardiologist,” I said. I grabbed my purse, and I left.

“You have to quit your job.” The doctor stood in front of me, frowning. “I’m worried about you,” he said. So, I started looking for a new job… and wound up sitting in front of the blonde-haired hazel-eyed woman. “You’re going to be great, someday.” I replay that moment over in my head a lot.  I wish I had said, “I’m already great!” but I didn’t. I just smiled sadly. I had left two jobs by then because I was underappreciated.  I left because I was sick of being invisible. I left because I wasn’t able to own my greatness. I could feel myself growing restless again. I knew I wouldn’t be able to handle the stress of trying to prove myself worthy of respect when I knew I shouldn’t have to. I kept wondering what I was doing wrong. What had I done to deserve this treatment? Was it lack of confidence? How could I make myself look older? Smarter? Why wasn’t I good enough already?

I had spent my whole life trying to be great. And now, with my advanced college education, loving husband, amazing children, home, car, career, and whole future ahead of me, I still had to strive for what I already knew I had. Greatness. Even though I already knew I was great, I was now aware that I hadn’t quite arrived at greatness in the eyes of others. This bothered me. After all, what did it matter how great I was if nobody even noticed? Why work this hard if nobody could appreciate the struggle? What was all this for? I sat in the teacher’s lounge with my head in my hands. “This is not what I signed up for,” I whispered. A colleague asked me if I was okay. I started to cry. She shut the door and sat with me. I told her I just needed a moment and that I was fine. I wasn’t fine though. I was fed up with being mediocre. I was tired of trying so hard to please others, and now, I wasn’t even sure I was happy with the path I had chosen. I wasn’t even sure who I was trying to please. I just sat there, heartbroken that I had worked so hard and had no idea what I wanted to do with myself.

N. Scott~