In fact, we say that people may usually be more or less accompanied by psychological and emotional problems, in general, we tend to refer to three levels, the first level is emotional problems, the second level is the psychological problems, including the psychological disorders we often talk about. The third level is mental problems. In fact, for most people, including ourselves, more or less all of us may have emotional problems.
So what do you think is the connection between emotions and cardiovascular disease?
A bad mood can cause or even aggravate the occurrence and development of heart disease, and in turn, the appearance of heart disease can interfere with a person’s normal mood. In fact it both are symbiotic and have the potential to worsen and promote each other’s relationship.
In addition to the pictures we saw in the opening scene, what type of cardiovascular patients, in general, will have some psychological problems, psychological disorders?
According to our clinical observation, in fact, there is often about the following pattern, for example, the elderly, because with age, accompanied by some ability to decline, while the psychological and emotional problems, will be born, which is related to age. The second is related to disease, when a person suffers from a disease, affecting his normal life and work, he may have a variety of emotional, psychological problems. And then, as we usually say, is an endogenous, because he was born with some personality problems, or some specific biological factors lead him to be a susceptible to emotional problems susceptible people.
What is the inevitable link between them? What is the inevitable link between poor mood and heart disease?
I think it is like this, in fact, we have a very clear expression in Chinese, which refers to sadness, when a person is struck and has emotional distress, his psychological and emotional impact will trigger a series of symptoms of heart disease, of course, there are some, he may only be symptoms, with the removal of emergency factors, after the emotional recovery, his symptoms may disappear. Others, under the effect of chronic emergency factors, will develop some changes in blood pressure and heart, and eventually will develop into real heart disease.
Tell us how you can include the diagnosis and treatment of psychological disorders in the treatment of heart disease, for example, during your consultation?
The most common recommendation is to add psychological assessment, emotional assessment, regardless of the type of angina pectoris or the specific type of heart disease, and we usually use some scales, or the doctor can clearly understand the patient’s emotions and inner things through interviews, and in turn we can assess how much such emotional problems affect the occurrence and development of heart disease. The patient’s heart condition is usually diagnosed by means of a scale or by the doctor’s interview.
What tests do we usually perform to diagnose whether the person has a mental illness?
Experienced doctors may be able to determine whether the patient’s emotional and psychological problems are physiological or pathological through a simple conversation, while other doctors, because they may not have specific psychiatric training, may adopt some scales to assess the patient’s emotional and psychological condition by asking a few questions, such as If the patient answers yes, then at least he is a suspicious patient with a double heart.
Can you give us one or two examples of patients that you have seen that may have had problems with both hearts, and then through treatment, both hearts have improved somewhat.
There are actually many such patients. Not long ago, we admitted a patient who was transferred to us from an outside hospital. I said, “Why? In fact, before here, we already found that he was a depressed patient, but never found a good entry point, because some people are very averse to words like depression and anxiety, and our doctors thought this was a good time to give him a psycho-psychological assessment, and actually found that he was a moderately severe depression problem.
Very powerful, and then asked, this is a painter, he is doing very well in his industry, he told, he said he started from high school, in fact, he is such a depressive mood, like hidden, in his heart lingering, in fact, is endogenous depression, there are many years, there is also a family history, his family also has a history of suicide, because this patient perennial depressive state, can not be relieved, we know After depression, the neurological, psychological, and even hormonal levels in the body are in a state of imbalance. In such a state of neurohormonal imbalance, it will trigger the endothelial damage of the arteries, which will lead to the emergency infarction in such a situation. In this case, if we do simple treatment of coronary heart disease and blood stasis reconstruction, the future healing is not good, we must treat the accompanying depressive state at the same time.
Now we are looking at double heart, not only from the biological point of view, treating some diseases of the heart itself, but also seeing the problems of his mental state, and as a psychiatrist to solve them for him.
We also know that nowadays, many people may be under great pressure at work and in life, but we often neglect our mental health.
Back in the studio, I found that we all have our own ways to relieve our negative emotions, but we all mentioned that many people may not know that heart disease patients may have some mental illnesses, and I was thinking that many people may not feel that they are usually unhappy, but they may be depressed or have a tendency to have mental illnesses. I would like to ask Prof. Liu, how is the number of visits to the Double Heart Clinic?
The volume of our Double Heart Clinic is through online registration and through our registration office, but basically it is still difficult to register, and sometimes I find it a little difficult to register myself.
In fact, there are still many people who are willing to come to the Double Heart Clinic to see a doctor.
If they are aware of the problem, they will come to us for help, but unfortunately, there are many patients who are not aware of it.
A lot of patients, he may feel that he only has a heart problem, there is no mental illness problem, maybe he does not want to face his mental illness, so he is not too willing to go to the hospital, what to do?
In fact, we say that we still need to remind everyone to be vigilant about double heart, because there are some heart disease patients, after the routine heart examination and treatment, should be very good recovery, such as his electrocardiogram, for example, some of his blood vessel pattern, including some blood flow, are very good, but the patient’s symptoms just linger, back and forth always attack, using any medicine does not work. In such cases, we must screen for emotional and psychological problems.
Is there such a patient who comes in with symptoms of heart disease, he has all the symptoms, but this test, all indicators are normal, purely a problem of psychological disease?
There are many of them, mostly in middle-aged and young people, because they are under high stress and in a state of emergency for a long time, their bad emotions are difficult to be relieved, which will turn into some symptoms of heart disease, the most common ones are feeling tightness in the chest, panic, and even premature beats.
What treatment will be done in this case?
Usually we will give him a two-way assessment, from the electrocardiogram heart ultrasound, including some conventional biological indicators, should be assessed accordingly, to see if he really has heart disease, how serious, if there is no heart disease, we need to assess some of his emotional and psychological problems at the same time, such a person may be bad mood, there are many people are under the cover, we say that some people’s depression, is a covert depression, looks very cheerful, but in fact he is still in a depressed state inside. So through some of our measurement methods, we are able to detect these patients and give them the appropriate treatment. One of the treatments is through distraction. The second is to improve the lifestyle and increase the use of drugs to regulate the nerves and fight his depression if necessary.
Have you encountered any problems during your regular outpatient visits to Double Heart?
I think the most difficult thing is to change one’s consciousness. There are many people who think that psychological and emotional problems are shameful, and I don’t want to talk about them, and I don’t need to give them to doctors, but they don’t understand that it is precisely these emotional and psychological problems that can lead to the development of heart or blood pressure diseases.
We also want to ask, we also know that now cardiovascular disease is actually the number one killer of human health, a lot of attention is said to be on the disease itself, that is to say, a heart, now mention two hearts, one is the heart itself, and psychological, you tell everyone, will not make the attention distracted?
I think it is necessary to emphasize the connection between psychology and heart disease. When a person suffers from emotional distress or a specific blow, his nervous system will be activated. In turn, if a person has heart disease, if he is not able to correctly understand and treat the diagnosis and treatment of such heart disease, it is very likely that the Arctic ice distress, can not go out of the psychological misunderstanding, slowly progress into depression or anxiety, or some other psychological problems.
As we mentioned earlier, if you have a psychological problem, you may not be aware of it yourself, and only bystanders may feel that this person may feel a bit strange. Can you tell us in the studio, do a self-assessment at home, or in what way you can let yourself know if there may be a problem, and we should go to the double heart clinic?
In fact, there are many such scales available online, and we usually use them for this kind of non-professional self-assessment, for example, the most commonly used is PHQ2, which actually asks two questions: do you think you have felt depressed and very depressed in this recent period of time? The second question is whether you are still interested in doing things? We say that we are exploring the intrinsic motivation of life. Not having any interest in doing things, not being happy with anything, is also a sign that one’s intrinsic motivation has weakened, and is actually a problem to be considered as depression.