Managing your emotions can save your heart

Srini Pillay, MD


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We often think of the heart and brain as being completely separate from each other. After all, your heart and brain are located in different regions of your body, and cardiology and neurology are separate disciplines. Yet these organs are intimately connected, and when your emotions adversely affect your brain, your heart is affected as well.

The negative impact of emotions when your heart is already vulnerable

There are two kinds of stress that impact your brain. Helpful stress (also known as eustress) can assist you with getting things done by helping you focus your attention. Unhelpful stress (distress), on the other hand, can be so severe that it can lead to fatigue and heart disease.

If you have coronary artery disease (CAD), your heart may be deprived of oxygen. This deprivation, called myocardial ischemia, can occur in as many as 30% to 50% of all patients with CAD. It can be further exacerbated by emotional stress. In fact, if you have any type of heart disease, any strong emotion such as anger may also cause severe and fatal irregular heart rhythms. Expressions like “died from fright” and “worried to death” are not just hyperbole — they are physiologic possibilities. Furthermore, when patients with newly diagnosed heart disease become depressed, that depression increases the risk that a harmful heart-related event will occur within that year.

The negative impact of emotions when you have no heart disease

Of course, stress can have a big effect on your heart even if you don’t have heart disease. Here’s just one example: In 1997, cardiologist Lauri Toivonen and colleagues conducted a study of EKG changes in healthy physicians before and during the first 30 seconds of an emergency call. They saw changes that indicated oxygen deprivation and abnormal heart rhythms.

More recent studies have also observed these changes in the setting of with stress, anxiety, and depression — all of which are, of course, brain-based conditions. Even in people with no prior heart disease, major depression doubles the risk of dying from heart-related causes.

Cardiac psychology: Tending to your emotions for your heart’s sake

It is important to control your worry and stress, not just because you will worry less and feel better, but because less worry means less stress for your heart. This applies to the entire range of stressors, from a small episode of acute panic to a larger context such as living through a natural disaster. For all the reasons outlined above, a new emotion-based approach to heart health, called cardiac psychology, is receiving increasing interest.

You really can change your brain and get a healthier heart in the process. Here are some ways to get started:

  • Seek professional help. Don’t ignore stress, anxiety, depression, excessive worry, or bouts of anger that overwhelm your life. Seek professional help. If you meet criteria for a diagnosis, treatment can help reduce symptoms, thereby protecting your brain and your heart.
  • Available treatments in cardiac psychology. Aside from more traditional psychiatric treatment and exercise, psycho-educational programs, educational training, stress management, biofeedback, counseling sessions, and relaxation techniques should all be considered before or after a heart-related event. Newer treatments such as acceptance and commitment therapy and expressive writing can also be helpful.
  • Exercise. Physical exercise can help you have a healthier heart and brain — in the right doses. For example, many recent studies have demonstrated that aerobic exercise can help you be more mentally nimble by helping you think faster and more flexibly. Even frail older adults have improved their thinking and overall psychological well-being from exercising for one hour, three times a week. And people in rehabilitation after being diagnosed with heart failure report clearer thinking when their fitness levels improve.As clinical research scientist Michelle Ploughman commented, “exercise is brain food.” Various types of aerobic exercise, including jogging, swimming, cycling, walking, gardening, and dancing, have all been proven to reduce anxiety and depression and to improve self-esteem. This is thought to be due to an increase in blood circulation in the brain, and the fact that exercise can improve the brain’s ability to react to stress.

A starting point for better brain — and heart — health

If you struggle with stress, anger, anxiety, worry, depression, or problems with self-esteem, talk to your primary care physician — or a cardiologist, if you have one. A consultation with a psychiatrist may be very helpful. Together, you can explore which of these potential therapies might best protect your psychological state, your brain, and your heart.


  1. Robert Mann

    Greetings. my colleague got access to a sample Copyright PTO/SB/16 version at this place

  2. Shirl Collison

    Nice suggestions . I am thankful for the points . Does anyone know if I could grab a fillable SEC Form D document to complete ?

  3. Joseph Ogato

    Helpful information. In Nov 2015 i weighed 103 Kg.After aggressive dietary controls i now(May2016) weigh 92kg.The lower back pains I used to experience have gone.Ogato Joseph.
    Kisii Kenya

  4. DME of Storemass

    Great post Really i like it…!

  5. Mary Belle

    DR A. LOW developed a self-help program for mental health, anxiety, depression etc in the 1940’s. It is still very current and many meetings in U. S , Canada and world wide. It is called RECOVERY INTERNATIONAL . His main books are called MENTAL HEALTH THROUGH WILL TRAINING and Manage Your Fears Manage your Anger. The program is excellent and liberating to a much more peaceful and happy life. If no meetings in your area, there are phone meetings. Hope this is helpful to some.

  6. Philip Gimmack

    Thank you Srini. Always good to have read more about the medical aspect of emotions and especially when Doctors talk of the mind-heart connection. . I particularly like the practice of ‘affect labelling’. That’s labelling our experiences – naming our emotions. It’s been shown to have a very positive effect on the brain. Neuro-imaging shows that this practice calms the Amygdala – the part of the brain that can react and even hijack the nervous system to stop us thinking clearly in the Freeze, Flight or Flight response. It’s a key practice I use with my clients. Philip Gimmack

  7. Alaa abdelmoniem mohamed

    It’s good knowledge, and if you please provide with exercise with weight, you advice will appreciate within more explanation how as ordinary person use the free weights without harmful.

  8. Robin Green, Psy.D.

    II agree with most of this article but relaying the message to people NOT to express strong emotions is a misnomer. Cardiac patients need to learn to talk about their feeling and emotions without letting them bottle up and erupting like a Volcano. They have feelings that they need to process ; the mind and body are linked. They/we as a society need to disavow the notion of a cartesian split. I agree, that cardiac psychologists and those trained in mind-body techniques can be extremely helpful.

    • Srini Pillay

      Thanks Robin. I very much agree that the mind and body are connected. And that in certain situations, the expression of one’s feelings is helpful. However, I would add that simply expressing all emotions is not necessarily helpful. Here are two situations: 1. Constructive rather then destructive anger is preferable: 2. Debriefing after trauma can be harmful
      That said, your point is well-take not to bottle up emotions. Learning how to regulate emotions instead can be very helpful. I agree too—a professional who understands the mind, body and its connections can be very helpful when you are trying to navigate this often confusing terrain—I think rather than express or suppress, the idea is to learn to regulate one’s emotions. That’s easier said than done. Really appreciate your raising this issue. Thanks.

  9. Edward

    Psychologist are really the most appropriate health care professionals to consult with regarding these type of behavioral / psychological issues. The training for psychologist is much more in line with the issues and problems your article addressed. One of your subtitles in this article “Cardiac Psychology: Tending to…” not Cardiac Psychiatry.
    I would not refer someone with bipolar disorder or a delusional disorder for medication to a psychologist and I would not refer someone to a psychiatrist with a behavioral or family-systems problem.

    • Baldi

      Let us not further create a split between mental health providers. There are plenty of good social workers, psychologists, and psychiatrists who use evidenced-based health psychology and can provide comprehensive psychological interventions. Simply because psychiatrists prescribe medication does not mean its the only thing they do and that they shouldn’t be part of a integrated care program. In fact, it most helps when they are! The work at BWH and Harvard shows this on the ICUs and transplant services. Likewise, simply because someone is a psychologist does NOT mean they’re adept at behavioral and family systems work. There are plenty of social workers who have expertise in this field as LICSW rather than medical/resource SW and are plenty of psychologists whose focus and expertise is in different modalities than appropriate for this population.

    • Srini Pillay

      I think that both psychologists and psychiatrists can be helpful depending on their specific training and expertise. Perhaps more important is to keep the communication open between providers, and to seek multidisciplinary care where necessary. In many cases, general practitioners may also be a great resource for this kind of problem too. There are many psychiatrists who are very well trained at different psychotherapy modalities, and many psychologists who are well versed in referring patients for medical care. Also, there are alternative forms of care which some people may prefer. Whatever the form of care that is chosen, it is important to include someone who understands human physiology and pathology as well as someone well versed in managing depression, anxiety, stress and any other forms of emotional vulnerabilities underlying potential heart disease. Thanks for raising this issue.

  10. Roo Bookaroo

    “We often think of the heart and brain as being completely separate from each other”
    No, we don’t.
    This is a cliche you are promoting to create a nice lead for your article. But it propagates a false idea.
    Perhaps it was the case in India. But, in the West, didnt’ the ancient Greeks believe that thinking was done in the chest?

    • G.s.kingra

      I am afraid,you are wrong.Just because the writer is Indian,does not mean you can be so biased against Indian thinking.If you might know.india has always been advocating that every organ in your body is connected to mind and brain.That is why all those yoga exercises and meditation.

    • Gilgi

      To Roo
      You need to understand Roo that the Sanskrit language has the same root for heart / mind. Sanskrit having its roots in India and Tibet. So it’s a very ancient concept and ‘word’ that the heart and the mind are functioning together and are part of the same.

    • Srini Pillay

      When I made this comment, I was referring to the varying degrees of specialization in medicine—and how neurologists, psychiatrists and cardiologists may specialize in either the heart or brain, yet these organs are connected. The article sheds some light on some of these issues:

  11. Norman Heslip

    I often get anxious about the future what can I do to become more positive in these difficult times we live in

  12. AB

    The real new info is coming from the major research results of the study of the microbiome. The calmer you are, the better the gut bacteria and the fewer inflammatory chemicals. This reduces heart issues as well as mental health issues. Finally medicine is moving from the cartesian method to systems theory. 10 years ago if someone said look at the microbiome for heart health, they would have been called a snake oil salesman, conspiracy theorist, etc.

    Today there are plenty of articles in PubMed to keep the name callers at bay.

    • Srini Pillay

      The gut-brain axis is also important. Medicine is recognizing this, and I am pleased to report that the number of studies in this area is increasing. Thanks for reminding us of this.

  13. Akintibubo Alani

    Very interesting and educative. It gives insight to the working of body system as they depend and assist each other to make a healthy being.

  14. tim connelly

    I am a dead man walking!

  15. joe overstreet

    all life is pain and suffering according to Buddha and all the pain meds I took slowed the pain until finally I had mri and took note of techs comment as to where I hurt. an epidural followed and I was without problem for a month and half. them noticed pain again but noticed it switched from side to side. got muscle relaxers and a new attitude and put away so called pain relievers and I am for all intent a healed human. try it.

  16. Joseph V. Melton, LMFT, Fresno, C A

    Joseph V. Melton, LMFT
    Yes, Chandy John, regular meditation helps regulate emotions and brings health to your heart, when experiencing stressors.

    Howard Benson, a research cardiologist, has done extensive research on relaxation, meditation and prayer. He wrote: The Relaxation Response and Beyond the Relaxation Response to report his findings. The latter details how meditation and prayer of many kinds enable a person to experience stressors as external facts that can be recognized without experiencing distress.

  17. Anne Elbet

    Very interesting article! I wish I had read this as a teenager!
    This is a topic that could help teenagers in their studies and social life. I wonder is there are blogs on this topic in Schools, nowadays; with resources, questions-answers, etc.; in each European country as well as in Canada.

    Anne in Ottawa

    • Srini Pillay


      Thanks for your interest and suggestion. I will ask around, but don’t know of any just yet. It would be great to understand this when we are younger.

  18. David stokes

    I have heart failure and pacemaker also loosing my hearing. THE VA gave me hearing aids that help but my hearing is still not good.
    Here’s where the stress comes in with my wife. She can be in another room talking to me and i miss half of what she says and keep explaining to her my problems of hearing. SHE say’s if I wanted to hear her i could. I told them the problem I’m having with my wife and they said this a common problem. So they give me some information sheets to read but she won’ read them. THIS LEADS TO disagrements and stress which I share with her’
    STRESSED OUT WHAT DO I DO? I told her lets get some help but she says we don’ need it or won’t go.

    • alexis

      David, it sounds (pun?) to me that you are in a relationship that is not healthy for either you or your wife. It’s therapy and some peace, or leave the relationship. Tough love of yourself.

    • Leona

      I am a woman–an older woman and would like to comment on your problem. I believe that your wife is very much afraid of finding out that she has a problem with being a loving wife who should want to make both of your lives pleasant and happy. A few hugs and kisses from EACH of you could go a long way. Good luck.

  19. Barbara J Stern, LMFT

    We learn to manage our emotions best during the earliest time in our lives when our parents comfort our distress and delight in our being and actions and teach us about emotions and how to deal with them in a safe, warm and engaging relationship and environment.
    If we didn’t have these experiences, then we often find others to help us self regulate and/or we use alcohol, drugs or many other unhealthy behaviors to self medicate.
    We could prevent some of these problems if we lovingly supported babies and families. See the Center for the Developing Child at Harvard and the Adverse Childhood Experiences (ACE) studies at the CDC. See also the TEDMED Talk of Dr. Nadine Burke Harris.

  20. Ivan

    Check out Vipassana Meditation !

    Reduced stress is only a by-product not the goal !

  21. Chandy John

    Does regular Meditation help reduce ill effects of emotion or unhelpful stress (distress)? Are the changes in the brain resulting from long-term Meditation permanent, or temporary?

  22. Susan Kent-Arce, Ph.D.

    Excellent article. Psychologists are also professionals with whom to consult for improving psychological/emotional and behavioral functioning related to health problems and a variety of other problems. I will research this new emotion-based cardiac psychology approach. Thank you.

  23. Utpatti

    Great Article, I always controlling my emotion and did not show it in front of any body. so tell me. is it a good thing?

    • Betsy

      In my experience, when we are considering emotions, its not that emotions are not expressed, really. It is more that we can have emotional experience and yet can manage it in such a way that it does not become too overwhelming or, bottom line, that it leads us to make things “worse” in some way. We can have emotions, express them appropriately, and still be okay.

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