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Heart Disease Tied to Depression, Anger

Chronic Anger, Hostility, or Major Depression May Increase Likelihood of Heart Disease, New Studies Show

What About Antidepressants?

As noted earlier, the new report on depression and heart disease showed a possible link between antidepressant use and the risk of sudden cardiac death.

Those findings raise more questions than they answer.

"The question is, is that just because the antidepressants were a sign of a more severe depression or was it a result of something about the antidepressants themselves?" Williams asks.

Williams notes that some antidepressants, called tricyclic antidepressants, are known to have possible effects on cardiac arrhythmias. But the new report doesn't show what kind of antidepressants the patients were taking or other details about their antidepressant use.

"It could be that the drug itself was contributing to the risk of sudden cardiac death in patients who were depressed ... but my guess would be that it's probably, if anything, a function of the severity of the depression," Williams says.

Binkley says that people taking antidepressants shouldn't jump to conclusions. "We need to collect much more information. This is one study," says Binkley.

Douglas agrees that the antidepressant findings aren't totally clear. But she says, "Don't take 'em if you don't need 'em."

Does Treatment Help?

Douglas and Binkley say studies haven't proven that treating depression (or hostility and anger) eases heart disease.

"We don't have much information on that," Douglas says.

"That's still something we need to learn much more about," Binkley says.

But Williams says a program he and his wife, Virginia Williams, PhD, have developed has been shown to lower blood pressure, depression, hostility, and anger.

Williams says the strategy, which is the basis of a company called Williams LifeSkills Inc. that he and Virginia formed and have a financial interest in, boils down to this:

When you're in a situation that triggers anger, sadness, or anxiety, ask yourself these four questions: Is this important? Am I having an appropriate reaction? Is this situation modifiable (can I do anything about it)? Is it worth it to me to do something about it?

"A 'no' to any of those four questions means ... change your reaction [to the situation]," says Williams. He suggests self-talk, breathing exercises, prayer, or whatever else it takes to shift your reaction.

But if you answer "yes" to all four questions, then it's time to be appropriately assertive, which Williams says means describing the problematic behavior, explaining how you feel, requesting change, and, if all that fails, setting reasonable consequences.

Williams also recommends focusing on damage prevention by improving communication and relationships.

That includes speaking clearly, listening well (not interrupting, acting interested in what the speaker is saying, recapping their main points when they're done, and being prepared to be changed by what you hear), showing empathy, and looking for opportunities to make your interactions with other people more positive (such as by paying compliments and being a good listener.)

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