When emotions take hold of the heart

In his research, Erik Olsson, Professor of Health Psychology at the Department of Women’s and Children’s Health, examines how psychological factors influence the heart – and how heart disease, in turn, can change how we think, feel and live our lives.

“We tend to think of the heart as a pump. But the body constantly responds to what we think and feel. It is a far more dynamic system than many people assume,” says Erik Olsson.

The heart reflects how we live

Erik Olsson’s interest in the connection between mind and physiology arose early in his career. Shortly after completing his training on the Psychology Programme in Uppsala, he encountered biofeedback and psychophysiological measurements, which allow real-time monitoring of the body’s reactions.

This led to a doctoral thesis on heart rate variability – how much the heart’s rhythm varies over time.

“You might think that a perfect heart beats completely evenly. But a heart that beats like a metronome is actually a bad sign. The body needs variation because we constantly have to shift between activity and recovery.”

That variation strongly reflects how we live our lives. Stress, worry, social relationships and lifestyle all influence heart function.

“The body is constantly trying to adjust itself to meet challenges in the best possible way. That applies to both our thoughts and our physiology,” says Erik Olsson.

Towards more holistic cardiac care

A significant part of Erik Olsson’s research concerns what happens after a heart attack. Medically, many patients recover relatively quickly, but the psychological impact can be long-lasting. Up to one-third experience some form of psychological distress following a heart attack.

“For some, it becomes an existential crisis. They have suddenly been very close to something that could have ended much worse,” says Erik.

Many patients also begin to avoid situations they associate with the attack.

“If the heart attack occurred during exertion, they may become afraid of raising their heart rate again. Then they might start avoiding exercise – even though physical activity is actually an important part of recovery. That can create a kind of vicious circle, since our behaviour greatly influences the risk of future heart-related problems.”

That is why psychosocial support after a heart attack is important, and something Erik Olsson believes should be a more natural part of healthcare.

“I really do not want to criticise cardiac care, because in many ways it is excellent here in Sweden. But I do think it could become more holistic. Of course, not all patients need therapy, but the care provided can sometimes become a bit too focused on only the medical aspects. Our focus and ambition lie not only on survival, but also on future quality of life.”

Research on “broken heart syndrome”

One of the most widely recognised areas of Erik Olsson’s research is Takotsubo, often referred to as “broken heart syndrome”.

The condition can cause symptoms that are almost identical to a heart attack – chest pain and shortness of breath – but without doctors finding any blockage in the coronary arteries.

Instead, the left ventricle of the heart takes on a characteristic shape.

“It resembles a Japanese octopus trap, a takotsubo. That is how the condition got its name.”

Research suggests that the syndrome can be triggered by extreme stress, in which very high levels of stress hormones affect the heart muscle. For some, it can be fatal, although most recover with early treatment.

“It is a fairly dramatic condition, but in most cases the heart recovers once the acute phase has passed.”

What makes the diagnosis particularly interesting is who is affected.

“Around 90 per cent of patients are women. This makes it one of the most gender-specific diseases we know of, but the exact reason for this is still uncertain. However, we do know that women generally report higher levels of stress, depression, anxiety and other psychological symptoms.”

Quality of life – not just survival

Looking ahead, Erik Olsson hopes that research will contribute to a broader perspective within cardiac care. Particularly younger patients may begin to rethink their lives after a heart-related event.

“My supervisor used to say that there are really only two important outcomes in medicine: life and death – and quality of life.”

According to Erik, quality of life sometimes risks being overshadowed when the focus is on risk factors and biomarkers.

“A good life always involves a certain amount of risk. If we try to eliminate all risks, we may end up with a life that is not particularly meaningful.”

The advice: keep doing the things that matter

If Erik Olsson were to give one piece of advice to people wanting to take care of both their heart and mental health, it is surprisingly simple.

“Do not forget the things that make life meaningful. Try, as far as possible, to return to the life you had before the heart attack or illness.”

After a heart attack, it can be easy to start avoiding things. But doing so also risks avoiding the activities that give life content and, indeed, quality of life.

“Feeling afraid of something does not necessarily mean that it is dangerous – and that is something one may need to remember,” says Erik Olsson.

Robin Widing