[dbbolton]

The paper states that depressed mood and exhaustion are a risk predictor for all-cause cardiovascular mortality comparable to hypercholesterolemia and obesity. Essentially this means that a person with clinical depression is about as likely to die from cardiovascular disease (main specific causes of death being being heart attack and stroke) as a person with high cholesterol or who is overweight, and all of which are more likely to die of CVD than someone with none of the above.

This study is purely correlative. They do not hypothesize or investigate the pathophysiology by which depression can lead to these problems. I'm sure there is some research in this area, but in my medical education I have not come across any specific examples. To my knowledge there is no consensus that depression directly causes hypertension.

I can tell you from clinical experience that people with depression generally do not take good care of themselves (and this is not a judgment, just an observation). Their diet is poor, they do not exercise regularly, and are non-compliant with medical therapies. In other words, their lifestyle leaves them vulnerable to a whole host of diseases. However, I would still argue that the biggest risk factors for essential hypertension are family history and race, not behavior or mental health.

[vanderZwan]

Well, for what this anecdote is worth: I was bullied bullied growing up, and I had tachycardia[0]. Both stopped around the time I went to college. I can count the number of times I've had it since on one hand (before it was multiple times per week), and it was always during periods I was suffering from extremely high socially induced stress. Severe heartbreak, the loss of someone very close to me, things like that. Since I've picked up mindfulness and become a more balanced, calm person I've not had it at all.

I know that there are many diseases one can have growing up that might just "go away" when you get older, and we usually blame it on hormonal imbalances, and your body growing up and figuring things out. I wonder we're underestimating how the many anxieties that teenagers suffer from might cause or amplify these issues.

[0] Since you're in the medical profession, I'm sure you know what tachycardia is, but for others: it's when the heart rhythm becomes so fast that the heart muscles can't keep up, and are no longer pumping blood properly. Luckily my form of tachycardia is regular and fairly harmless on its own. Anyway, in my case it would trigger when startled, usually when I was doing some kind of "inconsistent" physical exertion (by which I mean that it never happened when running or cycling, even if I pushed myself to my physical limit). So it seems to require a mix of social and physical stress, plus something unexpected happening (I guess the adrenaline triggers it?)

[dbbolton]

Tachycardia is technically any heart rate greater than 100 BPM. It doesn't necessarily mean that the heart is not pumping enough. What can happen with an elevated heart rate is that the heart doesn't have enough time between beats to fill properly, resulting in decreased stroke volume and cardiac output, but this is typically only seen clinically with certain dysrythmias that have very high rates (like in the 150-200 rage), or in the setting of cardiomyopathies (diseases of the heart muscle), MI (heart attack), or heart failure. If your heart muscle tissue was actually not able to keep up, it would mean you had one of these things, which you most likely didn't.

What you are describing sounds like textbook palpitations. It is completely normal for the heart rate to increase for a lot of reasons, including stress and being startled (via the sympathetic nervous system, or fight-or-flight response). A palpitation is when a person becomes very aware of their heartbeat and perceives it to be abnormal, regardless of whether there is any clinically objective abnormality. They are often associated with anxiety and can lead to a vicious cycle (person is anxious, then notices their heart is beating fast, so they become more anxious, their heart rate increases, etc.).

The silver lining here is that in all likelihood your heart was/is fine. Anxiety has also been proposed as a risk factor for CVD but my understanding is that this is still debated. So don't go thinking your history means you'll definitely have an MI.

None of this is meant to dismiss your experience though. Not three days ago I saw a young, healthy male in the ED who thought he was having a heart attack, and (you guessed it) his EKG and labs were 100% normal. It probably happens a lot more than people realize.

By the way, I'm not saying "don't go to the doctor because that 'heart attack' is all in your head". He absolutely made the right decision by coming in (better safe than sorry).

[_8fb6]

> Since I've picked up mindfulness and become a more balanced, calm person

Where did you learn mindfulness from? A book, therapy, or something else?

Is there anything you wish you knew when you had just started getting into mindfulness? I'm curious as to what you'd suggest.