People born with a heart defect are at greater risk of mental health problems

June 8, 2018 by Liza Morton, The Conversation
Credit: xpixel/

One in every 125 babies is born with a heart condition – but thanks to modern medicine more infants are surviving than ever before. In the developed world, 90% will now live into adulthood, compared with just 20% in the 1940s. However, there is no cure for these conditions and the person needs lifelong medical monitoring.

Congenital disease (CHD) doesn't just affect the body – it affects the mind, too. A growing body of evidence shows that people with CHD are more likely to suffer from mental health problems, such as anxiety, depression and post-traumatic stress disorder.

To date, this psychological impact has been understood as a consequence of the additional stressors that living with a serious lifelong medical condition can bring, such as missed schooling, spending lots of time in hospital (from childhood), and having to undergo frequent surgery. I know from personal experience how challenging this journey can be.

But a relatively new understanding about how our bodies regulate feelings of safety, risk and social connection may help to make sense – from a biological perspective – of this increased risk of .

Flight, fight or freeze

Polyvagal theory, which draws on the latest developments in neuroscience, psychology and biology, proposes that one of the body's most important jobs is to avoid threats in order to keep us safe. To this end, the body flits between three different "systems", depending on how safe we feel. When all is well, we stay in our social engagement system. This is our most evolved and healthy way of being. In this mode, we feel safe and sociable, and we are best placed to grow, develop, learn, recover and heal.

When we feel under threat, the fight or flight system is activated. The nervous system is called to action and we feel compelled to either fight or run to safety. This is felt as anxiety. However, if we feel like our life is at risk, we switch to our most primitive system by "playing dead". Physiologically, this system is deactivating – we become immobilised, feel numb or dissociate. Afterwards, we may struggle to recall what happened to us because the parts of our brain that make sense of events and store memories are shut down.

To feel healthy we need to be able to assess and adapt to our environment when we are both safe and unsafe. How well we can do this is partially shaped during our early years. If we experience a lot of trauma when we are growing up, we may be more likely to interpret situations as threatening. This affects how we manage stress. As social animals, it can also influence our relationships, as we need to be in the system, most of the time, for .

Since the heart is central to our nervous system, any heart problems may affect how efficiently our bodies respond to threats. This could, in part, explain why people with are at greater risk of anxiety, depression and . This risk is further increased by exposure to potentially traumatic early life events, such as surgery and being separated from parents due to periods of hospitalisation.

Feeling safe

This has important implications, from cradle to grave, for people living with a heart condition. This understanding could better inform medical care by focusing on establishing feelings of safety, for example, by promoting the importance of the parent's presence, touch and soothing voice to the child while supporting the psychological health of the child's family.

Teaching medical staff how to manage distress, how to communicate compassionately and the importance of encouraging the presence of loved ones would also be beneficial. This understanding also suggests possible interventions, specifically touch, play and music therapies for children.

For adults, a focus on safety and emotional regulation may be more beneficial than talk therapy. This seems particularly important for a population who may have grown up during a time when parents were discouraged from visiting their children in hospital and who may have endured illness and difficult medical experiences without the soothing presence of their parent. People living with this condition might also benefit from mindfulness, meditation and breathing techniques to help them feel safe.

We should also look to improve awareness and understanding about this hidden population – doing so would support social inclusion and feelings of connectedness and safety within wider society.

Explore further: Why long-term separation from parents harms kids

Related Stories

Why long-term separation from parents harms kids

June 6, 2018
As a society, we often wax eloquent about how important it is to nurture, support and protect our children. The sad reality, however, is that all too often major, life-changing decisions are made without any consideration ...

Parental touch may reduce social anxiety in children

May 23, 2018
Parental touch reduces children's attention to social threat and increases trust, particularly in socially anxious children. As a result, parental touch may reduce children's social anxiety. These are the conclusions drawn ...

How compassion can triumph over toxic childhood trauma

April 5, 2018
In a recent piece on the television show 60 Minutes, Oprah Winfrey discussed childhood trauma —shining a public spotlight on the lasting effects of abuse and adversity in childhood. Oprah herself is a survivor of childhood ...

Building resilience early in life can help children cope with trauma

May 25, 2017
Childhood trauma can have lifelong health, social and behavioral consequences.

Feeling sad? Here's how to beat the holiday blues

December 28, 2017
(HealthDay)—The holiday blues might be a common phenomenon, but there's plenty you can do to protect your mental health this time of year.

Stress in pregnancy linked to changes in infant's nervous system, less smiling, less resilience

November 23, 2017
Maternal stress during the second trimester of pregnancy may influence the nervous system of the developing child, both before and after birth, and may have subtle effects on temperament, resulting in less smiling and engagement, ...

Recommended for you

Researchers show that category learning can be influenced by where an object is in our field of vision

August 15, 2018
We humans are pros at category learning—the process by which we classify things, whether objects, concepts or events, into groups that share certain features that are relevant to us. We do it when we distinguish friends ...

Researchers link animosity in couples to inflammation, bacteria in bloodstream

August 15, 2018
Married people who fight nastily are more likely to suffer from leaky guts—a problem that unleashes bacteria into the blood and can drive up disease-causing inflammation, new research suggests.

Male tobacco smokers have brain-wide reduction of CB1 receptors

August 15, 2018
Chronic, frequent tobacco smokers have a decreased number of cannabinoid CB1 receptors, the "pot receptor", when compared with non-smokers, reports a study in Biological Psychiatry.

Unwanted or unplanned babies likely have more troubled close relationships

August 15, 2018
Findings appearing in the Journal of Social and Personal Relationships show people who believe they resulted from unwanted or unplanned pregnancies tend to have more insecure relationship styles as adults.

How we explain the behavior of others depends on our beliefs about their 'true selves'

August 14, 2018
Why did they do that? It's a question we ask every day in attempting to understand the behavior of others and make meaning of the world around us. How we answer the question, however, varies depending on our moral attitudes ...

Potent psychedelic DMT mimics near-death experience in the brain

August 14, 2018
A powerful psychedelic compound found in ayahuasca can model near-death experiences in the brain, a study has found.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.