A Steady Heart: A Cardiologist’s Advice for Lowering Stress

A calm, steady mindset doesn’t just protect against stress, it also supports our heart health, writes cardiologist Dr. Jonathan Fisher. In this first Mindful excerpt from Dr. Fisher’s new book, Just One Heart, we learn some of his recommended strategies for cultivating steadiness.

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“Dr. Fisher, we need help. A woman was just rolled into the emergency room having runs of V-tach. She’s a healthy fifty-six-year-old woman with no past medical problems…”

Introductions like these always get my attention. There’s a heightened sense of urgency when the heart does something wholly unexpected and potentially life-threatening. I glanced at the medical chart and saw the problem right away. Her heart was racing at three times the normal speed, in a rhythm called ventricular tachycardia (VT), and in a way that caused her to feel like she was going to pass out.

In such moments, I appreciate how remarkably steady a normal heart rhythm is. Beating one hundred thousand times daily and rarely missing a beat, the healthy human heart exemplifies calmness, consistency, and predictability. These are also core features of influential leaders and healers, which allow others to feel calm. On the contrary, an unsteady heart might beat at an average rate one minute, too fast the next, and too slow after that, throwing the entire body out of balance and into distress.

Making matters worse, I knew that her specific heart rhythm abnormality was particularly sensitive to her level of emotional stress. Her rhythm became more unsteady as she worried about her condition, creating a vicious cycle. A critical part of her treatment was to work to reduce her mental and emotional stress to calm her heart. Fortunately, by adding a warm, soothing presence amid an emergency along with the right combination of medications, our team stabilized her heart rate and returned her rhythm to normal.

Moments like this show how connected our thoughts, feelings, sensations, and heart health are.

Just as the physical heart has mechanisms to keep steady and adapt to circumstances, the emotional heart has a similar ability. Still, this ability can become overwhelmed, leading to agitation, chronic stress, and lasting harm.

Can We Change Our Stress Response?

Let’s begin by defining “stress,” which many of us use to describe the uncomfortable feelings of distress, frustration, anxiety, or being overwhelmed. Stress arises when we perceive a gap between the demands of a situation (commonly referred to as “stressors”) and the resources we have to meet those demands. While it’s essential to understand this definition, it’s equally important to acknowledge that only some have the same level of control over their stressors. Individuals facing chronic physical or mental illness, economic vulnerability, or experiences of abuse may encounter stressors that go beyond what can be addressed solely through personal strategies.

From the viewpoint of physics, physical stress is a quantifiable force, and its impact depends on the properties of the object it acts upon, much like how individuals respond differently to the same stress. In psychology, this parallels the concept of psychological “distress,” which arises when we perceive a mismatch between our challenges and our belief in our ability to cope with them. This understanding underscores the importance of recognizing that our perceptions fundamentally shape our internal response to stress.

By reframing our experience as a “stress reaction,” we acknowledge that its roots are internal, influenced by our characteristics and mindset. This perspective is vital for developing effective stress management strategies, especially for those encountering significant life challenges. This parallel between the physical and psychological responses to stress highlights the importance of individual factors in how stress is experienced and managed.

While avoidance might seem the easiest way to deal with stress, it can lead to increased fear and avoidance behaviors in the long run. Instead, cultivate openness and curiosity to face challenges more calmly and realistically. Embrace the chance for personal growth and insights that each challenging situation can offer.

On the path to stress mastery, we must acknowledge that our minds tend to exaggerate risks and bias toward predicting catastrophes, a tendency known as the “negativity bias.” These cognitive tendencies determine how we perceive and respond to stressors, impacting our overall experience of stress.

Ultimately, our ability to handle stress often depends on our capacity to control our attention and create accurate and helpful mental narratives about how we approach challenges.

Additionally, our ability to pay sustained attention and accurately appraise situations can be unreliable due to the overwhelming amount of information we encounter daily and a natural narrowing of our attention during challenges. Understanding these mental processes is fundamental because they influence how we interpret and react to stressors.

Despite these natural cognitive biases, we can improve our stress management skills by enhancing our attention and perception skills. With practice, we can learn to see situations more clearly and experience less distress. Ultimately, our ability to handle stress often depends on our capacity to control our attention and create accurate and helpful mental narratives about how we approach challenges.

Embrace Diastole to Give Your Heart a Break

Every healthy heart has two critical phases: squeezing (systole) and relaxation (diastole). While the squeezing gets much attention, the relaxation phase allows the heart to fill with blood, preparing it for the next beat. Problems with diastole can be as severe as those with systole, potentially leading to conditions like heart failure. Importantly, diastole isn’t passive; it actively consumes energy to ensure optimal filling. Similarly, in our daily