Head and Heart: The Psychological Effects of SCA

Walter Watts and other young survivors of sudden cardiac arrest (SCA) face not only changes in their health and behavior, but also changes in their ways of thinking about themselves and about life. Lauren D. Vazquez, PhD, is a clinical psychologist at Ochsner Medical Center’s Department of Psychiatry (New Orleans) who specializes in cardiac psychiatry.

“We think of cardiac events as being more in the experience of an old man than a young person. This incongruity really challenges a young patient’s idea of life and prompts different ways of thinking,” she says. “Like any other trauma, sudden cardiac arrest can have an impact.”

It’s easy, if not natural, to feel victimized by the event. A young person may mourn the loss of his or her previously healthy, normal life. Vazquez outlines three typical reactions a young SCA survivor may experience:

  • Emotional: Surviving the event results in a lot of anxiety. Survivors wonder, “Am I safe?” “Is it going to happen again?” “Do I need to start thinking about the end of life?”
  • Behavioral: There may be avoidance of the place where the SCA occurred. If the person was at the gym, he or she may avoid returning to the gym; if it was in the mall, he or she may resist going to the mall. Avoidance is an attempt to control the uncontrollable. By not returning to the scene, the survivor believes, at some level, he or she is avoiding a second SCA.
  • Social: There may be one of two extremes. Some SCA survivors isolate themselves and avoid contact with others, while others may not want to be alone, for fear it will happen again. Either way, this can limit their quality of life. It is also common to see sleep issues; many cardiac survivors have a fear of going to sleep.

Vazquez also identifies three “resiliency factors,” or changes in outlook and attitude that can help survivors live happier lives:

  1. Make the shift from victim to survivor. “They have to challenge their perspective of what happened and what they’re still going through,” says Vazquez. “All the medical investigations that occur afterward can be frightening and add to the trauma. You have to be able to view this as positive.” This is not always easy, she warns.
  2. Develop “quality of life prescriptions” and take them as regularly as you take medical prescriptions. Take time for the things that make life better. “People who have experienced sudden cardiac arrest have a second chance at life,” says Vazquez. “Their focus is on making that life count and enjoying every moment.”
  3. Seek an active, positive approach. “People who manage this will do well. It’s a process, to change your mindset,” says Vazquez.