WHAT IS PSYCHOCARDIOLOGY?

A 2018 article in the Psychiatric Times noted that, though interactions between the heart and brain have been recognized for thousands of years, the subject continues to gain complexity. Today, they are believed to be more multifaceted—and much more closely interrelated—than experts once thought.

In 2013, the medical journal Future Cardiology reported on the connection between cardiovascular disease and psychiatric illnesses such as mood and anxiety disorders. Authors pointed to numerous studies confirming that these frequently overlap in an individual (also called high comorbidity).

This comorbidity, they added, was bidirectional. In other words, heart conditions can increase the risk for psychiatric illnesses, while mental health conditions (as well as high stress levels) can negatively impact heart health. Psychocardiology explores this heart-mind connection.

By 2022, an editorial in Frontiers in Psychiatry listed several recent studies that examined this link. They led to various conclusions supporting the brain-heart connection:

• Stress has been shown to negatively affect the heart. Evidence points strongly to stressors as triggers of coronary events.
• Loneliness, social isolation, anger, and depression may contribute to cardiac events.
• Stress reduction practices may help reduce the risk of cardiovascular disease.
• Depression may lead to poorer outcomes in patients who experience cardiac issues, including increased risk of death. Depression is also associated with elevated risk for developing cardiovascular disease.
• Anxiety and posttraumatic stress disorder (PTSD) may be related to both cardiovascular events and cardiovascular disease.
• Symptoms of psychosis—including schizophrenia and bipolar disorder—have been linked with cardiovascular risk or incidence, but more research is needed on this connection.

Related: Cannabis: The Heart and Brain Risks No One Warned You About

THE HEART-BRAIN CONNECTION EXPLAINED

Researchers have established that the heart-brain connection is forged through the autonomic nervous system. Therefore, cardiac function “can be profoundly altered by…central autonomic commands, including those associated with stress, physical activity, arousal, and sleep.”

It helps explain how mental health affects heart health—and vice versa. Some examples include:

• Chronic stress and heart disease: Unfortunately, emotional stress and heart problems go together. Stress creates frequent cortisol surges, which in turn can damage arteries. A 2017 study established a link between stress-related activity in the brain’s amygdala and increased risk of cardiovascular disease.
• Anxiety and heart health: Anxiety triggers symptoms that can impact heart health. Johns Hopkins Medicine reports that rapid heart rate, increased blood pressure, heart palpitations, and decreased heart rate variability can increase the risk of cardiac events, heart failure, and death after a heart attack.
• Depression and heart disease: Inflammation is a key factor in numerous diseases, including heart disease and depression, and heart patients are at higher risk for mood disorders.

A 2017 report on heart disease and depression noted that “adults with a depressive disorder or symptoms have a 64 percent greater risk of developing coronary artery disease (CAD); and depressed CAD patients are 59 percent more likely to have a future adverse cardiovascular event, such as a heart attack or cardiac death.”

• PTSD and heart attacks: Once called “Soldier’s Heart,” trauma (including PTSD) increases the risk of cardiovascular concerns.
• Inflammation and brain function: Cardiovascular problems can contribute to cognitive decline. A 2022 review explained that, compared to the general population, patients with heart failure have reduced cognition and increased dementia risk. This may be due to changes such as reduced brain volume, reduced blood supply to the brain, and inflammation.
• Post-heart attack symptoms: Surviving a cardiac event can trigger mental health symptoms, including PTSD, depression, anxiety, and grief.

As a crucial part of the autonomic nervous system, the vagus nerve plays a major role in the brain-heart connection. This can help guide beneficial treatments.

Related: The Common Cholesterol Myth That Could Be Harming Your Brain

For example, a 2020 study explored vagus nerve stimulation as a therapy for cardiovascular issues. Authors noted that because the vagus nerve helps maintain physiological homeostasis, it interacts with the reflex pathways that regulate cardiac function.

The study further pointed out that vagus nerve activity, called vagal tone, has been linked with heart rate variability, which can reflect the body’s stress resilience and cardiovascular health. The vagus nerve also regulates sleep, mood, pain, stress, and hunger, making it a major factor in mental health.

Press Play to Discover More About Heart Health Risk Factors

In this video, Amen Clinics integrative nutritionist Cindy Santa Ana discusses the risk factors that increase your chances of getting heart disease, as well as some simple tips to reduce your risk.

Click below to tune in:

MENTAL HEALTH TOOLKIT #1: GROUNDING TOOLS FOR PANIC OR DISSOCIATION

While dissociation and dissociative disorders are distinct from panic attacks and panic disorder, some of their symptoms may overlap. For example, a study published in Behavioral Sciences in 2024 found that people with panic disorder may be more vulnerable to dissociation and anxiety when trauma occurs.

Meanwhile, repeated exposure to trauma can lead to complex posttraumatic stress disorder (CPTSD), which is associated with flashbacks, panic attacks, and dissociation.

In times of a mental health crisis, reach for grounding tools that help you return to the present moment. Here are some suggestions:

• Ice pack or cold washcloth. Applying a cold object on the face or chest, or even holding something cold in your hand, offers a physical distraction and centers you back in your body.
• Textured object. Feeling a smooth stone or playing with a fidget toy will ground you through the sensory experience of touch.
• 5-4-3-2-1 grounding technique. This exercise is easy to do anywhere. Observe your surroundings and name five things you see, four things you hear, three things you feel, two things you smell, and one thing you taste.
• Essential oils. Scents can have a calming or invigorating effect. Try soothing lavender or stimulating peppermint. For extra relaxation, inhale them deeply; slowing your breathing helps ease stress.
• A small mirror. Looking in the mirror can help you reconnect with yourself and reorient to your surroundings.

MENTAL HEALTH TOOLKIT #2: CALMING TOOLS FOR ANXIETY OR RAGE

Anxiety or anger can seem to take over your entire body. These episodes can be especially debilitating for those with related mental health conditions, such as anxiety disorders or intermittent explosive disorder (IED).

To soothe frazzled nerves, keep tools on hand that can regulate your nervous system and lower stress hormones. Here are some suggestions for your anger or anxiety toolkit:

• Noise-canceling headphones or a calming playlist. Research has found that listening to music can reduce anxiety. According to various studies, it may increase levels of opioids and dopamine produced by the body while lowering cortisol (or preventing cortisol increases) in stressful situations.
• Breathwork instructions or a breathing app. Deep breathing techniques activate the parasympathetic nervous system, which helps stimulate the body’s relaxation response. Try box breathing: breathe in for a count of four, hold for a count of four, breathe out for a count of four, and hold for a count of four. Repeat for a few minutes.
• Magnesium or another calming supplement. Magnesium helps regulate the body’s stress response. Other calming options include GABA, L-theanine, ashwagandha, and lemon balm.
• List of calming mantras or affirmations. Write down centering thoughts in advance so you can easily refer to them when they’re most needed. Try statements like “This feeling will pass” or “I am safe.”
• A soft object or blanket. Holding or wrapping yourself in a comforting material can help calm frayed nerves. You can also try getting underneath a weighted blanket, which research has found may reduce anxiety.

MENTAL HEALTH TOOLKIT #3: MIND RESET TOOLS FOR OBSESSIVE THOUGHTS OR WORRY

The brain-imaging work at Amen Clinics—over 250,000 brain SPECT scans and still growing—has shown that people who struggle with repetitive, undesired, or intrusive thoughts often have an overactive anterior cingulate gyrus (ACG).

Related: Do You Have Repetitive, Undesired, or Intrusive Thoughts and Urges?

The experts at Amen Clinics call this region the brain’s “gear shifter.” Too much activity in this region can lead to obsessive thinking patterns and getting stuck on intrusive thoughts.

Fortunately, changing your behavior can change your brain activity patterns to help balance the ACG. Certain tools can assist by activating the prefrontal cortex and interrupting thought loops. These include:

• A pre-written note to self. Write down rational and upbeat reminders when your emotions are neutral or positive. Reading them later can help diffuse intense feelings or interrupt rumination.
• ANT Therapy worksheet. When automatic negative thoughts (ANTs) occur, it’s important to pause. An effective worksheet will offer space for you to write down the negative thoughts, identify the pattern behind them, and answer questions for each: Is this thought true? Can I be 100% sure it’s true? How do I feel with the thought—and how would I feel without it? Could the opposite also be true?
• Gratitude journal. A review of 64 clinical trials found that gratitude interventions increased feelings of thankfulness and improved mental health. They also reduced symptoms of anxiety and depression while generating more positive mood and emotions.
• Bible verses, prayer cards, or spiritual quotes. Prayer and other spiritual practices can restore a sense of peace and perspective when negative thoughts threaten to take over. They work by connecting individuals with something larger than themselves.
• Puzzle book or activity. Distractions that engage the brain can work to stave off worry or repetitive thoughts. As a bonus, brain-stimulating activities (like crosswords or sudoku) improve working memory—and may even slow cognitive decline over the long term.

MENTAL HEALTH TOOLKIT #4: CONNECTION TOOLS FOR LONELINESS OR DEPRESSION

Loneliness has been called a public health crisis by the U.S. Surgeon General. In one study published in 2024, loneliness was found to be worse for human health than alcohol abuse, obesity, or even smoking 15 cigarettes a day.

Moreover, social isolation can worsen depression and even physical pain. That’s why it’s important to build connection points in your life. Even if you feel you don’t “need” them right now, they will be imperative for when you do—such as when facing grief, loss, or other life challenges.

Related: 10 Ways to Cope With Grief and Loss

Here are some connection-building ideas for your loneliness or depression toolkit:

• List of safe people to text or call. Name at least three people who can offer support. During difficult times, a nonjudgmental listener can be instrumental in your coping and healing process.
• Group chat or crisis helpline info. Keep on hand resources, like the 988 Suicide and Crisis Lifeline, with professionals who are trained in providing crisis support. Or join with people who have experience in your particular issue (such as grief or cancer support groups).
• Written reminders. When life feels challenging, it’s easy to forget basic truths that can help you survive—and even thrive—through them. Keep written reminders on hand, such as “You are loved” and “This pain is temporary.”
• Pet photos or mementos. Four-legged friends have been shown to reduce stress, ease loneliness, and lower blood pressure. Even photos and mementos from your pet can trigger positive feelings.
• Letter from your “wise self” or a loved one. Feeling disconnected is common in times of low mood or loneliness. Letters that explain why you’re special, or that detail your character assets and achievements, can help you reconnect to yourself and your purpose.

In fact, eating disorders in midlife and eating disorders in older women are on the rise. Though research is still very new, epidemiological research from 2023 shows approximately 2 percent  to 7.7 percent of older women meet the requirements for an eating disorder diagnosis such as anorexia, bulimia, or binge-eating disorder.

In particular, anorexia nervosa—characterized by having an intense fear about gaining weight and severely restricting food consumption causing unhealthy weight loss—is rearing its head again or for the first time in women at midlife.

Anorexia is officially categorized into two subtypes: the restricting type and the binge eating and purging type:

Older women with anorexia usually have had symptoms since adolescence that were either overlooked or poorly treated. Now the life transitions and stressors common in midlife and beyond—such as caring for aging parents, divorce, children leaving the home, and menopause—are exacerbating anorexic symptoms in women.

Identifying and treating anorexia at any age is critically important as it has one of the highest mortality rates of any psychiatric illness. Indeed, patients with anorexia nervosa have a 521 percent increased chance of dying compared to someone from the general population, according to 2025 research findings.

Here’s what you need to know about anorexia symptoms in older women, its unique challenges, and the most comprehensive course of treatment.

WHAT IS ANOREXIA?

Anorexia nervosa is a treatable eating disorder in which an individual severely limits their food intake leading to a less-than-minimal healthy body weight. They additionally have a strong fear of gaining weight or becoming fat, or they exhibit persistent behavior that interferes with weight gain.

Often, their self-worth is tied to their body shape or weight. They may be unhappy with their body shape and weight. O they persistently fail to understand the gravity of their low weight.

But not all individuals with anorexia are “thin.” Sometimes an individual with a history of living in a larger body can become preoccupied with losing weight and may lose a substantial amount of weight but still remain in a range considered healthy.

This is an example of what’s called atypical anorexia nervosa. Surprisingly, this lesser-known atypical anorexia is three to four times more common than anorexia, according to research in the Journal of Abnormal Psychology. 

Anorexia is officially categorized into two subtypes: the restricting type and the binge eating and purging type: