In a charming article titled, “Shakespeare as Health Teacher,” from a 1916 issue of The Scientific Monthly, James Frederick Rogers, M.D., writes of the Bard: “A curer of disease he certainly was not, but as teacher of mental and bodily sanity he has had a clientele that is numberless.”
Rogers recalls Shakespeare’s depiction of grief as a cause of apoplexy (a blockage or hemorrhage of a blood vessel that leads to the brain) in Henry IV. Among his many examples of medicine and well-being in Shakespeare, however, Rogers does not note any involving heart health. In Othello, Gratiano commiserates with Desdemona over the death of her father, Brabantio: “I am glad thy father’s dead. Thy match was mortal to him, and pure grief shore his old thread in twain.” Desdemona’s father dies from heartache, which can be interpreted as a poetic way of suggesting a very literal and potentially fatal event, namely a heart attack.
King Lear also endures and eventually dies from a heart racked by grief. His older daughters, Regan and Goneril, mistreat him, and his youngest daughter, Cordelia, dies before his eyes, prompting him to experience not just figurative, but also actual, chest pains. For example, he cries out, in Act 2, Scene 4, “O, how this mother swells up toward my heart! Hysterica passio, down thou climbing sorrow! (…) O me, my heart, my rising heart.”
I have worried about the heart health of my own mother, who, like Lear with Cordelia, watched my sister die from colon cancer just last October. My mother has a history of heart problems, including enlargement of the heart, and her ongoing emotional grief - okay, depression - over my sister has often been accompanied by very real physical pain in her chest, which she has described alternately as a tightness and sharp shooting.
Today, as a society, we are very aware of the impact our mental health can have on our physical health. Unlike in Shakespeare’s era, we, thankfully, or so we think, have an array of medications to help patients in need manage conditions such as anxiety and depression, high blood pressure and Coronary Heart Disease (CHD), etc. A recent article in the Journal of the American College of Cardiology, which investigates the health associations between metal health and heart problems, gives cause for concern.
The article, entitled, “Depression and the Risk of Sudden Cardiac Arrest and Coronary Heart Disease in Women,” reveals the findings of The Nurse’s Health Study, a study that began in 1976 and followed 121,701 women aged 30 to 55 on a bi-annual basis (Patients with a history of CHD, stroke or cancer were excluded). The study found a direct link between symptoms of depression and risk of CHD events. And, like previous studies of its kind, it also found that depressive symptoms were associated with an increased risk of fatal ventricular arrhythmias and Sudden Cardiac Death (SCD).
What is particularly interesting about The Nurse’s Health Study, however, is the finding that depression treatment, namely antidepressant use, may increase the risk of ventricular arrhythmia and even SCD. Given the number of people I know being treated for depression, this makes my own heart swell. As the authors of the article suggest, more research on the association between depression and antidepressant use and the increased risk of cardiac events are, indeed, warranted.
Whang, et al. “Depression and the Risk of Sudden Cardiac Arrest and Coronary Heart Disease in Women,” JACC 53:11 (March 17, 2009): 950-958.