Counseling? Therapy?

Hello all:

Been awhile since I've posted but I need some advice from a group who knows what it is like to experience a cardiac event. I'm in a rut and I can't seem to get out of it. 

In January of 2019, I woke up and felt fine. Made coffee and was working on emails when I passed out. When I came to, I sat there for a few minutes thinking I just wasn't awake. Minutes later, I passed out two more times. Got to the hospital, and while they were running tests, I went into asystole (12 seconds). They rushed me from radiology into the ER and I had a second episode (another 12 seconds). The cardiologist was standing over me when I came to and told me I was in complete degree heart block and needed a pacemaker. Within minutes, they were moving me into an ambulance, sent a nurse from the hospital to ride with EMS (in case I went into cardiac arrest), then they transported me to a cardiac center 20 miles away. Within two hours, I had a pacemaker. They even let me go home the next day. My recovery went smooth and all of my interrogations since then have turned out fine. My EP did put me on Metoprolol which I've been on since that time. 

A year ago I was having some issues with chest pain. The cardiac catherization showed a 60% blockage of the left artery. The doctor said no intervention was necessary and they would treat me with meds and keep an eye on it. All of my bloodwork this past year has been great. My bad cholesterol went way down and the good went up. My routine cardiologist seems to be really happy with the reaction to the meds. 

From time to time, out of nowhere, my heart will race like I'm running for my life. I'm sure a lot of it is anxiety. Even the doctor has said he feels anxiety is the contributing factor to a lot of the episodes. Three weeks ago, my BP was high (I could hear it in my ears) and he put me on Lisinopril which has leveled it out. But this past Saturday, I ended up in the ER with palpitations. While it was happening, it felt like someone was driving a sword from my chest through my back. Just to be safe, I went to the ER. The ECG showed tachycardia, but after three hours and a myriad of bloodwork, the doctor let me leave when my HR was around 80. The ER doc said she thought I was fine. I have a follow-up with my regular cardiologist this coming Friday (not because of this episode -- it is part of my six month routine check-ups).

I am riddled with anxiety. I am not making excuses, but before I had the PM, I lost my parents in a short amount of time, six months later my 22 year relationship busted up, then our dog died a few months beyond that, and I became almost reclusive. I acted as if things were fine but I was suffering. Then bam, the heart issue and the PM. My neighbor who is a nurse for Hospice swears I was in broken heart syndrome which led to the cardiac issue. 

I'm functional. I work and do what I need to do daily. But every single day, several times a day, I keep thinking that my heart is going to fail me. Every little twinge makes me think it's my heart. When my heart picks up speed (like it did Saturday and landed me in the ER) I automatically think the worst. Even though it is going on three years since the asystole and PM implant, it seems like it just happened. A friend I confided in says he thinks I have PTSD from the day I went into asystole and the whole situation. He's encouraged me to get therapy to help myself get out of this funk I'm in. But so far I've resisted thinking I can handle it or it will go away. Obviously I'm not handling it. Here I am. Some days I feel ike I'm hanging on by a thread. 

So I'm here to ask if anyone has gone through therapy or gotten counseling after your cardiac event. And if you did, was it helpful? If I thought it would help, I would do it. But if I'm just going to sit around and tell some stranger about the day it all happened, and not figure out how to get past it, what's the point of the time and money? 

If you've been through therapy after your cardiac event, whether it was a month later or 10 years later, I'd like your feedback.

Thanks in advance! 



by Julros - 2021-12-05 21:35:49

Hi Mark. I hope I am not speaking out of turn because I have not experienced an arrest, but I was very emotional after my ablation and device implant. In speaking to my daughter, who has worked with traumatized women and children, she said I sounded like I had PTSD and advised counseling. 

I struggled to find a good couselor, though. This was before the advent of online counselors, so perhaps one can more easily find a good fit. I did get some help with  counselor #3, but even she said I probably needed more than she had to offer. She noted that I seemed to have been treated poorly by my health team and urged me to change. I finally did, and that made a huge difference. No more panic attacks in doctors' offices! 

I have done a lot of reading, and learned that my sympathetic nervous system was likely in overdrive: I was quick to anger, had racing thoughts, and was often distracted. I used a couple of different apps on my phone for controlled breathing and medication, to turn down the fight or flight response, and lower my adrenaline levels. And strenuous exercise. 

A  book I reccomend is by Kirby Reutter called "The Dialectical Behavior Therapy Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma and Post-Traumatic Stress Disorder". It really helped me to get a handle on my rage and resentment. . 

You deserve to feel better and enjoy your life. You will need to reign in your sympathetic nervous system ( adrenaline is a hell of a drug) and learn to experience joy. It can happen. 

Best wishes. 


counselors help

by Tracey_E - 2021-12-06 09:40:36

You would not be the first to talk to a counselor. What have you got to lose?? Give it a try. 

Courage to go forward

by Gotrhythm - 2021-12-06 11:49:03

Sorry you've been through such a rough time. 

I think you already see the need for counseling and you understand that you are not looking just for someone who's a nice person and easy to tell your problems to. You want effective therapy that will make a real difference. 

Ideally, a therapist who specializes in heart issues and how they interact with emotional issues would be best. But how to find one?

Fortunately, in North Carolina we have several university associated hospitals scattered across the state. Probably there's one not too far from you. Call them and see who they would recommend.

It takes courage to face into the need to change. I'm proud ouf you.

Broken heart syndrome is real and needs to be treated

by Gemita - 2021-12-06 12:33:50

Hello Mark and anyone considering Counselling Therapy,

I received Cognitive Behavioural Therapy (CBT) after a cancer diagnosis some years ago.  CBT helps to treat many conditions including depression, anxiety, panic attacks, phobias, obsessive compulsive disorder, post traumatic stress disorder and some eating disorders.  CBT can be very effective in getting to the root of our problems, but it can be a slow, painful process in getting to a stage where we begin to feel better and to take back control of our lives.  Also it is important to say that CBT can be hard work and we must be strongly motivated to change for change to occur and for us to be able to face what we most fear.  When our fears are out in the open, they can no longer hurt us.  Keeping worries bottled up will only eat away at us, causing stress and illness. There can be no holding back during therapy and we have to be prepared to be honest about what is really troubling us, however painful that proves to be.  We cannot hide the truth from our therapist.  Like with cardiac rehabilitation, the harder we work with CBT therapy, the more we benefit.

Looking at your comments, the loss of your parents, then your partner after 22 years followed by your pet dog would certainly need to be discussed with your therapist since these events were fundamental in making you the person you have become.  Your therapist will want to know how you coped during this period.  You will be encouraged to talk about your break up with your partner.  Your deepest feelings might surface.  Would you be prepared to share these intense feelings with a therapist, to trust him or her because this is what you may need to do to get better?

I worked on a one to one basis with my CBT therapist when all my anger and fear came out.  My tumour (biopsy) was initially considered to be benign and yet some three years later I had a rapidly spreading cancer and was suddenly facing serious disease and I wanted to know why and to blame someone for getting it so wrong.  Therapy also covered difficult times in my childhood, especially my relationship with my step father.  We then spoke about my present life with my husband, my children.  Therapy covered my fear of cancer and what it might mean for my future.  Looking back it was a painful process but a necessary one to go through to relieve the pressure that had built up inside me.  Once my fears were out in the open, painful memories had been released, I suddenly felt calm with clarity of thought and was able to start to live my life "effectively".  Nothing could hurt me now.  My relationship with my family improved and I started to believe I could overcome any illness.  Of course I was extremely lucky to have survived a poor prognosis, although a change in lifestyle, diet and a positive attitude certainly helped my recovery.

What I would say is that if any member is suffering from emotional problems as well as from a fear of what might lie ahead with their pacemaker or heart condition, to have a word with their doctors first to see what is available in the form of talking therapies.  This certainly beats swallowing a pill and suppressing emotions which really need to come out.  I appreciate some of us may need help with medication initially for anxiety or depression but working also with a therapist is, in my experience, the most effective way of getting "to the root of the problem".  I wish you well Mark

My experience

by lildanishgirl - 2021-12-06 13:39:12

I had an unexpected cardiac arrest a few years ago at the age of 32...and had an ICD implanted. It was a very traumatic and life changing event, that's for sure. I was lucky, because at the time, there was free counselling available for heart patients (through my hospital). I was also hesitant (and skeptical) about therapy but I went ahead with it for 2 months (once a week), and it made a HUGE difference!!! The therapist I saw, used Cognitive Behavioural Therapy (CBT). Could you maybe reach out to your hospital and see if there's therapists that know more specifically about what you've been through? My therapist specifically worked with heart patients who had been through traumatic events.

I would say go for it! It might make a difference for you (like it did for me), or it might not. The only way to know for sure, is to try :)

counseling helps

by athena123 - 2021-12-06 17:55:56

Hi Mark, glad you came on here because you will find a wealth of knowledge from people's personnal experience and how they deal with issues. I too had my bout with anxiety and still today but not as bad as before. were humans and we all react to life's events. some can handle it well and some may not. I was the latter and 5 months after my PM i experienced my first panic attack and from there led to me having general anxiety. I went the way of medicine for close to a year because i felt i couldnt control it. I then realized there are more natural ways of fighting anxiety and Gemita talked upon CBT which does work. I found a good therapist who i can unwind to and just get everything out and talking about it and learning to keep my mind occupied has helped tremendously. You will get better and you will grow stronger because looking at myself it took my family , therapist to help lessen the burden because anxiety can be debilitating and you need to deal with it head on like say, breathing techniques, exercise is great , but also set aside some goals for your self this way you can keep your mind occupied. stay strong mark, were here if you need us. 


by Katja3 - 2021-12-07 06:01:45

I'm a psychologist and psychoanalyst by profession, with first hand experience of cardiac issues. I'm happy to attend people who have had cardiac events, although unless  you are in greater London, video appointments may be the way to go. You can find me through Google


by Mark.n.NC - 2021-12-11 02:02:04

Hello all!

I want to say THANK YOU for your generous and heartfelt responses!  I read each and every one and appreciate you sharing your thoughts and experiences. It means a lot.

I had a follow-up with my routine cardiologist today. It was a general follow-up but I've also had some episodes of tachycardia and palpitations lately, so they are going to interrogate my pacer next week to see if anything is out of whack. Otherwise my bloodwork and tests look great. I was going to send a pacer test from home, but the battery in the receiver unit is dead. Medtronic sent a new one out today. Turns out the batteries in the home receivers (the part you hold over your pacer to send a test) only lasts about two years, so they are sending a new one. In the meantime, the pacemaker clinic at my cardiologist's main office is going to do the interrogation next week.    

The doctor and I also talked about therapy. He was all for it. He said he's had patients that had life-changing events such as mine and needed some help to get past the anxiety. So he is making a referral for some outpatient counseling. They should be calling next week. Turns out the hospital system has its own behavioral health unit and provides counseling. One of the counselors has excellent reviews for trauma/anxiety. So I'm looking forward to getting started and moving ahead. I pray it will be -- as they say -- just what the doctor ordered. Some days I am so riddled with anxiety, it is hard to leave the house. I'm tired of that. I want to get on with a good quality of life in whatever time I have left.

The cardiologist's nurse joked with me and told me "Mark, you'll probably live to be 90! You're going to be okay!" My response was, 90 is fine, but I just want to enjoy getting there. 

Again, thanks one and all for the wonderful advice, your experiences, and for the well wishes! You're terrific!

I'll keep you all posted! Wish me luck!


by lildanishgirl - 2021-12-11 13:52:34

I'm so happy to hear that you're on the right track! I kept checking this thread for an update :) I can see from your last post that you're in good spirits, which is a great start! All the best!!

great news

by athena123 - 2021-12-11 14:04:38

Good to hear mark. you're going to be fine. your test are all good and the Dr suggested therapy for your anxiety, which suggest that medically your fine. working on your anxiety is all you need to do, and believe me it gets better. I was the same way, kept thinking something was wrong with me. My Ep would say to me do i looked worry, then neither should you, now go live your life. thats all. good luck. mark 


by Smthbrbr3 - 2022-01-08 21:03:54

My anxiety and emotions are not getting better! I just feel like curling up on the couch and not leaving it! I am going to call about counseling and my psychiatrist is having me up my dose of buspirone but I feel like that has made the anxiety worse. I feel like it's never going to get better!

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I am 100% pacemaker dependant and have been all my life. I try not to think about how a little metal box keeps me alive - it would drive me crazy. So I lead a very active life.