Coping With Trauma and Stressful Events as a Patient With an Implantable Cardioverter-Defibrillator
The lifesaving value and improved quality-of-life outcomes of the implantable cardioverter-defibrillator (ICD) are well established. However, for some patients, having an ICD implanted or receiving a therapy from the device can be considered stressful or traumatic. In fact, the experience and diagnosis of heart problems can be traumatic. Here, we review potential stressful or traumatic ICD patient experiences and provide an action plan for developing effective coping responses.
Is There a Difference Between a Stressful Event and a Traumatic Event?
Most people with ICDs have faced stressful and potentially traumatic events at some point in their life. Reactions to traumatic events range from brief, normal, and healthy to long-term, pathological, and debilitating. The difference between an event that is considered stressful and an event that is considered traumatic is primarily the personal reaction to the event. If the reaction is one of fear, helplessness, or horror, it is typically considered traumatic by mental health specialists.
Posttraumatic stress disorder (PTSD) is a specific reaction to a traumatic experience. This reaction involves symptoms such as high anxiety, avoidance, and re-experiencing the event in the form of unwanted thoughts, dreams, or flashbacks. In the general public, approximately 8% of people meet the criteria for posttraumatic stress disorder,1 whereas 20% of ICD patients have significant symptoms of PTSD, meaning that 1 in 5 people with an ICD has PTSD.2 Although many more than 20% of ICD patients experience ICD-related “traumatic experiences,” not all develop trauma reactions such as PTSD. Risk factors for developing PTSD symptoms include lack of support from family or friends, a family or personal history of mental illness, a history of sexual or physical abuse as a child, or a cognitive or thought disorder.3 Ultimately, the distinction between a stressful event and a traumatic event has more to do with a person’s reaction to the …