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42 Cardio Diabetes Medicine 2017

The Sugary Mind and the

Burdened Heart: A View Point

Avinash De Sousa,
Research Associate, Department of Psychiatry, Lokmanya Tilak Municipal Medical College,
Mumbai. Founder Trustee and Consultant Psychiatrist Desousa Foundation, Mumbai.

INTRODUCTION : Women are affected more adversely by the factors
mentioned above and are also more prone to diabe-
Diabetes and heart disease are two of the silent
killers of the modern era. While there are multiple tes and heart disease due to the interplay of multiple
physiological reasons suggested for the causation of hormonal factors.
these disorders and the pathophysiology is well un- Broken hearts and distraught marriages are common
derstood, there are a number of psychosocial factors causes of medical illness. The stress of a disturbed
that contribute to the genesis of these conditions. It relationship often takes a toll on both individuals in
is very important that the treating physician is aware the relationship especially the one who suffers in a
of these factors which affect the patient and also disturbed relationship. There is enough research ev-
vitally important that a psychological evaluation be idence to suggest that heart attacks and diabetes
done when such factors are elucidated. The current are common in the first few months after divorce
paper shall posit the various psychological factors or break ups. The chronic stress of a disturbed re-
that contribute to the development of diabetes and lationship raises the level of cytokines that are pro
heart disease and shall suggest methods for the ho- inflammatory and lead to triggering of a cascade
listic management of these conditions. of pathways that lead to the development of heart
A variety of psychosocial factors have been implicat- disease and diabetes. Disturbed relationships cause
ed in these disorder. These range from personal to hormonal abnormalities in the individual involved and
interpersonal and family as well as marital factors. may affect mood and lead to further anxiety and
Loneliness is a major risk factor that has been shown stress that causes medical disease. The trauma of a
to cause both these disorders. Migration to a new troubled relationship can be huge and psychological
city and the adjustment that follows along lack of help sought early in the problem can avert the de-
social support and work environments that may be velopment of medical problems. Relationship coun-
unfriendly and hostile all build further to the burden sellors that work on healing the problem relationship
of loneliness. Lonely individuals are twice as more may help prevent lifestyle related medical morbidity
prone to a heart attack and a poor lifestyle that ac- in these subjects.
companies Loneliness increases the risk for one to Marital dissatisfaction is another cause of death due
develop diabetes. Work place issues and poor job to medical disease and many couples in disturbed
satisfaction and workplace harassment are other marriages suffer for years before help is sought.
factors that contribute to the genesis of these con- There is also an element of one person cheating
ditions. Unfriendly coworkers and a tyrannical boss on the other that can cause immense psychological
is often a cause of silent heart attacks. Job change trauma to the partner that has been truthful and may
is often advised as a lifestyle modification for heart be a silent factor in the genesis of medical problems.
disease and diabetes. A positive workplace environ- There is also a need for couples to address the bur-
ment reduces the risk of developing diabetes and den of sexual dissatisfaction in marriage. In a country
heart disease by 25%. Sexual harassment at work is a like India where one third of marriages are said to
risk factor for the development of medical problems get sex less,there is a direct need to look at sexual
in women. This is more common when the issue is unhappiness in marriage as a direct risk factor for
handled in an unjust manner by the management. the medical morbidity that shall ensue.

GCDC 2017