1. Thinking about stress and anxiety in people with ICDs
Introductions – brief introduction to the role of a clinical psychologist in cardiac rehab.
Dr Matthew Beadman
Registered Clinical Psychologist in Cardiac Rehabilitation
March 2018

2. First of all, why talk about anxiety and stress?
Approximately 30-50% of people
experience distress following ICD implantation
2. Depression
3. Anxiety 11-26% - more common in people who have been shocked
4. PTSD 12%
…………………..so about 1 in 4 patients
Importantly, many people report improvements in their quality of life as a result of the ICD.
Anxiety is a common side effect of having an ICD. Between 13-38%.

3. Stressors associated with having an ICD?
Physical stressors (e.g. surgery, medication, the demands of getting to appointments, lifestyle changes)
Emotional/psychological stressors (e.g. adjusting to loss and change, anxiety about the device going off, low mood, sadness, anger and frustration, managing reactions of family and friends, living with uncertainty)
Spiritual stressors (e.g. questioning our faith, asking why me?, or struggling with the unfairness of the situation)
Social stressors (e.g. difficulty meeting up with others, isolation, other people not understanding)
Practical challenges (e.g. work, childcare, arranging how to get to hospital for appointments)

4. + = The good news… fuel the fire
We often can’t control stressful events.
However, how we THINK and how we ACT can
Fortunately, we can choose to respond differently
And we can learn to take some of the logs away
fuel the fire

5. How might we fuel the fire?
Worrying about the ICD going off
‘How will I know it is working? How can I be sure the battery won’ fail?
Thinking in a repetitive fashion about the last time it went off
This can depend on somebody’s relationship with the ICD – maybe it’s a bit like a burglar alarm?

6. How might we take some logs away?
The 4 Ps….
Planning
Planning for if the ICD goes off
2. People
Who can I talk to about how I’m feeling?
Helpful qualities from other people: humour and empathy, not necessarily problem solving
3. Present moment focus
Who can I ask for help and/or who can I talk to about my frustrations?
Try to pay attention to the present moment
Beware of the video camera in your mind: am I on fast-forward or rewind?
Improve the present moment – plan absorbing, pleasurable or satisfying activities
4. Preserving behaviours
Deliberately doing things that bring a sense of reward, satisfaction, fun or enjoyment
Getting back to normal, everyday activities

7. Does anyone have any questions?
Thank you
Does anyone have any questions?