A cardiac-crisis survivor’s story
From an early age, congenital heart problems have given Bruce Lowen a will to survive that drew open admiration from his doctors and cemented a tight bond between him and his mother. But a lifetime of heart troubles has also sapped his energy, driven a wedge between Lowen and his father and brother, and discouraged the 65-year-old from pursuing lasting relationships.
Every day, Lowen, who lives in Las Vegas, wavers between his resilience as a survivor and the despair that can come with loneliness, chronic illness and lingering anger and self-doubt at having been abandoned by a father who didn’t seem able to deal with his son’s infirmity.
Lowen is depressed, and has been for most of the long life he never expected to live. He also suffers from congestive heart failure — the result of having survived congenital cardiac abnormality, five heart surgeries and a handful of cardiac crises.
He says he does not know whether heart disease caused his depression or whether a lifetime of relationships blunted and derailed by his grim medical prognosis caused his depression. Either — or both — could have contributed.
What Lowen does know is that, while advances in cardiac care have given him more years of life than he ever expected, his depression has been a formidable obstacle to enjoying that windfall.
These days, Lowen says he has trouble falling and staying asleep, and rarely gets more than three hours of sleep at a time. The resulting lack of energy discourages him from the walking that his doctor has recommended. A trip to the library or supermarket tires him out.
He’s lonely. But “relationships take a certain amount of energy,” he says. “I’m not particularly interested in making new friends.”
An August study found that of depression’s many manifestations, its hallmark physical symptoms — poor appetite, sleep disturbance, low energy — are the most corrosive to the heart. Following 1,024 medically stable heart patients for six years, the authors found that subjects who reported these problems were more likely to die of any cause, or suffer a heart attack, stroke or heart failure, than were subjects who predominantly reported feelings of sadness, guilt, worthlessness and thoughts of suicide.
“We act as if depression is one physical thing,” says Alexander Glass of the New York Psychiatric Institute, an expert on the heart-disease-depression link. “But it’s a syndrome, and there are a lot of ways of getting there.”
For Lowen, inheritance — his mother suffered from depression — and family dynamics may both have predisposed him to depression. But the physical toll of living with heart disease, including several coronary artery bypass procedures, probably also have played a role.
Lowen flies back and forth to Massachusetts General Hospital for his medical care, and his physicians have urged him many times to seek help for his depression. He takes no antidepressant medication; he says they don’t work for him and has resisted trying them again.
But psychotherapy, Lowen firmly believes, has saved his life as surely as heart surgery has. For a time in his 30s, he says he obsessed about jumping in front of a subway in New York City, where he grew up. He says he would like to get back into therapy but hasn’t yet taken the step.
For now, his devotion to his cat, Inshallah (Arabic for “God willing”) is what keeps him from actively considering suicide. “I wouldn’t abandon her,” he says.
But he still questions — frequently — whether his life is worth living.
“With both issues, you have to expend a lot of energy to try to survive,” he says. And each — his heart disease and his depression — “has made the other more complicated.”
