One man’s tale of mind-heart health
In his years as a banker and then an automobile executive, Fred Deutsch never let on that he labored in the shadow of depression. He got up early every day and marched off to work — though all he craved was the oblivion of sleep. Ignoring his crushing anxiety, he put in long hours, often under intense pressure, and says he has two ruined marriages to thank for it.
He tried many medications and spent hours in psychotherapy in hopes of banishing what he calls his “malaise.” But his depression has been “fiercely resistant,” dogging him for most of his adult life, says the 72-year-old Santa Monica man.
After Deutsch lost his beloved third wife to breast cancer almost 15 years ago, he struggled to get out of bed for three years, thinking things couldn’t get much worse.
And then his broken heart became more than a metaphor.
Following hip surgery in 1999, doctors told Deutsch his heart was beating erratically, the result of a leaky valve in one of his heart’s chambers. In time, they told him, it would need to be fixed with surgery.
By 2005, his heart had entered a danger zone. His relatively benign case of atrial fibrillation had given way to life-threatening ventricular fibrillation. He collapsed — by coincidence, while volunteering in a hospital — and within two days had a pacemaker in his chest.
Deutsch’s cardiologists sent him home with orders to exercise and maintain a healthy diet. They never asked him about depression, said Deutsch. And he never volunteered it. “I wouldn’t think there’d be any basis for their asking about it,” he says. “When I was visiting with them, I wouldn’t be manifesting any symptoms.”
The days when Deutsch could keep his dual nemeses locked up in separate compartments are long gone. Whether depression caused his cardiac woes is no longer of immediate importance: What is clear is that depression has made his life lonely and miserable. And it has stalled his recovery.
He used to exercise regularly but stopped going to the gym a couple of years ago. He eats, at most, one meal a day. For most of every day, he feels weak and tired — he doesn’t know whether his depression or his heart is to blame. He says he is lonely but feels he has nothing to offer a potential mate. He has abandoned efforts to meet women and rarely gets together with friends or family. Instead, he reads or watches TV on his bed, with his cat, Smoky Joe, at his feet.
“I know better — that’s the thing that bothers me,” says Deutsch, again and again. “I don’t want to go through the rest of my life the way I am now. And I don’t want to go through the rest of my life without a partner. But it’s hopeless. All I want to do is sleep.”
The antidepressant that helped him for a while — Wellbutrin — seems to have ceased working. Talk therapy gave him insight but little comfort; he’s abandoned it for now.
“I understand all the factors, and here I am, stuck in a malaise. My life is just passing me by,” he says.
In the meantime, his health has declined on other fronts as well. He has suffered a ruptured spleen and developed cataracts. His hearing is failing.
“I’ve never tied my heart and depression together,” he says. “But I can see that there might be a link.”
Columbia University cardiologist Alan Rozanski says cardiologists miss an opportunity — and shirk their responsibility — when they fail to ask a patient about his state of mind. Depression is sufficiently common in heart patients that a doctor should anticipate it, he says.
Whether or not it helps heal the heart, he adds, “we as physicians have a responsibility for helping people deal with depression.”