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In the second of two interviews with Medscape, Dr. Ornish talks about what he considers the least understood and most important parts of the Ornish Lifestyle Medicine program (Intensive Cardiac Rehabilitation) —love and connection.

“People who are lonely and depressed are three to 10 times more likely to get sick and die prematurely.”

The interview is based on a talk he gave at the American College of Cardiology (ACC) Scientific Sessions called “The Transformative Power of Lifestyle Medicine: Love and Intimacy.”

theheart.org | Medscape Cardiology: In your ACC talk, you reviewed some of the data linking depression and social connection with poor outcomes. Can you summarize that for our readers?

Dean Ornish, MD: Study after study has shown that people who are lonely and depressed are three to 10 times more likely to get sick and die prematurely compared with people who are not depressed and who have a stronger sense of love, connection, and community. For example, a study in JAMA, by Nancy Frasure-Smith,[1] found that 6 months after a heart attack, people who were depressed were four times more likely to be dead than those who weren’t depressed. This was independent of the usual risk factors like cholesterol, blood pressure, weight, and even smoking and left ventricular function.

I wrote a book about this in 1998 called Love & Survival, which reviewed what were then hundreds (now thousands) of studies showing that people who are lonely and depressed are many times more likely to get sick and die prematurely—not only from heart disease but from all causes—when compared with those who have a strong sense of love, connection, and community.

In conducting the Lifestyle Heart Trial, we met with people twice a week for 5 years. I got to know these patients very well. I would ask them, “Why do you overeat/drink too much/work too hard/smoke cigarettes? These behaviors seem so maladaptive to me.” They would look at me and say, “You don’t get it. These behaviors are very adaptive. They help us deal with our loneliness. They help us get through the day.” They would say things like, “I have 20 friends in this pack of cigarettes and they are always there for me when nobody else is”; “Food fills the void”; or “Alcohol numbs the pain.”

Working all the time is a more socially acceptable way that many physicians use to distract from the pain. Video games, surfing the Internet, watching too much TV—there are so many ways we have of literally or figuratively bypassing pain. But pain is the messenger; it’s there to get our attention, to say, “Hey, listen up: You are doing something that is not in your best interest.” If you don’t listen to the pain and just numb it without changing these underlying causes, it is a little like clipping the wires of a fire alarm when your house is burning and then going back to sleep thinking that you solved the problem.

Read the full interview here.

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