Mondayitis: the struggle is real

By definition, Mondayitis is the tired, stressed and apathetic feeling experienced by persons returning to work on a Monday after the weekend. This seemingly contagious condition is triggered by Sunday Funday, and symptoms persist until Friday Evening.

While you may not come across Mondayitis in medical textbooks, researchers have revealed that heart dysfunction is, in fact, most common on Mondays.

Heart dysfunction, or an adverse cardiac event, includes chest pain (angina pectoris), heart attack (myocardial infarction), and irregular or abnormal heart rhythm (arrhythmia).

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Stethoscope. Credit: Dr. Farouk [CC BY 2.0] via flickr.
Researchers used the database from a clinical trial called the Cardiac Arrhythmia Suppression Trial (CAST) to prospectively examine the month, the season and the day of the week of onset of heart attacks. They found that heart attacks strike in a number of patterns related to the day of the week, and the season of the year. These patterns were observed in a variety of patient groups, and appear to be related to climate, occupation, and other factors.

Researchers have also found that, in addition to Mondays, adverse cardiac events are most common during:

  • Autumn and winter
  • The middle of the morning
  • Earthquakes, hurricanes or other natural disasters
  • Edge-of-your-seat FIFA world cup matches
  • Terrorist attacks

These are all stressful settings, so it’s not surprising, right? But what is the physiological link between acute stress (i.e. rapid onset and/or short-lived stress) and our risk of cardiac dysfunction?

While this link is not 100% clear, researchers have made important advances in understanding stress, stress-related illness, and how the brain rules the body. For example, the rise in adverse cardiac events in the morning has been attributed to sympathetic nervous system (SNS) activation.

The SNS itself activates the “fight or flight” response through a series of interconnected nerve cells, or neurons. These neurons release acetylcholine, a chemical messenger that binds and activates what are called nicotinic acetylcholine receptors (like a lock and key mechanism; the receptor is the lock and the acetylcholine is the key). In response to this activation, neurons release noradrenaline, a hormone that binds and activates adrenergic receptors in the body. Adrenergic receptors signal the “fight or flight” response, which includes pupil dilation, increased sweating, increased heart rate, and increased blood pressure. This response takes place as soon as we get out of bed in the morning.

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Stressed College Student. Credit: CollegeDegrees360 [CC BY-SA 2.0] via flickr.
What’s more, there is also a link between chronic stress (i.e. long-lasting stress) and SNS activation, and our risk of cardiac dysfunction. This chronic stress is induced by disease states such as obesity.

A team of researchers at Baker IDI Heart and Diabetes Institute in Melbourne assessed 18 lean and 25 overweight or obese individuals between the ages of 18 to 30. The overweight or obese group had kidney, blood vessel, and heart dysfunction, and higher blood pressure. They also had a higher level of SNS activation. An arguably more frightening finding, though, is that the overweight or obese group had this organ damage and dysfunction without the tell-tale signs and symptoms of cardiovascular disease (e.g. chest pain, shortness of breath, and fatigue). It is for this reason that heart disease has been called a “silent killer”.

So, both acute and chronic SNS activation, or a heightened response to stress stimuli, drive cardiac dysfunction.

While it is important to note that SNS activation is only one of many drivers of cardiac dysfunction, this research ultimately may help us come up with strategies to prevent adverse cardiac events. Interestingly, weight loss and exercise not only protect the heart and blood vessels from damage and dysfunction, but are also associated with decreased SNS activation.

So while we may not yet have a cure for Mondayitis, we do know that to keep our heart healthy, we need to eat well, exercise more, and stress less!

Original articles and more information:

Chronobiology of acute myocardial infarction: cardiac arrhythmia suppression trial (CAST) experience (abstract access).

Sympathetic nervous system activity is associated with obesity-induced subclinical organ damage in young adults (open access).

If you know something about myocardial infarction, and would like to learn more about arrhythmias, this video is an introduction to some of the different types (i.e. atrial fibrillation, supraventricular tachycardia and ventricular tachycardia).


4 Responses to “Mondayitis: the struggle is real”

  1. rsleaby says:

    Thanks for the comment Olivia – no I hadn’t read anything about this but I have just looked it up and researchers suggest that the day light savings and heart attack link may be explained by sleep deprivation, our circadian clock (sleep-wake cycle) and our immune function: http://www.sciencedaily.com/releases/2012/03/120307162555.htm

    Perhaps these are all linked to sympathetic nervous system activation too?

  2. Olivia Campbell says:

    I’ve heard that the onset of day light savings is related to high numbers of heart attacks occurring. Did you read anything about this?

  3. rsleaby says:

    Thanks for the comment vchhen – I agree Monday mornings are always a struggle, and it really is fascinating just how closely heart function is related to stress!

  4. vchhen says:

    I’m definitely not an expert but I do feel stress really hits you on a Monday – it’s more so of an apprehension of all the work/assessments you have to do over the next several days which therefore leads to increased stress! I mean, I definitely feel it! But I do find it absolutely fascinating that small amounts of stress may be linked to cardiac dysfunction at some point in life…