Twists & Turns: Mental Health Accommodations

February 24, 2026

Kira Alston


Welcome to Twists & Turns, a new column written by SCAD Alliance Board Member Kira Alston, M.S., C.R.C., offering perspectives to help SCAD patients navigate the often challenging post-SCAD journey. A multi-SCAD survivor herself, Kira is a Disability Management Specialist with a major university where she helps persons with disabilities with reasonable accommodations in the workplace.

So…What Now?

A Spontaneous Coronary Artery Dissection (SCAD) heart attack often strikes without warning, affecting healthy individuals, in many cases, who may not have a history of coronary artery disesase or be at risk for a traditional, plaque-based heart attack. Young women of childbearing age, specifically, are one important subgroup of SCAD.

Of course, physical recovery is definitely important, but our emotional and mental well-being is just as important. For many survivors, anxiety, depression, PTSD, and fear of recurrence are a part of the next steps in the healing process.

Why Mental Health Matters After SCAD

Having a SCAD can leave survivors feeling alone, vulnerable, and uncertain about what happens next. Nightmares, panic attacks, hypervigilance, and difficulty concentrating are common. These symptoms can significantly impact daily life, relationships, and the ability to return to work. Remember, you are not alone.

Ask for Support

Under the Americans with Disabilities Act (ADA), you may be entitled to reasonable accommodations at work or school that support your mental health during recovery. Reasonable accommodations are designed to help you to perform essential job functions without placing an undue hardship on your employer. The accommodations must work for you and your employer whether temporary in duration or long-term/ongoing.

Mental health reasonable accommodations options may include:

  • Flexible scheduling or part-time return-to-work plans

  • Work-from-home options when possible

  • Quiet spaces or reduced sensory stimulation

  • Additional breaks during the day

  • Modified job tasks or extended deadlines where available

  • Support for medical or therapy appointments

Talk with your cardiology specialist, mental health provider, or primary care doctor about what accommodations might help you. Ask for written documentation of your functional limitations to support your request and provide it to your employer/Human Resources Department. “Functional limitations” is defined as the level of difficulty a person experiences in daily life due to a disability or medical condition.

You are a WHOLE PERSON with a new health experience!

Be kind to yourself. Recovery from SCAD is more than cardiac rehab and stress tests. You have to acknowledge the scars that you cannot see, validate your emotional experience, and create environments at work, home, and in care settings where true healing can happen for you. Advocate for yourself–you have a lot more living to do!

 

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