Heart disease is the number one cause of death in the United States.1 Bouncing back after a heart attack or heart surgery is never easy, and this recovery can create the additional risk of developing depression.

With 1 in 10 America suffering from depression, these two illnesses are bound to co-occur for some people.2 But this relationship is much more than a coincidence. The relationship between heart disease and depression is bidirectional, meaning that each can increase the risk of developing the other. People with no history of depression are at increased risk after a heart attack, and people who are depressed develop heart disease at a higher percentage than the general population.3

Researchers estimated the rate of depression is as high as 33% among people who have had a heart attack.4 This is because a heart attack can influence a person’s general attitude about the world and their future. Being incapacitated by the event can also cause a decrease in self-esteem when roles at work and in one’s family change. Guilt is a common symptoms of depression, and people who’ve had a heart attack may feel guilty about the behaviors which damaged their heart and body. They may also feel ashamed of how they are not physical as capable as they once were. Once this depression develops, people have even less energy to exercise, take medication, refrain from drinking or smoking, and eat healthy. In a dangerous cycle, these behaviors increase the risk of future cardiac events.5

In turn, depression can lead to heart disease because it increases the risk of behaviors associated with poor physical health. People who are depressed are more likely to drink, smoke, and overeat to cope with their low mood. They’re less likely to exercise, and they experience higher levels of stress, which can lead to high blood pressure and arrhythmia. All of these behaviors can increase the risk of heart attack, dying after a heart attack, being readmitted to the hospital, and slowing recovery after surgery.6

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Signs of Depression

Because heart disease and depression can both lead to fatigue, trouble sleeping, and performing daily responsibilities, it can be easy to overlook the presence of depression. It’s normal for a person to feel sad or irritable after a heart attack or major surgery, but if these feelings persist for more than two weeks, depression may be present. Signs of depression can include:7

  • Lack of interest in activities
  • Depressed mood or irritability
  • Changes in sleep patterns
  • Changes in appetite
  • Feelings of guilt or despair
  • Lack of energy
  • Trouble concentrating
  • Suicidal thoughts

Treatment Options

There are many treatment options which can provide relief to depressive symptoms and help you regain the energy and motivation to improve heart health. Some of these include:

Talk therapy – Also known as psychotherapy, talk therapy can help an individual change patterns in thinking, learn coping skills for symptoms, and help prevent future depressive symptoms. It can also provide an opportunity for an individual to talk about the challenges of heart disease.

Medication – Antidepressant medications may be prescribed to help combat symptoms. Ask your doctor what medications work safely and most effectively with heart disease. Medication has also been proven to work best in conjunction with talk therapy.

Peer support – Many people find that support groups for heart conditions, mental illness, or both can provide both emotional support and psycho-education. If there isn’t an in person group in your area, consider looking online for support.

Action Steps

If you’re not sure where to get started, here are some solid action steps for combatting heart disease and depression.

Use rehabilitation resources – If you’d experienced a cardiac event or have had surgery, be sure to stay plugged into a rehabilitation program that focuses on nutrition and exercise. These lifestyle changes can help lift your mood and serve as protective factors to prevent future episodes of depression.

Be social – Because people with heart disease may have less energy and struggle with self-doubt, they may begin to isolate from friends and family. Stay connected to friends, and talk to your family about the challenges you face. Reach out to a mental health professional or peer support groups to help you regain confidence and agency in your life.

Be vocal – If you have a heart condition, your doctor should automatically screen you for depression. If they haven’t, speak up at your next appointment and ask about possible treatment options, such as medication and counseling.

Practice healthy habits – Getting dressed every morning, moving your body, and returning to activities you enjoy can all protect you from depression or from symptoms worsening. A positive mood can lower blood pressure and give you the energy to focus on physical health and lowering the risk of cardiac events.

Above all, never feel that you are alone when you face physical or mental illness. Support is available, so don’t hesitate to seek out resources and professionals who can provide you with the best treatment and guidance along the way. Your heart and mind can be healthier and happier with the right attention and care.

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Last Updated: Nov 25, 2018