It’s not unusual for someone who has been diagnosed with heart disease to feel depressed or sad. The lifestyle changes that follow, including altering diet, taking new medication and medical monitoring, can be overwhelming. If someone has survived a cardiac event like a heart attack or had a cardiac-related surgery, they may also have permanent limitations that affect their day to day life. If this describes you or someone you know, it’s important to be aware that it brings an increased risk for depression and take steps to address it before it becomes a major problem.
Depression is very common among people with serious heart disease.
|General population||5 percent|
|Medical outpatients||10 percent|
|Coronary heart disease||20 percent|
|Heart failure||30 to 40 percent|
|Bypass surgery||Up to 50 percent|
Source: JAMA 2006
If these feelings linger for more than two weeks in a row or if they develop over time, you may be experiencing more than sadness. You may be feeling the effects of clinical depression or another major depressive disorder and it’s important not to ignore it. New research finds that people diagnosed with both coronary heart disease and depression are twice as likely to die in the ten years following their diagnosis compared to people who only have heart disease. In both the United States and Canada, heart disease is a leading cause of death. In the U.S. alone, about 610,000 people die of heart disease every year. That’s about one in every four deaths. This is why the American Heart Association recommends that patients receiving treatment for heart attacks and other cardiac events be screened for depression.
“Considering how common depression is, it’s important that employers educate themselves and their employees about depression and train supervisors to understand and recognize the condition,” says LHSFNA Management Co-Chairman Noel C. Borck. “These measures can include giving a toolbox talk about depression that includes symptoms, telephone contacts and support groups. Employers should encourage employees to get help if they need it and assure them that all conversations about mental health needs will remain confidential.”
Symptoms of Depression
- Trouble concentrating, remembering details and making decisions
- Feelings of guilt, worthlessness and helplessness
- Pessimism and hopelessness
- Insomnia, early-morning wakefulness or sleeping too much
- Loss of interest in things once pleasurable, including sex
- Overeating or appetite loss
- Aches, pains and headaches that won’t go away
- Digestive problems that don’t get better, even with treatment
- Persistent sad, anxious or “empty” feelings
- Suicidal thoughts or attempts
The effects of clinical depression on heart health can be both physical and psychological. They can also influence each other. Research finds that depression is twice as likely to occur in people with heart disease compared with the general population and people with depression are at increased risk for developing heart disease.
On the physical side, depression can increase risk for inflammation and conditions that include high blood pressure and hardening of the arteries. Untreated clinical depression can increase risk for a heart attack or blood clots that can lead to a stroke.
The psychological component can affect how well a person with heart disease responds to treatment and how a patient who has suffered a heart attack or stroke or who has undergone a cardiac surgery recovers. Patients who are depressed have more difficulty following essential treatments. They are more likely to skip important heart medications, for example. They are also more likely to engage in harmful lifestyle habits that can interfere with treatment. These include smoking, excessive alcohol consumption, lack of exercise, poor diet and lack of social support.
What Should You Do?
- If you are feeling depressed, get help.
- See if you have access to a Member Assistance Program (MAP) through your employer or your health and welfare fund.
Let your doctor or health care provider know how you are feeling – they need to first rule out physical or medical reasons contributing to why you feel the way you do. They may also recommend that you be seen by a mental health professional; ask for a list of referrals. The good news is that depression often responds well to treatment. Medications and psychotherapy are effective for many people.
[Janet Lubman Rathner]