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Heart disease and depression

Heart disease and depression often go hand-in-hand.

  • You are more likely to feel sad or depressed after a heart attack or heart surgery, or when symptoms of heart disease change your life.
  • People who are depressed are more likely to develop heart disease.

The good news is that treating depression may help improve both your mental and physical health.

What is the Connection?

Heart disease and depression are linked in a number of ways. Some symptoms of depression, such as lack of energy, can make it harder to take care of your health. People who are depressed may be more likely to:

  • Drink alcohol, overeat, or smoke to deal with feelings of depression
  • Not exercise
  • Feel stress, which increases the risk for abnormal heart rhythms and high blood pressure.
  • Not take their medicines correctly

All of these factors:

  • Increase your risk of having a heart attack
  • Increase your risk of dying after a heart attack
  • Increases your risk of being readmitted to the hospital
  • Slow down your recovery after a heart attack or heart surgery

Signs of Depression

It is pretty common to feel down or sad after having a heart attack or heart surgery. However, you should start to feel more positive as you recover.

If the sad feelings do not go away or more symptoms develop, do not feel ashamed. Instead, you should call your health care provider. You may have depression that needs to be treated.

Other signs of depression include:

  • Feeling irritable
  • Having trouble concentrating or making decisions
  • Feeling tired or not having energy
  • Feeling hopeless or helpless
  • Trouble sleeping, or sleeping too much
  • A big change in appetite, often with weight gain or loss
  • A loss of pleasure in activities you usually enjoy, including sex
  • Feelings of worthlessness, self-hate, and guilt
  • Repeated thoughts of death or suicide

Treating Depression

Treatment for depression will depend on how severe it is.

There are two main types of treatments for depression:

  • Talk therapy. Cognitive behavioral therapy (CBT) is a type of talk therapy commonly used to treat depression. It helps you change thinking patterns and behaviors that might add to your depression. Other types of therapy may also be helpful.
  • Antidepressant medicines. There are many kinds of antidepressants. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the two most common types of medicines used to treat depression. Your provider or therapist can help you find one that works for you.

If your depression is mild, talk therapy may be enough to help. If you have moderate to severe depression, your provider may suggest both talk therapy and medicine.

What you can do

Depression can make it hard to feel like doing anything. But there are ways you can help yourself feel better. Here are a few tips:

  • Move more. Regular exercise can help reduce depression. However, if you are recovering from heart problems, you should get your doctor's OK before starting to exercise. Your doctor may recommend joining a cardiac rehabilitation program. If cardiac rehab is not right for you, ask your doctor to suggest other exercise programs.
  • Take an active role in your health. Studies show that being involved in your recovery and overall health can help you feel more positive. This includes taking your medicines as directed and sticking to your diet plan.
  • Reduce your stress. Spend time each day doing things you find relaxing, such as listening to music. Or consider meditation, tai chi, or other relaxation methods.
  • Seek social support. Sharing your feelings and fears with people you trust can help you feel better. It can help you better handle stress and depression. Some studies show it may even help you live longer.
  • Follow healthy habits. Get enough sleep and eat a healthy diet. Avoid alcohol, marijuana, and other recreational drugs.

When to Call Your Doctor

Call your health care provider if:

  • You hear voices that are not there.
  • You cry often without cause.
  • Your depression has affected your ability to participate in your recovery, or your work, or family life for longer than 2 weeks.
  • You have 3 or more symptoms of depression.
  • You think one of your medicines may be making you feel depressed. Do not change or stop taking any medicines without talking to your provider.

If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

References

Beach SR, Celano CM, Huffman JC, Lanuzi JL, Stern TA. The psychiatric management of patients with cardiac disease. In: Stern TA, Freudenreich O, Smith FA, Fricchione GL, Rosenbaum JF, eds. Massachusetts General Hospital Handbook of General Hospital Psychiatry. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 26.

Freedland KE, Carney RM, Lenze EJ, Rich MW. Psychiatric and psychosocial aspects of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 99.

Lichtman JH, Froelicher ES, Blumenthal JA, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350-1369. PMID: 24566200 pubmed.ncbi.nlm.nih.gov/24566200/.

Wei J, Rooks C, Ramadan R, et al. Meta-analysis of mental stress-induced myocardial ischemia and subsequent cardiac events in patients with coronary artery disease. Am J Cardiol. 2014;114(2):187-192. PMID: 24856319 pubmed.ncbi.nlm.nih.gov/24856319/.

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  • Depression

    Animation

  •  

    Depression - Animation

    If you often feel sad, blue, unhappy, miserable, or down in the dumps, you may have depression. Let's talk about depression, and what you can do to get out of your funk. Depression often runs in families. This may be due to your genes, passed down by your parents and grandparents, the behaviors you learn at home, or both. Even if your genetic makeup makes you more likely to develop depression, a stressful or unhappy life event may triggers the depression. Depression can have many causes, including internal factors like genetics, or negative personality. External factors, substance misuse, or trauma and loss. Common triggers include alcohol or drug use, and medical problems long-term pain, cancer or even sleeping problems. Stressful life events, like getting laid off, abuse at home or on the job, neglect, family problems, death of a loved one, or divorce, can send someone spiraling into depression. There are three main types of depression; major depression, atypical depression and dysthymia. To be diagnosed with major depression, you must demonstrate 5 or more of the primary symptoms for at least two weeks. Atypical depression occurs in about a third of patients with depression, with symptoms including overeating, oversleeping, and feeling like you are weighed down. Dysthymia is a milder form of depression that can last for years if not treated. Other forms include the depression that is part of bipolar disorder, postpartum depression, occurring after a woman gives birth, premenstrual dysphoric disorder, occurring 1 week before a woman's menstrual period and seasonal affective disorder, occurring in both males and females during the fall and winter seasons. No matter what type of depression you have and how severe it is, some self-care steps can help. Get enough sleep if you can, exercise regularly, and follow a healthy, nutritious diet. Avoid alcohol and recreational drugs. Get involved in activities that make you happy and spend time with family and friends. If you are religious, talk to a clergy member. Consider meditation, tai chi, or other relaxation methods. If you are depressed for 2 weeks or longer, contact your doctor or other health professional before your symptoms get worse. Treatment will depend on your symptoms. For mild depression, counseling and self-care may be enough. Either psychotherapy or antidepressant medicines may help, but they are often more effective when combined. Vigorous exercise and light therapy could offer significant benefit alone or in combination. Healthy lifestyle habits can help prevent and treat depression, and reduce the chances of it coming back. Talk therapy and antidepressant medication can also make you less likely to become depressed again. In fact, talk therapy may help you through times of grief, stress, or low mood. In general, staying active, making a difference in the life of others, getting outside and keeping in close contact with other people is important for preventing depression.

  • Depression

    Animation

  •  

    Depression - Animation

    If you often feel sad, blue, unhappy, miserable, or down in the dumps, you may have depression. Let's talk about depression, and what you can do to get out of your funk. Depression often runs in families. This may be due to your genes, passed down by your parents and grandparents, the behaviors you learn at home, or both. Even if your genetic makeup makes you more likely to develop depression, a stressful or unhappy life event may triggers the depression. Depression can have many causes, including internal factors like genetics, or negative personality. External factors, substance misuse, or trauma and loss. Common triggers include alcohol or drug use, and medical problems long-term pain, cancer or even sleeping problems. Stressful life events, like getting laid off, abuse at home or on the job, neglect, family problems, death of a loved one, or divorce, can send someone spiraling into depression. There are three main types of depression; major depression, atypical depression and dysthymia. To be diagnosed with major depression, you must demonstrate 5 or more of the primary symptoms for at least two weeks. Atypical depression occurs in about a third of patients with depression, with symptoms including overeating, oversleeping, and feeling like you are weighed down. Dysthymia is a milder form of depression that can last for years if not treated. Other forms include the depression that is part of bipolar disorder, postpartum depression, occurring after a woman gives birth, premenstrual dysphoric disorder, occurring 1 week before a woman's menstrual period and seasonal affective disorder, occurring in both males and females during the fall and winter seasons. No matter what type of depression you have and how severe it is, some self-care steps can help. Get enough sleep if you can, exercise regularly, and follow a healthy, nutritious diet. Avoid alcohol and recreational drugs. Get involved in activities that make you happy and spend time with family and friends. If you are religious, talk to a clergy member. Consider meditation, tai chi, or other relaxation methods. If you are depressed for 2 weeks or longer, contact your doctor or other health professional before your symptoms get worse. Treatment will depend on your symptoms. For mild depression, counseling and self-care may be enough. Either psychotherapy or antidepressant medicines may help, but they are often more effective when combined. Vigorous exercise and light therapy could offer significant benefit alone or in combination. Healthy lifestyle habits can help prevent and treat depression, and reduce the chances of it coming back. Talk therapy and antidepressant medication can also make you less likely to become depressed again. In fact, talk therapy may help you through times of grief, stress, or low mood. In general, staying active, making a difference in the life of others, getting outside and keeping in close contact with other people is important for preventing depression.

A Closer Look

 

Self Care

 

 

Review Date: 1/18/2022

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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