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The Heart-Mind Connection

Cardiovascular disease closely linked to depression

The mind and body are strongly linked, and depression is a common mental health disorder linked to cardiovascular disease. If you’ve been diagnosed with cardiovascular disease, it’s important to address not just your heart health, but your mental health, too.

Two out of every five cardiac patients experience symptoms of clinical depression. According to the American Heart Association (AHA), 33 percent of patients who have had a heart attack experience depression. One study showed that heart attack caused post-traumatic stress disorder (PTSD) or other conditions that interfered with daily functioning in 12 percent of patients, and those with PTSD were twice as likely to suffer another serious heart event or die within two years. Also, major surgery, such as open heart surgery, can lead to depression. There are several possible reasons for this, but pain after surgery and side effects of anesthesia are two potential culprits.

Why It Matters

If you have depression and cardiac disease, regardless of which diagnosis came first, you are more likely to have a poor outcome from your illness. Multiple studies have been conducted on this topic over the past couple of decades, and they show that people who have depression and cardiac disease may be at increased risk of:

  • Premature death
  • Longer hospitalization
  • Re-admission to the hospital
  • Progression of disease
  • Poor quality of life

According to research, this could be due to lifestyle factors: If you are depressed, you may be less likely to follow a healthy diet and get proper exercise, and more likely to smoke and drink alcohol. Depression is also linked to higher levels of inflammation in the body, which can worsen cardiovascular disease.

Mental Health Support for Cardiovascular Patients

Because depression is so closely linked with cardiovascular disease and cardiac events, it’s important to include mental health care in your cardiovascular treatment plan. Depression can keep you from complying with treatment recommendations, slow healing and increase your risk of having another cardiac event. An eight-year study conducted with 300 patients who had a certain type of cardiovascular disease and depression showed that those patients treated with antidepressant medication had better long-term outcomes than those who were not.

“When cardiac patients experience a decline in mood or interest for more than a week, I encourage them to talk to their doctor and be open to an evaluation for depression,” says Kim L. Feingold, PhD, director, Cardiac Behavioral Medicine, Northwestern Medicine Bluhm Cardiovascular Institute. “Not only does depression not feel good, but it can impede health behaviors and lead to worse cardiac health. The good news is that treatment for depression is safe and effective for cardiac patients.”

Dr. Feingold, Gail M. Osterman, PhD, and Paul Goetz, PhD, specialize in helping cardiac patients and their families adjust to a diagnosis and cope with challenges throughout the course of treatment. Their techniques include strategies that encourage behavior change, improve coping strategies, minimize stress, reduce emotional distress, help with extended hospitalizations, and prepare for an upcoming procedure or surgery.

Support groups may also be beneficial. Mended Hearts Chicago holds monthly educational forums at Northwestern Memorial Hospital to support patients with heart disease.

Learn other heart health tips.