Heart Disease and Depression
I am feeling depressed after my heart attack. What can I do?
Don’t be ashamed or surprised if you are having some depressed feelings after your heart attack, heart surgery or stroke. Heart disease and depression are more common than you might think.
It’s not uncommon at all and you are definitely not alone. Your attentive physician will likely have you evaluated for depression after a heart attack and further direct you for appropriate treatment if it is determined that you have clinically significant symptoms of depression. Be open about this assessment. Depression is a treatable condition. Reducing your suffering and increasing your zest and enjoyment of life is good for you. Quality of life is everything. Part of your recovery includes taking care of the depression that can follow.
“When it comes to a heart attack or stroke – people typically think of the physical challenges. But the emotional taxing of our well-being that commonly follows is often overlooked, but very real.”
– Benjamin W. Carrettin, 2011 –
Be active in your recovery!
Follow your physicians plan for you, take your medications as your physician prescribed, adopt the diet and exercise recommendations, be vigilant in your attendance to your cardiac rehab program, and of course, spend time with your trusted friends and family. And if your physician feels that counseling is warranted – welcome the suggestion. Patients with heart disease who have a trusted confidant with whom they can share distressing thoughts and feelings have been found in prior research to have lower mortality rates. Even though there is no guarantee that counseling after a heart attack or surgery will prolong your life we do know that effective treatment of depression can reduce suffering and improve your quality of life.
I’ve never been to a counselor before. How does it work?
Breathe. Initially, you may be a bit nervous, but counseling should seem in many ways just like having a conversation with a trusted friend. I will ask questions, listen carefully to you and make suggestions. I consider my clients to be the reigning authority on the details of their own lives and as experts, together, we work to improve the quality of yours. While I am diligent and dedicated to my profession, I am also committed to ensuring that my clients are treated with the utmost dignity and respect. Please feel welcome to call me anytime with your questions or concerns. I’d be happy to talk with you.
Heart Disease and Depression: The Undeniable Link and How to Deal With It
The relationship between heart disease and depression can be seen as a two-way street. According to several studies that have been conducted in the past, around 15% of people with cardiovascular disease and 20% of those who have undergone heart surgery are suffering from major depression. In the same way, a high percentage of people with depression show symptoms of heart disease even if they do not seem to have any cardiovascular problem in the past. With this, it is important to recognize the problem as soon as possible, and consequently, identify the courses of action that will prove to be necessary before it becomes too late.
What is Depression?
For most of us, feeling sad and moody is a common occurrence. If you remember a sad event in your life or if you miss someone, you will most possibly delve into negative emotions. However, for some people, this sadness is experienced in a manner that is more intense and longer, such as for several weeks. In some cases, they experience being sad with no significant reason at all. This is most probably one of the most obvious signs of depression. It is a condition that goes beyond having a low mood as it can have a significant impact on one’s overall state of health.
Depressive disorders can be a result of different factors, such as physical health, family history, stress, imbalance in the chemicals in the body, and environment, among others. When a person is experiencing depression, it is common to feel bad about one self, to lose productivity at work, to forget about loved ones, and to have a change in attitude. Behaviors and attitudes will be the basis of diagnosing if a person is possibly depressed or not. The good news, however, is that there are depression treatments that are promising in terms of being able to resolve the problem.
Among others, the following are some of the most common symptoms of depression:
Loss of interest in socialization
Dependence on drugs and alcohol
Inability to concentrate
Lack of productivity at work
Having suicidal thoughts
Loss of appetite
Heart Disease and Psychological Impacts
For people who have recently had a heart attack or any other cardiovascular disease, it is apparent that their life is being affected in ways more than one. For instance, following such occurrence, it is normal for the patient to have a change in mood and attitude, have embarrassment and self-doubt, feel worthless, especially if the disease renders one of being incapable to work, and feeling guilty about having a bad lifestyle in the past that has resulted into such condition. Most people become filled with anxiety and uncertainty, which, consequently, can be one of the most common symptoms of depression.
The Relationship between Heart Disease and Depression
In many studies in the past, the link between these common health problems have been explored, and without any surprise, many of them have concluded how the two are indeed related to each other. For instance, in one study, it has been asserted that the presence of depression even after recovery from a heart attack can increase the chance of mortality by as much as 17%, as against the 3% rate of mortality among people who are no longer showing signs of depression. In addition, it has also been asserted that people who are suffering from depressive symptoms show an increase in platelet reactivity, which is one of the factors that trigger cardiovascular diseases. More so, another study has revealed that people who are suffering from heart disease and depression noted a lower quality of life. It is also worth noting that a person who is suffering from depression may be more likely to resort to negative habits, such as smoking and drinking alcohol, both of which will make one at higher risk of having heart disease.
One of the most common options for the treatment of depression is through the use of medications, which are prescribed by a doctor. (Remember, do not simply go to taking medicines if they are not prescribed by your physician as doing this can worsen the problem rather than having it resolved.) The most common would be anti-depressant medicines, including selective serotonin uptake inhibitors. Doctors will know best which one will work for you. A careful assessment of your health condition will be required to avoid possible side effects. *If you have more than one doctor providing care for you and prescribing medication – be sure they all have a release to be able to speak to one another and make certain every one of them have a complete and accurate list of all your medications.
Providing social support is also necessary for people who are suffering from heart disease and depression. According to several studies in the past, patients should create an effort to re-engage with their social network. In the same way, friends and family should never make the patient feel isolated because of the condition. Providing support will be effective in the prevention of depressive symptoms.
Taking medications is more commonly complemented with psychological treatments. This is important not only for the purpose of treating the current condition, but also to make sure that the signs of depression will not continue to burden you in the future. Through mindfulness cognitive behavior therapy (M-CBT) and interpersonal therapy, a seasoned and experienced professional therapist or counselor will help you to change your perspective in life, and hence, providing you with a more optimistic attitude to fight depression.
10 Common Symptoms Of Depression
Every year approximately 10 per cent of the American population suffers from depression. Depression is a grave illness that affects day to day life and destroys families. It is a disorder that controls the mind and its functions causing loss of appetite, sleeplessness, mood swings, and a deep sense of despair.
The symptoms of depression are varied and the severity changes with time. And, according to experts depression can be an inherited disorder, or caused by life threatening illnesses, or stress. Other causes are certain diseases, medicines, drugs, alcohol, chronic exposure to high stress environments or mental illnesses. Women have been seen to experience depression more than men and this is attributed to hormonal swings, menstrual cycle changes, pregnancy, miscarriage, pre-menopause, and post-menopause. But male depression in the U.S. is on the rise for a variety reasons.
Common symptoms are:
1. An unshakable sadness, anxiety, or emptiness.
2. Overwhelming hopelessness accompanied by pessimistic feelings.
3. Extreme guilt, feelings of helplessness, and no sense of self worth.
4. Loss of energy, a slowing down of metabolism, and activity levels. Being plagued by constant fatigue.
5. A sense of helplessness along with an increasing inability to focus and indecisiveness.
6. Loss of sound sleep and development of extreme insomnia.
7. Inexplicable weight loss or weight gain. Triggered by loss of appetite or eating binges.
8. Brooding and suicidal inclinations.
9. Irritability, short temper, as well as restlessness.
10. Physical afflictions like headaches, digestive disorders, and chronic pain for no particular reason.
If you experience any of the above along with a marked change in behavior do consult your doctor. They will give you a thorough examination to rule out physical causes for depression as well as any underlying medical problems. Then if needed they will recommend you for counseling or other supportive services.
Here are some quick tips for dealing with Mild to Moderate Depression:
Take matters in hand and try and erase negativity from your mind. Cut out from you life terms like exhaustion, worthlessness, and hopelessness. Change your life by setting yourself a few goals. Try and relax, meditate, and enjoy music. Start new activities that absorb your time as well as interests. Go out and meet people and participate in group activities. Avoid the company of negative people – this is huge, but isolation is not the answer. You have to add positive, communal experiences. Make up your mind to enjoy a movie, ballgame, family outing, picnic, or trek. Be positive, self confident, and have faith in yourself. Faith is itself can be a great healer. Decide to change your world for the better. However do follow the doctor’s advice. Treatment options can include: anti-depressant medicines, psychotherapy, as well as lifestyle changes.
For Severe Depression
If your depression escalates, seek help from your family physician or health care provider. If you are suicidal, call the emergency response, suicide hotline or go to your nearest emergency room. Do call a local health department, a community mental health center, or hospital or clinic. Someone will extend a helping hand and talk you through the crisis.
More Information on Heart Disease and Depression
Cardiac events, surgery, heart disease and depression. These are all familiar, often feared and typically held as foreign to us personally. But for many of us or those we love – these can become all too real very quickly.
When someone experiences a heart-attack, heart surgery or stroke, the immediate concerns obviously are physical health and management of the immediate situation. But when they survive and move on with their day to day activities, it is important to manage their mental health as well.
According to several studies done by researchers, it has been clear that about 40% of the patients with heart diseases and cardiac events suffer from depression. Depression has become very common after a heart attack. About 20% of post cardiac patients who suffer from depression have the severe form of it, while the others have it mildly. The good news is that this can be treated, but, this has been temporary most of the time. Long term survivors of cardiac events fall into depression in the rate of one out of three every year.
Also the researchers have shown that physical inactivity has become an independent risk factor for increased depressive symptoms after a cardiac event. Of course, it is understandable that getting diagnosed with a heart disease is really sad. But the process of this sadness and how the person copes with it is also important. Some accept the health status of their own selves, and focus on rehabilitation and regaining the health which he has lost or to recover as much as possible. But some find it hard to accept and the early sadness converts to depression over time.
One of the main things a person should be concerned about is that if the patient mood or outlook has changed significantly or they are not enjoying life as they did before. Do not dismiss apathy and malaise – these are concerns and should be discussed with a professional. Below are the main symptoms which will hint that the patient has not recovered from the psychological effects which he had suffered due to this health state. If you are having a loved one or you yourself are suffering from such a situation, it is best to go to a doctor. Counseling can help you come out of the depressive state you are in.
Depressive state after a cardiac event is not a normal thing and sometimes, your cardiologist may not understand that you have depression. To understand and to save yourself or your loved one from this state, you will have to observe them carefully.
A person with depression will likely have five or more of the following symptoms;
• Frequent feelings of sadness or emptiness
• Loss of interest in pleasurable activities
• Strange eating or sleeping patterns
• Excessive crying
• Thoughts of suicide and death
• Difficulty concentrating or remembering
• Feelings of worthlessness or helplessness
• Unexplained aches and pains that don’t respond to treatment
Depression is not the only matter, after a cardiac surgery. Some people also suffer from Post Traumatic Stress Disorder (PSTD) or anxiety. Even though the relationship between heart and mind are not understood, it is evident that a major surgery in the heart can cause some chemical changes in the brain. Doctors say that it is good to talk to a patient who has undergone a heart surgery, before you do your surgery. Also, they recommend that, a post cardiac surgery patient should do counseling after the major surgery.
Without treatment, depression can be fatal. For heart patients, depression can cause increased risk of heart attacks and coronary artery diseases. That is why you need to be careful about your psychological status, in order to have a full recovery and an effective rehabilitation.
If you feel like having depression and that something is disturbing your day-to-day work and social relationships, then it is necessary to get treated by a mental health specialist.
If you want to be more specific, here are some reasons to seek help;
• If you have low mood and lack of happiness daily, for about two weeks.
• If you find it very difficult to recover from your heart disease and if you feel a lack of motivation and confidence. This is a symptom of depression being settled in your brain.
• If you have difficulties carrying out your daily work, such as marketing, having good neighborhood, having a good relationship with family and etc.
• Low social activeness can also suspect that the patient is finding it hard to move with others and is also one of the symptoms of depression.
• If a person has suicidal thoughts and feelings.
Suicide is not a solution for any problem and it can harm not only the person who tries to commit suicide, but the loved ones as well. If you have any suicidal thoughts, call your physician or 24 hour suicide hotline right away.
The symptoms and a proper history can help a doctor predict or diagnose the prognosis of a patient. How long the psychological affects last and how often it occurs help us understand whether the patient is processing this health state in a natural way or whether he is slipping into depression. Diagnosing this status wholly depend on the patients attitude and behavior and not by the lab reports and others.
There are many treatment methods for depression; medications, psychotherapy or a combination of both can be used. Among medications new antidepressants such as Selective Serotonin Re-uptake Inhibitors (SSRI) are safe to be used for cardiac patients.
Psychotherapy can help a person to regain the normal thoughts and activities. It helps to provide social support and help the patient develop positive thinking. Supportive models of talk therapy appear to be the most effective in treating post cardiac surgery depression. Talking about the surgery and the experience the patient had can remove the fear, depression and sadness they have had after surgery.
Furthermore, a healthy lifestyle, regular exercises, proper sleep and a healthy diet together with a relaxation technique which will help to remove the stress after the surgery will help the patient manage psychological negativity which comes after surgery.
Early diagnosis and treatment of post cardiac surgery depression is important to gain effective rehabilitation and to prevent recurrent heart attacks. If left untreated, it increases the risk of mortality, depression and heart attacks.
As always a proper support system and a helpful background are important in helping a depressed person come out of the situation.
If you are family or a loved one of a patient who has undergone a cardiac surgery, here are some tips and suggestions;
• Encourage the patient to seek medical help and follow the therapy as asked. Make sure that he is consulted by a proper medical professional so that the diagnosis can be made as soon as possible and treated effectively.
• Educate yourself and family about post cardiac surgery depression. This will help you and your family to understand the patient’s situation. There are many support groups and organization which will provide you with enough information.
• You should know that depression is not a person’s attitude, weakness or quality and that it is a disorder with biological, psychological and interpersonal components.
• Help your family member follow the prescribed treatment plan and practice the coping techniques and problem-solving skills he or she is learning during psychotherapy. Following the doctor’s instructions will help him recover soon.
• Make sure medications are available if prescribed, attend therapy sessions together with a family member if the patient feels that it is needed, encourage the patient to follow recommended lifestyle changes and follow up with the proper health care providers.
• Recognize that depression is often expressed as hostility, rejection and irritability. Offer consistent support to your loved one. This can be daring, but it is one of the most important parts of a treatment plan. People with depression can feel alone and isolated. Giving consistent support and understanding are critical. Making them feel that you are with him, helps a lot more than you think.
• Adopt an interaction style that puts the depressed person in charge. For example, instead of suggesting, “Let’s go to the movies tonight,” try this: “I’d like to see a movie tonight. Which one of these do you want to see with me?” When he is in charge, he feels that he can manage things and this will help the negativity vanish away. (Remember that treatment is effective and your loved one will start to improve in 2 to 3 weeks, achieving full improvement in a couple of months. Notice and praise any significant improvement.)
• Reward your family member with opportunities such as visiting friends or going out for activities. Don’t force these, though. Suggestions and requested would be the best option.
• Take breaks from the depressed person from time to time. It will help both of you. A break will help you regain your active mind as well as the patient will feel that he is not forced.
• Consider family or marital therapy: these forms of therapy bring together all those affected by depression and help them learn effective ways to cope together.
• Consider support of community support groups, either for the depressed person, or for you as the family member, or better yet for both of you.
Outpatient Professional Counseling For Heart Disease and Depression
If you are looking for the best way to deal with heart disease and depression in Houston, Texas, I can extend a helping hand through outpatient professional counseling. With my extensive experience and knowledge in working specifically with the emotional challenges that often complicate serious medical issues, I provide services that preserve the dignity and privacy of my clients and that are customized to their specific needs. Compared to other local treatment options, outpatient counseling delivers a wide array of benefits, such as giving you the freedom to do the things you normally do while undergoing treatment. My professional services will help you and your loved ones live a normal, healthier, and happier life even if you have heart disease and are showing signs of depression.
Call Now (713) 489-3329
Ben Carrettin is a Nationally Board Certified Counselor (NCC), Licensed Professional Counselor-Supervisor (LPC-S) and Licensed Chemical Dependency Counselor (LCDC). He is the owner of Practice Improvement Resources, LLC; a private business which offers an array of specialized counseling, evidenced-based clinical consultation, Critical Incident Stress Management (CISM) and targeted ESI-based services to individuals and businesses.