Depression and Heart Health: A Two-Way Connection

A heart attack can lead to depression, but the reverse is also true. Why the ties between mental and cardiovascular health matter.

1:00 PM

Author | Jane Racey Gleeson

An estimated 10 percent of Americans ages 18 and older report having depression, according to the American Heart Association.

For heart attack patients, that figure more than triples: 33 percent of them develop some degree of depression.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

And while depression can follow the onset of cardiovascular disease, the chain of events also may happen in reverse.

"It's very complicated," says Michelle Riba, M.D., a clinical professor of psychiatry and an associate director of the Comprehensive Depression Center at Michigan Medicine. "Almost every major cardiac condition has psychological issues that need to be addressed."

Which is why monitoring a heart patient's mental health is just as important as treating his or her physical condition, experts agree.

According to research in the Journal of the American Heart Association, persistent depression may double the risk of stroke in adults ages 50 and older. What's more, recent research in Circulation: Cardiovascular Quality and Outcomes reports that the combination of stress and depression can significantly increase a heart patient's risk of death or heart attack.

Symptoms and support

"A patient who receives a heart disease diagnosis is likely to feel anxiety or depression, depending on the diagnosis and the treatment," says Riba, adding that different types of heart disease can lead to different types of depression or anxiety.

SEE ALSO: 'Not Just a Man's Disease': Why Women Need to Care About Heart Health

"Each carries a unique psychiatric issue for individual patients," she says. "For example, a patient who faces the challenges of living with an implantable cardioverter defibrillator may have anxiety about the device being activated and how that will feel."

Other bodily changes might cause emotional shifts.

Some cardiac patients may no longer be able to do the things that once were part of their stress-reduction routine, such as running or other physical activities. Not only are they now unable to relieve stress with their usual coping mechanisms, but they could also feel anxiety about their health and their diminished capacity to exercise.

Even medication can play a role: "The drugs used to treat many heart-related diseases are also known to potentially exacerbate depression or anxiety in some patients," Riba says. "We need to be aware of which medications are better in treating certain types of heart disease."

Doctors, she notes, must take a personalized approach with each patient, determining "what will work best for him or her in the way of medication and/or forms of psychotherapy."

Patients, meanwhile, must also keep their physicians informed of any notable changes in mood throughout recovery.

"A patient should ask for help for their depression, anxiety or other psychological conditions," Riba says. "We hope that with more education and support, patients will feel comfortable discussing their emotional issues with their clinicians."


More Articles About: Heart Health Heart disease Depression Cardiovascular: Diseases & Conditions
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories mushrooms in a microscope
Health Lab
How cannabis and psilocybin might help some of the 50 million Americans experiencing chronic pain
Recent developments represent a dramatic change from long standing federal policy around these substances that has historically criminalized their use and blocked or delayed research efforts into their therapeutic potential.
Health Lab
Mother-son heart bond: Woman relives congenital heart journey through newborn
A mother relives congenital heart journey through newborn.
Health Lab
Protecting heart health during pregnancy
Experts discuss pregnancy and heart health.
heart organ yellow blue
Health Lab
Around 10% of deaths from coronary stenting, balloon angioplasty are preventable
Around 10% of all deaths following percutaneous coronary intervention are potentially preventable, a study led by Michigan Medicine finds.
Mothers Babies Postpartum
Health Lab
Rapid rise seen in mental health diagnosis and care during and after pregnancy
Perinatal mental health research shows more pregnant people and those who have recently given birth are getting diagnosed and treated for depression, anxiety and PTSD, but disparities remain.
Microscopic image of bone marrow with pink and white hues
Health Lab
Novel risk score for cardiovascular complications after bone marrow transplant
More bone marrow transplants, also known as hematopoietic stem cell transplantation, are being offered to older patients, a population at greater risk of cardiovascular disease.