Recovering from a heart attack can be a scary and unsettling process. Not surprisingly, about 65 percent of people experience symptoms of depression after a heart attack, reports an August 2001 article published in the journal "American Family Physician." Furthermore, roughly 20 percent of heart attack survivors qualify for a diagnosis of clinical depression. Depression itself is a risk factor for heart disease. Likewise, depression after a heart attack is associated with an increased risk of cardiac complications and adverse events.
Many people experience "the blues" while dealing with a major health concern like heart disease. Clinical depression, or major depressive disorder, is a persistent condition that can lead to complications. According to the American Psychiatric Association, features of major depression include depressed mood, changes in appetite and sleep habits, lack of interest in activities, inability to concentrate and possibly suicidal thoughts. While some changes in mood may reflect medication effects and physical symptoms after a heart attack, screening for depression by a professional can help identify an underlying depressive disorder.
Depression After a Heart Attack
The recovery period after a heart attack, or myocardial infarction, often involves adjusting to new medications and potential physical limitations. This experience can understandably affect mood, energy levels and sleep patterns. In many cases though, these symptoms go unrecognized and may progress to lasting depression. Less than 25 percent of people who have heart disease and major depression are actually diagnosed with depression, note the authors of the August 2001 article in "American Family Physician." Failure to receive an accurate diagnosis can affect the prognosis following a heart attack, as people with major depression may be less likely to take their medications and may be more apt to smoke and drink alcohol.
People who experience major depression after a heart attack -- known as post-MI depression -- are at increased risk for future heart attacks and cardiac hospitalizations. According to an article published in the January 2009 issue of "The Annals of Family Medicine," increased release of stress hormones and higher levels of inflammatory proteins may help explain why people with post-MI depression are more prone to complications than people without major depression. Furthermore, people with post-MI depression may be less likely to seek out social support, which can be particularly important during recovery.
Studies examining whether post-MI treatment for depression with either medications or psychotherapy prevent heart-related complications have been inconclusive so far. Nevertheless, the American Heart Association recommends that people who experience a heart attack undergo screening for depression. General strategies already known to improve outcomes following a heart attack -- including participation in an exercise program approved by your doctor and relying on loved ones for emotional support -- may also boost mood and help alleviate post-MI depression.
See Your Doctor
If you or a loved one experience symptoms of depression after a heart attack, be sure to tell your doctor. Depressed mood, poor concentration and changes in eating or sleeping habits may be warning signs that should be addressed. If you have thoughts about hurting yourself, know that help is available and seek urgent medical attention.
- The Annals of Family Medicine: AAFP Guideline for the Detection and Management of Post–Myocardial Infarction Depression
- American Family Physician: Assessment and Treatment of Depression Following Myocardial Infarction
- Journal of the American College of Cardiology: Depression After Myocardial Infarction -- Unraveling the Mystery of Poor Cardiovascular Prognosis and Role of Beta-Blocker Therapy
- Journal of the American College of Cardiology: Only Incident Depressive Episodes After Myocardial Infarction Are Associated With New Cardiovascular Events
- Circulation: Depression and Coronary Heart Disease
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