In recognition of World Heart Day on 29 September, we take a closer look at the links between heart conditions and mental health.
The connection between mental health and heart health is complex. Research carried out by the British Heart Foundation has shown that patients with severe mental health problems are two to three times more likely to suffer from heart disease. Conversely, 68% said their heart condition had affected them mentally, emotionally or psychologically, the most common symptom being anxiety, with 77% saying they suffered from it.
But what comes first – the chicken or the egg? Do people who suffer from common mental health issues such as depression, anxiety and stress turn to a lifestyle which encompasses all the high risk factors for developing heart disease such as drinking, smoking and eating fatty foods? Or is it the other way round? Do people who develop heart disease by these lifestyle factors become depressed, anxious or stressed as a result of a heart disease diagnosis? There is no firm link of a stressful and anxiety laden life leading directly to heart disease, but there is a sense in the medical community that it is a risk factor.
Research from the Universities of Edinburgh and Southampton showed that young men who were diagnosed with a variety of mental disorders were more likely to develop coronary heart disease in later life. These mental health disorders included not only depression but also schizophrenia, bipolar disorder, neurotic disorders and personality disorders.
Regardless of the starting point, the key is to break the cycle and treat the symptoms of any mental health condition present as well as treating the heart condition. Treatment in the form of a talking therapy such as Cognitive Behavioural Therapy (CBT) should be offered to patients with a cardiovascular problem and suffering from a combination of low mood, loss of interest or pleasure, disturbed sleep patterns, change in appetite, fatigue, agitation, poor concentration, low self-worth and thoughts of death. Usually, five or more of these symptoms would be in place for several weeks to make a diagnosis of depression and the type of treatment would depend on the severity of the symptoms.
The use of antidepressants in patients with some form of heart condition has been the subject of much debate with articles published suggesting they are both harmful and beneficial. This highlights the importance of individual care and a process of ongoing review of medications by a cardiologist and psychiatrist working together.
If you have a heart condition and are suffering from any of the symptoms above, get in touch. Our consultant psychiatrists have many years’ experience in treating patients with complex mental health conditions and whose physical or heart health may also be having an effect their mental well-being.