Receiving a diagnosis of a heart condition, whether as a result of an acute event or after a period of feeling unwell, is never welcome. If it happens to you, you need to look after not only your heart but also your mental health: they are closely entwined.
It’s little surprise that the British Heart Foundation found that 68 per cent of people they asked said their condition had affected them mentally, emotionally or psychologically.
And the mental health effects of heart disease can be significant. A fifth of people who have had an acute cardiac event experience serious depression and another quarter experience minor depression. Around a quarter of people with congestive heart failure show depressive symptoms. Many never seek help, but it seems that depression makes it harder for people to look after themselves and to follow treatment and rehabilitation for their heart, so they recover less well.
What’s more, depression has been associated with a four-fold increase in the risk of heart disease in otherwise healthy people so if you think you may be depressed you must take it seriously, not only in its own right but also because of its connection to heart disease.
You may find that some people say that feeling depressed is a normal response to having a long-term illness, and this may include some of the health workers you meet. But if you think you may be depressed, seek treatment because no one should suffer depression, whether they have a heart condition or not.
A man of 55 years was referred to Dr Adrian Winbow by his GP, with apathy and poor concentration. He had seen a cardiologist three months before and was admitted to a coronary care unit at the local hospital with a myocardial infarction. This was a terrifying experience for him and he felt that he was going to die. He made a good recovery from his cardiac illness, but had marked insomnia, depression and suicidal ideas. He was diagnosed as having a moderate depressive episode (post-myocardial depression) and was prescribed antidepressants, that were safe for his previous history of cardiac disease. He made a good recovery from his depression, much to the relief of his family.
Twice as likely: putting long-term conditions and depression on the agenda, Arthritis Research UK, British Heart Foundation, Depression Alliance, Diabetes UK, Macmillan Cancer Support, National Rheumatoid Arthritis Society, 2012.
‘Heart disease and mental health’, Heart Matters, British Heart Foundation,
‘Primary Care Guidance: Treating depression in people with coronary heart disease’, Royal College of General Practitioners Mental Health Forum, 2011.
