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Can You Have Depression After A Heart Attack?

It is common to feel some amount of depression after having a heart attack. If you believe you are experiencing depression after having a heart attack, it is important to consult a doctor. Many people often remain in doubt about whether they are depressed or not after a heart attack. Read on to find out about whether you can have depression after a heart attack or not.

Can You Have Depression After A Heart Attack?

Signs of Depression After Heart Attack

It is quite common for people to experience depression after suffering a heart attack. According to research done by the Heart and Vascular Institute at Johns Hopkins Medicine, people with depression are much more likely to experience a heart attack later on in life as compared to people who have never had a mental health condition.(1) If you feel you are experiencing depression after having a heart attack, it is necessary to let your doctor know at the earliest.(2,3,4,5) It is possible that some lifestyle adjustments and changes in your heart disease medications can help improve your mood. However, it might also be that you need to take specific treatment for depression, which is why speaking to a doctor is important.(6,7)

Some of the common signs of depression include:

  • Persistent feelings of sadness or worthlessness
  • Apathy
  • Fatigue
  • Feeling restlessness
  • Loss of appetite
  • Poor concentration
  • Difficulty sleeping

Here’s what to do if you are experiencing depression after a heart attack.

Consult A Doctor To Get A Proper Depression Assessment

If you suspect you may be experiencing depression, it is essential to consult your doctor to understand if you may need treatment. If you have had a heart attack, your doctor is likely to carry out a depression assessment when you go for your annual checkup. However, if you are experiencing symptoms of depression, you should consider making an appointment for a depression assessment before you are due for the yearly checkup.(8,9)

During your depression assessment, your doctor will ask you questions about your overall health and symptoms of depression. Questions may include when your depression symptoms began, how often you feel sad, and what steps you have taken if any, till now to treat it. These questions will help your doctor get an idea about whether you are experiencing depression or other acute symptoms of another mental health condition.

You are diagnosed with clinical depression if you have had these symptoms for at least two to three weeks or longer. Your doctor will only come up with a treatment plan after understanding the full extent of your depression.

You May Have To Opt For Cardiac Rehabilitation

Cardiac rehabilitation is an educational method that many cardiologists frequently recommended to those who have had a heart attack.(10) During cardiac rehabilitation, you will be educated on how to eat a heart-healthy meal, which type of exercise is the best for you, and how to feel more motivated and try to stick to the recovery process.(11)

Cardiac rehabilitation also involves some group sessions. This affects many people in a positive manner as you get to meet and interact with others who have had a similar experience like yourself. The support of others also acts as a significant motivating force to recover and follow a healthy lifestyle after your heart attack.(12)

Don’t Forget To Take Your Heart Medications

Not many people know that one of the most common triggers for experiencing depression after having a heart attack is not following your treatment plan. It is extremely important for your well-being and health that you take the medications as prescribed by your doctor and also make the proper lifestyle changes.

It is also possible that your feelings of depression stop you from taking your medication, thus creating a vicious cycle. Apathy is another common symptom of depression, which may cause you to neglect following your treatment plan.(13)

If you are finding it challenging to commit to your treatment plan, you should let your doctor know. Your doctor may consider putting you on a different medication or try a new treatment plan. In severe cases, you may be prescribed antidepressant drugs as well.

Exercise Regularly, But With Your Doctor’s Approval

Once you have recovered sufficiently from your heart attack, your doctor will recommend you to start exercising. This will not only help improve your heart health, but it will also be good for your recovery process. Start by exercising for short times, and slowly build up your strength and endurance. You can start with a simple half an hour walk around the block a couple of times a week. Then, as you start regaining your strength, build up to a brisk walk to a jog. However, do not push yourself and exercise at a pace you are comfortable with.

Exercise is an important factor that can prevent depression because it increases the release of serotonin, which is a brain chemical that boosts your mood. Every time you exercise, you will reap the benefits for both your brain and your heart. While you will not see the physical benefits of exercising immediately, but you will find that it puts you in a happier state of mind almost immediately.(14,15,16)

If you want to experience more benefits of exercising, head outdoors. Studies have shown that being outdoors has a positive impact on your mood. So, depending on the weather, consider exercising outside of your home.(17)

However, keep in mind that if you experience any symptoms of a stroke or heart attack, like nausea, vomiting, chest pain or lightheadedness, stop exercising immediately and seek immediate medical assistance.

Increase Your Intake Of Plant-Based Foods

After you have a heart attack, you will be given some form of nutritional counseling before being discharged from the hospital. Your dietitian or nutritionist will advise you to restrict or cut down your intake of sodium, processed foods and unhealthy fats. At the same time, you will be recommended to increase your intake of plant-based foods like legumes, fruits and vegetables, whole grains and olive oil. Fatty fish that are rich in omega-3 fatty acids are also recommended during this time as they are great for the heart.(18,19)

You will also find that when you stop having processed and packaged foods and increase your consumption of plant-based foods, you will be in a better mood. This is because these foods help protect your mind and brain. Such type of diet has been linked to a significantly lower rate of depression.(20)

Consider Taking Talk Therapy

Recovering from a heart attack can be an isolating experience, and even with the support of your friends and family, you may still find yourself feeling lonely and unable to explain your mental condition to others. This can increase your risk of developing depression.

Attending talk therapy with a professional mental health expert can help you at this time. During talk therapy, your therapist will help you understand and work through your feelings while also find solutions to help relieve your symptoms of depression. In fact, many people have reported that the skills they picked up during talk therapy helped them throughout their lives.(21)

Many people get confused between a therapist and a psychiatrist. A psychiatrist is capable of prescribing medications for treating mental issues, but a therapist cannot prescribe any medicines. But, a good therapist can help you find out if you need further help from a psychiatrist.

Antidepressants Can Help

While making lifestyle changes can help prevent depression after a heart attack and also make you feel better, but depending on the severity and longevity of your depression symptoms, you may need to take antidepressants, even if for a short time.

Some of the most commonly prescribed depression medications are selective serotonin reuptake inhibitors (SSRIs). Drugs like Xanax, Paxil, and Zoloft may be prescribed to help regulate your mood and make you feel better.

If you feel antidepressants may help you manage your depression, you should discuss this with your doctor. Your doctor will help you determine which type of drug will work best for you and also make you aware of any potential side effects of antidepressants.

However, it is important to remember that you have to give ample amount of time for these drugs to take effect. It may take up to a month or even more to start experiencing any results.(22)

Conclusion

Experiencing depression after a heart attack is actually more common than you may think. Your overall health can definitely have an impact on your mood, and your mood can also have an effect on your overall health. It is essential that you take care of your heart after you have suffered from a heart attack. By following your treatment plan properly, you are likely to notice an improvement in the depression symptoms as well. If you still continue to feel depressed after many weeks have passed and you have made lifestyle changes, you should see your doctor to discuss any potential treatment changes and what steps to take next.

References:

  1. 2021. Depression And Heart Disease. [online] Available at: <https://www.hopkinsmedicine.org/health/conditions-and-diseases/depression-and-heart-disease#:~:text=%E2%80%9CWhat%20we%20can%20say%20with,soon%20after%20the%20heart%20attack.> [Accessed 25 January 2021].
  2. Williams, R.B., 2011. Depression after heart attack: why should I be concerned about depression after a heart attack?. Circulation, 123(25), pp.e639-e640.
  3. Jiang, W., Krishnan, R.R. and O’Connor, C.M., 2002. Depression and heart disease. CNS drugs, 16(2), pp.111-127.
  4. Nemeroff, C.B., 1998. The neurobiology of depression. Scientific American, 278(6), pp.42-49.
  5. Davidson, K.W., Kupfer, D.J., Bigger, J.T., Califf, R.M., Carney, R.M., Coyne, J.C., Czajkowski, S.M., Frank, E., Frasure-Smith, N., Freedland, K.E. and Froelicher, E.S., 2006. Assessment and treatment of depression in patients with cardiovascular disease: National Heart, Lung, and Blood Institute Working Group Report. Annals of Behavioral Medicine, 32(2), pp.121-126.
  6. Gehi, A., Haas, D., Pipkin, S. and Whooley, M.A., 2005. Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study. Archives of internal medicine, 165(21), pp.2508-2513.
  7. Grenard, J.L., Munjas, B.A., Adams, J.L., Suttorp, M., Maglione, M., McGlynn, E.A. and Gellad, W.F., 2011. Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis. Journal of general internal medicine, 26(10), pp.1175-1182.
  8. Beck, A.T. and Beamesderfer, A., 1974. Assessment of depression: the depression inventory. S. Karger.
  9. Nezu, A.M., Nezu, C.M., Lee, M. and Stern, J.B., 2014. Assessment of depression.
  10. Dalal, H.M., Doherty, P. and Taylor, R.S., 2015. Cardiac rehabilitation. Bmj, 351.
  11. Wenger, N.K., 2008. Current status of cardiac rehabilitation. Journal of the American College of Cardiology, 51(17), pp.1619-1631.
  12. Mampuya, W.M., 2012. Cardiac rehabilitation past, present and future: an overview. Cardiovascular diagnosis and therapy, 2(1), p.38.
  13. Tang, W.K., Lau, C.G., Mok, V., Ungvari, G.S. and Wong, K.S., 2014. Apathy and health-related quality of life in stroke. Archives of physical medicine and rehabilitation, 95(5), pp.857-861.
  14. North, T.C., McCULLAGH, P.E.N.N.Y. and Tran, Z.V., 1990. Effect of exercise on depression. Exercise and sport sciences reviews, 18(1), pp.379-416.
  15. Cooney, G.M., Dwan, K., Greig, C.A., Lawlor, D.A., Rimer, J., Waugh, F.R., McMurdo, M. and Mead, G.E., 2013. Exercise for depression. Cochrane database of systematic reviews, (9).
  16. Mead, G.E., Morley, W., Campbell, P., Greig, C.A., McMurdo, M. and Lawlor, D.A., 2008. Exercise for depression. Cochrane database of systematic reviews, (4).
  17. Thompson Coon, J., Boddy, K., Stein, K., Whear, R., Barton, J. and Depledge, M.H., 2011. Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environmental science & technology, 45(5), pp.1761-1772.
  18. Harris, W.S., Miller, M., Tighe, A.P., Davidson, M.H. and Schaefer, E.J., 2008. Omega-3 fatty acids and coronary heart disease risk: clinical and mechanistic perspectives. Atherosclerosis, 197(1), pp.12-24.
  19. Harper, C.R. and Jacobson, T.A., 2005. Usefulness of omega-3 fatty acids and the prevention of coronary heart disease. The American journal of cardiology, 96(11), pp.1521-1529.
  20. Skarupski, K.A., Tangney, C.C., Li, H., Evans, D.A. and Morris, M.C., 2013. Mediterranean diet and depressive symptoms among older adults over time. The journal of nutrition, health & aging, 17(5), pp.441-445.
  21. Rupke, S.J., Blecke, D. and Renfrow, M., 2006. Cognitive therapy for depression. American Family Physician, 73(1), pp.83-86.
  22. Serebruany, V.L., Glassman, A.H., Malinin, A.I., Nemeroff, C.B., Musselman, D.L., Van Zyl, L.T., Finkel, M.S., Krishnan, K.R.R., Gaffney, M., Harrison, W. and Califf, R.M., 2003. Platelet/endothelial biomarkers in depressed patients treated with the selective serotonin reuptake inhibitor sertraline after acute coronary events: the Sertraline AntiDepressant Heart Attack Randomized Trial (SADHART) Platelet Substudy. Circulation, 108(8), pp.939-944.

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Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 25, 2021

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