Hopelessness and the Heart Attack: The Role of Depression in Heart Disease
“Everybody obviously has a mood dip after a
Several medical studies, says Kubzansky, have tracked heart attack patients for many months after they left the hospital. The studies found that the patients with diagnosable depression suffered more heart complications including death.
Identifying the Risk Factors for Heart Disease
In the United States, heart disease is the number one killer of men and women. To help determine who may need more aggressive treatment after a heart attack, physicians assess each patient’s risk factors. Most known risk factors center around complications of the heart itself or predisposing traits like
Finding the Connection
To understand why depression in heart attack patients may lead to worse complications, doctors look for common biologic patterns that connect the two. The current prevailing theory focuses on the balance of the actions of the nervous system. Part of the nervous system, called the autonomic nervous system, constantly regulates our internal organs without our awareness.
For example, we don’t need to tell our lungs to breathe or our hearts to beat. The autonomic nervous system does these things on its own. But if the autonomic nervous system is off-balance, many normal functions of the body are affected. Scientists note that patients with depression have distinctive changes in the balance of their autonomic nervous systems. Some believe these changes may underlie the connection between depression and heart disease.
If there is a biologic connection between depression and heart disease in people with weakened hearts, can depression also be a risk factor for heart disease in people with normal hearts? According to a medical review, this does indeed seem to be the case.
Treating Depression Effectively
For some heart attack patients, symptoms of depression may resolve without treatment. For others, whose symptoms persist, data sheds light on effective treatment. A large medical study showed that the antidepressant
Another large study of heart patients with depression, however, found that patients treated with psychotherapy had the same rate of heart complications as their counterparts who did not get psychotherapy. But patients in this study who took antidepressant medications seemed to do a little better. The investigators call for further research to determine the best way to treat depression and reduce complications in heart attack patients.
In sum, any patient who has suffered a heart attack should discuss the risks of depression with their doctor. Likewise, patients with depression and no evidence of heart disease should be aware of all heart disease risk factors and should evaluate their individual risks with their physicians.
American Heart Association
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
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Last reviewed March 2010 by
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