Depression and heart disease are among the most common health conditions in America. Research suggests a connection between the two. Managing either heart disease or depression can be a battle in itself. Dealing with both at the same time is challenging — not just for overall health but also for your social, emotional, and physical well-being and quality of life.

In this article, we explore the connection between heart disease and depression, how members of MyHeartDiseaseTeam manage both, and what you can do to improve your health and quality of life.

How Do People With Heart Disease Experience Depression?

Several MyHeartDiseaseTeam members have shared their experiences living with heart disease while also facing chronic depression, major depressive disorder, or depressive episodes.

As one member wrote, “I used to walk on a treadmill five days a week for 30 minutes, but since I have been on trazodone 150 milligrams for insomnia and depression, it makes me feel dizzy and hungover every day. I hope the insomnia and depression go away so I can stop trazodone and focus on my heart health more. I will try to post positive things, but if I’m being totally honest, some days are just not all that positive.”

After posting that she had had a so-so day, one member explicitly asked, “Does heart disease make depression worse?” Another member responded, “I have heart disease and depression as well. I have had some very rough days that I have gone through over the last three months. I am on psychiatric medication and seeing my psychiatrist monthly. I just started counseling. I need to brush up on my coping skills and learn how to handle the problems I am in right now.”

The Relationship Between Depression and Heart Disease

According to Johns Hopkins Medicine, the relationship between heart disease and depression appears to go both ways. Some people with no history of depression become depressed after developing heart failure or experiencing a heart attack. Meanwhile, those with no history of cardiovascular disease who have depression may develop heart disease at a higher rate than those without depression.

Another study from Johns Hopkins Medicine states that about 20 percent of people who have a heart attack are diagnosed with depression shortly after. Depression is thought to occur at similar rates in those living with heart failure.

It can be hard to prove that heart disease contributes directly to a first-ever depressive episode in those who were not previously feeling depressed. People with undiagnosed depression or depressive episodes may have gone undiagnosed until seeing their doctor for cardiac-related problems. However, the longer people stay in the hospital for cardiac issues, the more likely they are to experience depression.

Two to four weeks after a heart attack, it is common to feel depressed and anxious. These emotions may be the result of not knowing what to expect or not being able to do simple tasks without becoming overly tired.

One of the most important parts of recovery is to start exercising gradually. Once you are shown what you can still do safely, you are less likely to worry about limitations. Exercise has been shown to reduce anxiety and depression.

Other researchers have found that about 20 percent to 30 percent of people with cardiac conditions also have depression and that depression can significantly worsen a heart disease prognosis. This research also determined an increased risk of depression in those diagnosed with heart disease, indicating a two-way relationship between these conditions.

What Can Cause Depression in Those With Heart Disease?

As noted in publications from the University of Iowa, depression and heart disease share some common lifestyle habits and risk factors, including a sedentary lifestyle, limited exercise, obesity, smoking, excessive alcohol consumption, skipping medications, and eating mostly unhealthy or nutrient-deficient foods.

Aside from these risk factors, several other circumstances may contribute to or make depression worse in people living with heart disease.

Life With Heart Disease

Living with a chronic condition like heart disease presents unique challenges — financially, physically, emotionally, and socially. In some cases, the stress of being diagnosed with a chronic health condition like heart disease can affect your mental health and contribute to depressive symptoms. These issues include persistent feelings of anxiety or sadness, difficulty sleeping, fatigue, cognitive difficulties, and more.

Emotional stress or behavioral changes are common as individuals come to terms with the changes that heart disease can have on their lives. These changes can involve social interactions, the food they eat, and day-to-day activities. Struggling to manage negative or confusing feelings can lead to depression or depressive risk factors. Not surprisingly, approximately one-third of people with chronic health conditions like heart disease experience depressive symptoms.

Although a heart disease diagnosis can make you feel as if your whole life has been upended, it may not negatively change the way you live your life. Sometimes, the acute episode serves as a warning that may push you in a healthier direction. Pursuing adequate care and adopting the right management techniques in your day-to-day life — not only for your heart but also for your mental, emotional, social, and physical health — can be the first steps in making heart health a better and overall positive change in your routine.

Biological Connections Between Heart Disease and Depression

It is not known whether there are biological links between the two conditions. However, research has determined that depression is associated with worsened coronary heart disease outcomes. This is because people with depression may be less likely to participate in physical therapy and may be less compliant with taking medications and following medical advice.

Treating Depression With Heart Disease

Depression is a serious mood disorder that affects all aspects of your daily life. Talk to your cardiology team or another health care provider if you believe you may be experiencing depression.

There is currently a shortage of conclusive research regarding the treatment of depression in those with heart conditions, in particular. However, there is plenty of evidence-based research available on how those living with depression can treat their condition and improve their quality of life. Consult your cardiologist before beginning any treatment plans or making lifestyle changes to make sure they do not negatively affect your cardiovascular health or heart disease treatments.

Manage Your Heart Disease

Although it may not treat mental health conditions like depression, managing your heart disease is one of the first steps toward feeling better overall. Work with your doctor to understand your condition and how heart disease affects you — both mentally and physically. By getting your heart disease under control, it can be easier to find the time and energy to care for your mental health properly.

Therapy or Counseling

Psychotherapy (commonly referred to as talk therapy or counseling) with a licensed mental health professional is a form of mental health care proven to greatly help those living with mental disorders, including major depressive disorder.

One study from the journal Cognitive Therapy and Research found that psychotherapy led to overall improvements in mood, thinking, and physical function, as well as reduced stress responses. Furthermore, a meta-analysis conducted by Cambridge University found that psychotherapy for depression often results in significant improvement in overall quality of life.

Unlike antidepressants, which can effectively lessen depression symptoms but do not address the root cause of the disorder, psychotherapy works to analyze and correct the source of the depression by increasing your social support network. This type of treatment can help you develop more positive thinking patterns and promotes healthy coping mechanisms to manage the effects of your condition.

Several different types of therapy are effective for depression, including cognitive behavioral therapy. Your primary care provider or another doctor may provide a referral for a mental health specialist if you are unsure where to start.

Physical Activity

Depression may leave you feeling drained or unmotivated, making it harder to work up the energy to get moving. Research from the Mayo Clinic has found that any form of physical activity — not just structured exercise — can reduce stress, improve mood, and improve a range of health conditions including heart disease. Physical activity releases endorphins (the body’s “feel-good chemicals”), which can help improve your mood.

Getting physical activity is also recommended as part of a heart-healthy lifestyle. For those with heart disease, regular exercise can help strengthen the heart muscle and promote weight loss, which can potentially help with symptoms like fatigue and shortness of breath commonly seen in those with heart disease. A good exercise program and sometimes referral to a cardiac rehabilitation center can often improve your spirits and help fight depression.

As always, consult with your doctor before beginning a new exercise regimen. They can help you determine a routine that works with your health and fitness level without jeopardizing your well-being.

Antidepressants

Antidepressants are among the most common and recognized treatment options for depression. There are many different types of antidepressant medications. Selective serotonin reuptake inhibitors are widely accepted as the safest option for people with (and without) cardiac issues due to an established safety record, and plenty of studies confirm their impact.

Support Groups

If you have heart disease and depression, support groups can offer an expanded social support network, making it easier to cope with depression and isolation. Support groups can also benefit those who have family members with heart disease who want to educate themselves on supporting their loved ones or maintaining proper heart health.

Consider asking your doctor or mental health professional about available support groups for those living with heart disease or depression. These meetings can be a valuable way to improve your mental well-being, make connections, and find ways to better your quality of life.

Find Your Team

Living with heart disease and other chronic conditions can greatly affect your day-to-day life, but you don’t have to go it alone. On MyHeartDiseaseTeam, you can connect with more than 52,000 members from across the globe working to manage their cardiac conditions. Here, you can ask questions, offer support and advice, and find a team of others who understand life with heart disease.

Have something to add to the conversation? Share your thoughts in the comments below or by posting on MyHeartDiseaseTeam.