You are not alone: Mental health and heart disease

Denial, fear, sadness, stress, anger, and loneliness are some of the emotions that people may feel after a cardiovascular disease diagnosis or after a cardiac event. Patients may be in denial and not be able to accept their condition. People may be fearful of their condition recurring or worsening or fearful because their future seems uncertain.

Feelings of sadness and anger may be experienced due to life suddenly changing and now having limitations on their abilities. People may experience stress from financial uncertainty due to hospital bills, medication costs, and having to stop working for some time. Feelings of loneliness may arise due to not having a support network of people who have experienced their specific condition or having minimal to no social or familial support.

The development of a mental health condition is common.

Depression and anxiety are two common mental health conditions that patients experience after a cardiac event or after receiving a diagnosis of a specific cardiovascular disease. A 2020 study published in Frontiers in Psychology found that the rates of depression in the early and late recovery of a cardiac event were 17% and 15%, respectively. The rates of anxiety in the early and late recovery of a cardiac event were 28% and 27%, respectively.

Symptoms of mild to severe depression according to the American Psychiatric Association:

•   Feeling sad or having a depressed mood
•   Loss of interest or pleasure in activities once enjoyed
•   Changes in appetite–weight loss or gain unrelated to dieting
•   Trouble sleeping or sleeping too much
•   Loss of energy or increased fatigue
•   Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
•   Feeling worthless or guilty
•   Difficulty thinking, concentrating, or making decisions
•   Thoughts of death or suicide

Are you experiencing symptoms of Generalized Anxiety Disorder?

Symptoms of Generalized Anxiety Disorder, according to the American Psychiatric Association:

•   Persistent and excessive worry that interferes with daily activities
•   Restlessness or feeling on edge
•   Easily fatigued
•   Irritability
•   Difficulty concentrating
•   Muscle tension and headaches
•   Problems sleeping

Resources and treatment options are available for you.

There are resources available to help patients cope with these emotions. Attending support groups and cardiac rehabilitation are great ways to communicate with others that have a shared experience and understand what you are going through. Additionally, treatment options are available for mental health conditions that meet the diagnosis criteria.

If you are experiencing symptoms of depression and anxiety, talk to your physician. They can screen you for depression and anxiety using the Patient Health Questionnaire and the Generalized Anxiety Disorder Scale, prescribe medication, refer you to psychotherapy, or refer you to a psychiatrist (an M.D. or D.O. specializing in diagnosing and treating mental disorders) if necessary.


Until Next Time!

Stephanie Coulter, MD

Thank you to Symone Taylor for her contributions to this issue of Straight Talk.