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Managing Depression after a heart attack
According to the National Institute of Mental Health, about 1 in 20 American adults experiences major depression in a given year. That number increases to about 1 in 3 for people who have survived a heart attack.

Research over the past 20 years shows that people with heart disease are more likely to suffer from depression than people who are healthy. With this information, as well as the fact that people with depression are at greater risk for developing heart disease, the message is that depression is a serious condition. Through self-awareness and treatment, you can regain emotional and physical heart health.

“Several studies also show that if you have had a heart attack and suffer major depression that is untreated, it is likely that you will have another heart attack, and suffer more damage,” says Dr. Bruce Schell, clinical psychologist at Palmetto Health Heart Hospital. “It is important that you be aware of how a heart attack can hurt more than your heart.”

Reacting to the heart attack.
Feeling shocked, tearful and scared are normal reactions to such an event, even for a few weeks after the attack. However, if the feelings deepen and linger, you may develop depression. If not treated, you are at high risk for a subsequent heart attack.

Knowing if you are depressed.
Signs of depression include continual crying and/or feeling nothing is pleasurable anymore. You say no to doing the activities that you once enjoyed. You think of yourself as worthless. Recurring thoughts such as “my life is over” or “I am irrevocably damaged” are indicators of depression.

Taking steps to recovery.
The longer depression lasts, the more it affects the quality and quantity of your life. You are less likely to continue taking any medications you need, make the needed lifestyle changes, or finish your cardiac rehabilitation program.

To take steps toward full body recovery, follow your physician’s orders in attending cardiac rehab, taking any medications, and in adopting a heart-healthy lifestyle. Once rehab is over, this means continuing to eat right, exercising regularly, and avoiding previous bad habits.

“Do not be afraid to ask your doctor questions,” says Dr. Schell. “As you recover, anxiety and worry may interfere with your memory, so take your spouse or a friend with you to your doctor’s appointment to help you understand and remember. Ask questions until you understand. Your cardiologist wants you to be fully informed about your health.”

Seeking treatment.
Treatment options are individualized to each patient. The common ingredients are psychotherapy and an antidepressant. “Psychotherapy and medication are more effective together than either by itself.” says Dr. Schell. “It is important to note that the therapy must be aimed specifically at what is going on in the present, at the feelings associated with your cardiac event and the impact it has made on your life. It should not be about dredging up your past.”

Being among friends and family.
“Most of the heart patients I see have chronic heart disease. Chronic disease can wreak havoc on relationships,” says Dr. Schell. Continue your friendships. Dr. Schell advises his patients who feel withdrawn to get back into their social lives, as well as get re-involved in their church, synagogue or spiritual community.