A recent study found that heart attack survivors with depression also tend to have higher rates of high blood pressure (hypertension), coronary artery disease, diabetes, heart failure and chronic obstructive pulmonary disease (COPD), compared to those who do not develop depression. Additionally, people with depression are at higher risk of a stroke than those with no depression symptoms.  

If you or someone you know has experienced a heart attack and you’re concerned about depression, it’s important to discuss your concerns with a physician. Here, a Northwestern Medicine psychiatrist identifies the signs of depression to watch for and resources that can help.

Psychological Impact of a Heart Attack

Having a life-altering experience like a heart attack is stressful and can impact your mental health. You may notice some of the following changes days to weeks after a heart attack:

• Anger
• Denial of the problem
• Guilt
• Fear
• Loss of identity
• Loneliness

“Cardiovascular health and mental health are linked together,” says Tracy Binius, MD, a psychiatrist at Northwestern Medicine Central DuPage Hospital. People who experience cardiovascular disease, such as heart failure, stroke and heart attack, have a higher risk of developing depression and are at an increased risk of having another cardiovascular event.

Conversely, depression can increase the risk of heart disease. People with depression tend to engage in lifestyle choices that can lead to heart disease such eating an unhealthy diet, smoking and exercising less, says Dr. Binius. The relationship between mental health and heart health is a two-way street. Unfortunately, many people who experience depression do not seek treatment.

How to Tell If You or a Loved One Is Depressed 

Feeling down for a few days after your heart event is normal and should go away within a few weeks. However, if those symptoms persist you may be experiencing depression. Since depression can be an emotion as well as a term for a medical illness, it’s important to know the key symptoms:

• Feelings of hopelessness, sadness, or pessimism
• Changes in sleep patterns, such as an inability to sleep or sleeping too much
• Decreased energy, fatigue, feeling slowed down, so much so that small tasks take extra effort
• Loss of appetite and weight loss, or increased food cravings and weight gain
• Inability to concentrate, make decisions and remember things
• Unexplained body physical problems, such as body aches or headaches
• Loss of interest or pleasure in hobbies that usually are enjoyable
• Recurring thoughts of death, suicide or suicide attempts

When these symptoms may indicate depression, they are usually severe enough to cause recognizable problems in daily activities such as work, school, or your relationships. If you experience five or more of these symptoms for at least two weeks, you may be diagnosed with depression.

Caring for Your Mental Health

While you’re in the process of identifying your feelings, it’s also important to find ways to support your well-being as you recover. There are a variety of treatment options for your mental and physical health following a heart attack. “Face-to-face counseling is the best intervention for adjustment to life after a heart attack,” says Dr. Binius. Here are additional ways to take care of your overall health, according to Dr. Binius:

• Maintain a healthy diet
• Get regular exercise
• Keep in touch with your friends
• Spend less time on social media
• Watch less TV
• Engage in social activities
• Quit smoking

Recovering is a journey and each path is different. But it’s important to move forward, accept your feelings and make small adjustments each day. The best part about having a second chance at life is that you recognize the changes that need to be made, and you can make them accordingly at your pace. Remember to give yourself grace and enjoy all that life has to offer.

Support After Heart Attack Diagnosis

A supportive community encourages a strong recovery. The support of family and friends can help relieve your stress and anxiety, but it’s also important to reach beyond your immediate network.

At Northwestern Medicine, we offer cardiac rehabilitation which includes inpatient and outpatient services that are designed to support you during the recovery process. There are different sessions within cardiac rehabilitation that help with all areas of recovery, such as exercise programs, stress reduction, and treatment plans to help you quit smoking. We also offer year-round classes, events and support groups that are online, virtual and in-person. They can help you live a healthier, happier and more informed life.      

If you feel that you may need medication to help with anxiety or depression, talk to your physician. If you or someone you know is having thoughts of suicide, call or text the National Suicide and Crisis Lifeline at 988 or chat with a trained specialist at 988lifeline.org.