Most people expect the physical challenges that come with a heart attack or heart disease diagnosis. What many don't expect is the emotional toll. Fear, anxiety, sadness and even depression can become part of recovery for some patients, sometimes lasting long after they leave the hospital.
Between 33% and 50% of heart attack survivors experience some form of psychological distress, including depression, anxiety, psychosocial stress or post-traumatic stress disorder, according to the American Heart Association. Roughly 1 in 3 develops symptoms of depression. Persistent psychological distress also is associated with an increased likelihood of future cardiac events, although researchers have not established a direct cause-and-effect relationship.
"Many people fear they'll have another medical emergency or that their diagnosis will require difficult treatment, surgery and hospital stays," says Dr. Maxwell Prempeh, an Atrium Health Floyd and Harbin Clinic cardiologist. "Others may grieve the life they envisioned, struggle to come to terms with their new reality or have concerns over how others view them. All of this can increase the likelihood of developing depression."
Heart health and emotional health work both ways
The connection between heart health and emotional health works both ways. A heart attack or heart disease diagnosis can affect emotional well-being, while ongoing stress, anxiety and depression can affect cardiovascular health. Researchers believe this relationship may involve the body's stress-response system, inflammation and lifestyle factors such as sleep, physical activity and medication adherence.
"Not only can heart attacks or heart disease diagnoses cause depression, but deep sadness or emotional stress can also cause transient heart disease such as cardiomyopathy," Dr. Prempeh says.
One example is stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy or "broken heart syndrome." This temporary heart condition can develop after intense emotional or physical stress and may closely resemble a heart attack, causing symptoms such as chest pain, shortness of breath and dizziness.
Although relatively uncommon, Takotsubo syndrome is increasingly recognized because its symptoms can look so much like a heart attack. Fortunately, most patients recover and heart function often returns within several weeks with supportive care. Because its symptoms can mimic those of a heart attack, immediate medical evaluation is essential.
Help is available
"Fortunately, there are measures that can be taken from a clinical perspective to help patients with any mental health struggles they are experiencing alongside their cardiac diagnosis," Dr. Prempeh says. "We can talk through concerns related to their heart condition and connect them with resources that can improve their mental health and quality of life."
Dr. Prempeh recommends several approaches that may help patients during recovery:
- Cardiac rehabilitation to support physical and emotional recovery.
- Support groups to reduce feelings of isolation.
- Therapy to develop healthy coping strategies.
- Heart-healthy habits such as regular physical activity, healthy eating and good sleep.
- Stress-management techniques such as mindfulness and meditation.
Emotional health is just as important as physical health. Atrium Health Floyd and Harbin Clinic encourage patients recovering from a heart attack, heart procedure or heart disease diagnosis to discuss persistent feelings of depression, anxiety, stress or other emotional changes with their care team. Early recognition and support can improve quality of life and help patients navigate recovery with greater confidence.
To learn more about depression care available through Atrium Health Floyd and Harbin Clinic, visit Depression Care at Atrium Health Floyd and Harbin Clinic.