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Mental Health & Heart Risk

What types of mental health problems can contribute to heart disease?

The mental health problems that can play a role in heart disease are usually broken down into 2 categories: emotional factors, including depression, anxiety, and hostility; and chronic stressors, including low social support, the strain of being a caregiver, and work stress.1

How common are mental health problems for people with heart disease?

A large survey showed that 2.8% of otherwise healthy people experienced psychological distress—symptoms that fall short of a diagnosis for mental illness. By comparison, 10% of women with heart failure, 6.4% for those who had had a heart attack, and 4.1% of people with other types of heart disease experienced psychological distress. In this survey, women were more likely than men to show signs of psychological distress (67.2% vs. 32.8%).2

Women are also more prone to depression than men after a heart attack or bypass surgery.3, 4 A study of more than 93,000 women found that having any sort of serious heart-related event—such as a heart attack or stroke—or a major procedure to treat heart disease (e.g., bypass surgery) makes a person much more likely to suffer from depression.5 Your doctor can recommend ways to deal with any mental health problems you may be having.

See also: Mental Recovery After a Heart Attack or Procedure

What is depression?

A person is considered to be clinically depressed if they have a depressed mood and a lack of interest in activities that used to be enjoyable, lasting for at least 2 weeks, and accompanied by at least one of the following: changes in appetite, sleep disturbance, fatigue, agitation, feelings of guilt or worthlessness, problems concentrating, and suicidal thoughts.6-8

Symptoms of Depression32
National Institute of Mental Health

  • Persistent sad, anxious, or empty mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being "slowed down"
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, waking up early, or oversleeping
  • Loss of appetite and weight loss, or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

How common is depression?

According to the National Institute for Mental Health, about 18.8 million Americans (9.5% of the population) 18 years and older suffer from depression in a given year; nearly twice as many women (12%) as men (6.6%) suffer from depression each year.9

An even greater number of women have depressive symptoms that are not severe enough to be classified as clinical depression. In the Women's Health Initiative Study (WHI) of more than 93,000 postmenopausal women without clinical depression, depressive symptoms were reported by nearly 16% of women. Hispanic and American-Indian Alaskan-Native women had the highest rates of depressive symptoms while Asian-Pacific Islanders had the lowest rates.5

How common is depression for people with heart disease?

A national survey found that for people age 15 to 54 years, about 5% will suffer from depression. The rate of depression among people with heart disease was about 3 times higher (15%).10

How does depression affect my risk of heart disease?

Depression affects heart health in many ways, though more research is needed to understand exactly how. Depression can alter your heart's ability to beat properly; it can increase the buildup of fatty plaques in your blood vessels; and it has been linked to eating and exercise habits.7, 8, 11-15

A study of nearly 63,000 women in the Nurse's Health Study found that women who experienced the symptoms of depression were 50% more likely to die of heart disease than women who did not, even after other heart disease risk factors were taken into account.67 Depression also increases the chance of having another heart attack in people who have already had one. The more depressed you are, the higher your risk of having heart troubles.7, 8, 16

Next: Anxiety & Heart Risk

Filed in Am I at Risk? > Stress


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