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Is it normal to feel depressed after a heart attack or heart procedure?

About one in five people suffer from major depression after a heart attack, bypass surgery, or angioplasty.1 Some degree of depression occurs in up to a third of all heart attack survivors.2 Women generally experience more depressive symptoms than men after a heart attack or bypass surgery.3, 4 People with additional illnesses – such as diabetes, kidney, or liver disease – who survive a heart attack are more likely to experience depression.5

Symptoms of Depression

Your physician may not recognize signs of depression,1 so it’s important that you familiarize yourself with them. Some people experience only a few symptoms while others experience many.

Symptoms of Depression 6
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

 

For more information:
Depression and Bipolar Support Alliance
Mental Health America

Can depression affect my recovery?

Many, but not all,7, 8 studies have found that depression increases the risk of dying after a heart attack.9-14 In women, depression appears to increase the risk of dying from a heart-related cause within the first year of a heart attack.15 In a study of people who underwent bypass surgery, depression was a stronger predictor of lack of functional improvement for women than men.16 The effects of depression can also last a long time: depression one month after surgery is associated with the recurrence of chest pain up to 5 years later.17 If you’re depressed, you may also be less likely to take your medicine or make the lifestyle changes prescribed by your healthcare provider.8

Is it normal to feel anxious after a heart attack or bypass surgery?

Anxiety is common after a heart attack or heart surgery; up to one third of heart patients experience anxiety.17Anxiety levels are highest in the first 12 hours after a heart attack.18 Many studies have shown that anxiety is more common in women than men after a heart attack or bypass surgery.18-22 For most heart patients, levels of anxiety return to normal after hospital discharge. If you can’t shake your concerns, you may have an anxiety disorder. About half of anxious heart patients still experience symptoms up to 1 year after their heart attack.17

Symptoms of Anxiety

Physicians do not usually check for anxiety so it can go undiagnosed in heart attack survivors.23, 24 Because of this, you should familiarize yourself with the symptoms of anxiety. Some people experience only a few symptoms while others experience many.

Symptoms of Anxiety 6
National Institute of Mental Health

  • Unable to relax or concentrate
  • Easily startled
  • Fatigue
  • Headaches
  • Muscle tension and muscle aches
  • Trembling or twitching
  • Irritability
  • Sweating or hot flashes
  • Feeling lightheaded or out of breath
  • Nauseous
  • Going to the bathroom frequently
  • Trouble falling or staying asleep

 

For more information:
Anxiety Disorders Association of America

Can anxiety affect my recovery?

Anxiety after a heart attack does not appear to increase your risk of dying,7, 8 but one small study found that people with higher anxiety levels 48 hours after their heart attack were five times more likely to have heart rhythm and blood flow problems.25 Another study of heart attack patients found that anxiety did not increase the risk of dying from a heart-related cause after 1 year in women, but slightly increased the risk of dying for men with very high anxiety levels.15

What if my anxiety symptoms are more severe?

Sometimes people who survive a heart attack or undergo bypass surgery suffer from a specific type of anxiety called post-traumatic stress disorder (PTSD). PTSD is a condition that develops after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened.

Symptoms of Post-Traumatic Stress Disorder

Symptoms of PTSD are more severe than the symptoms of general anxiety. PTSD is usually diagnosed if several of these symptoms persist for one month or more.

Symptoms of Post-Traumatic Stress Disorder6
National Institute of Mental Health

  • Recurring memories of the heart attack
  • Recurring nightmares about the heart attack
  • Emotional distress when passing by hospitals, or on the anniversary of the attack
  • Emotional numbness
  • Sleep disturbance
  • Heightened vigilance – expecting the worst with every ache or pain
  • Irritability or outbursts of anger
  • Avoidance of reminders or situations that remind them of the heart attack



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