What kinds of treatment are available for depression and anxiety?
Treatments for depression and anxiety include several different forms of therapy from a variety of counselors. Antidepressant medication may be helpful if therapy does not work for you.
Does psychological counseling help heart patients?
Psychological counseling is a broad term that can include talk therapy, stress management, relaxation exercises, coping techniques, and, in some cases, the use of antidepressant medications. Psychological counseling may be included in a cardiac rehabilitation program or performed independently. Studies show that heart patients who undergo either type of psychological counseling have lower levels of depression and anxiety and a better quality of life.26, 27
Does psychological counseling as part of cardiac rehabilitation reduce the risk of dying?
Heart patients who underwent psychological counseling as part of cardiac rehabilitation programs have greater reductions in psychological distress, blood pressure, heart rate, and cholesterol levels than people who underwent cardiac rehabilitation without a counseling component.28 Some, but not all studies 29, 30 found that people who participated in cardiac rehabilitation with psychological counseling were less likely to die or experience future heart problems.28 This reduced risk of heart problems and death was not always seen in women and elderly patients.31
Does independent psychological counseling reduce the risk of dying?
Counseling done outside of a cardiac rehabilitation program does not appear to provide the same benefits. In the largest study of psychological treatments, people treated with cognitive therapy (a more active form of therapy aimed at changing the way you think and associate behaviors) and/or antidepressants after a heart attack were just as likely to die or have another heart attack as people who did not receive psychological treatments.32 When the results were broken down by race and gender, psychological treatment slightly reduced the risk of heart attack and death in white men, but not in white women or minority men and women.
In studies of psychological counseling done outside of a cardiac rehabilitation program, women don't seem to derive as much benefit as men do, possibly because the treatments are less likely to work in women. Two studies of heart patients found that women were less likely than men to see improvements in depression and anxiety after a counseling intervention.33, 34 Montreal researchers found that the risk of dying from any cause was slightly higher for women who received counseling compared with those who did not.34 If the psychological treatment does not reduce your depression and anxiety, it is unlikely to reduce your risk of dying or having another heart attack. The Montreal study found that men and women who experienced reduced depression and anxiety after psychological counseling (i.e., the treatment worked) were less likely to die or be hospitalized for a heart-related cause than men and women in whom the treatment failed.
How important is emotional support from family and friends?
Social ties and emotional support from friends and family are important during the recovery process. Social ties can include a spouse, close family members, and friends, as well as participation in group activities (social gatherings, religious organizations, etc.). Socially isolated heart attack survivors are four times more likely to die than survivors with social ties.35 Heart problems, such as chest pain ( angina) or another heart attack, also occur more often in isolated individuals.35, 36 Emotional support from friends and family helps prevent depression, which in turn can reduce your risk of dying.9, 10 It's important to discuss your fears and concerns with your family members because people who suppress their feelings tend to do worse over time.
How can I cope with the reactions of my friends and family to my illness?
It's very common for your family and friends to experience anxiety, depression, and fear after you have a heart attack or heart procedure.37 Studies of people who had a heart attack, angioplasty, or bypass surgery found higher levels of anxiety and depression in the spouses than the patients.38-40 After a heart attack or heart procedure, you may feel that you are getting well, but close friends and relatives may be troubled by what has happened to you. Your spouse may feel that they're not getting enough support from healthcare providers,41-43 which can be both upsetting and frustrating. It's possible that your spouse's stress could delay your recovery.44, 45
Sometimes the reaction of your friends, children, or significant other may manifest as denial of the severity of your illness or even anger. This negative reaction may be a coping mechanism used to deal with feelings of fear. Your family members and friends may be afraid that you'll have another heart attack, or die. It may ease their fears to know that there are steps you can take to reduce your risk of future heart problems, such as taking your medicine as prescribed, eating healthier foods, and getting more exercise.
They may also be reassured to know that there are things they can do to help you in the event of a heart attack. Encourage them to become informed about heart disease. They should be familiar with heart attack symptoms and what to do if you experience them. It may also be helpful if they learned cardiopulmonary resuscitation, or CPR. Courses are usually offered at local hospitals, fire and rescue departments, or Red Cross chapters.
Click Here to Find Your Local Red Cross Chapter
How can I join a support group?
If you had a heart attack or have been diagnosed with heart disease, you may wish to join a support group of other women with heart disease to meet people who understand your specific fears, sadness, and worries. To find a support group, check with your local hospitals. WomenHeart, the National Coalition for Women with Heart Disease, runs free support networks with many locations all across the country. You can also try The Mended Hearts, Inc., which you can join for a small fee.
For more information:
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