Depression and Heart Failure
People tend to think about physical wellbeing after experiencing a heart attack or cardiac surgery. However, depression is a critical symptom. There is a heightened risk of anxiety and depression after a heart failure diagnosis.
According to the American Heart Association, one in 10 Americans (age 18 and older) have depression. Symptoms of depression are about three times more common in patients after an acute heart attack.1 In patients with heart failure, depression and anxiety remain common.2 In fact, according to the Cleveland Clinic, 15% of heart failure patients and up to 20% of patients who have undergone coronary artery bypass graft (CABG) experience major depression.1
It has become part of my life
As someone who lives with heart failure, none of this is surprising. Heart failure and/or an acute heart attack are not just words on a piece of paper – the symptoms are debilitating and heavily burdensome. Moreover, these symptoms, especially with heart failure, do not just go away. They are hopefully managed with medications, but this management and vigilance become part of patients' lives. It has become part of my life every day.
With the tangible losses that accompany this new diagnosis, not to mention the medical trauma experienced from potentially facing death, it is therefore very understandable that many heart failure patients experience dim or hopeless feelings. Depression has also been found to impact our ability to stay well.3
What is depression?
Feeling sad or blue is different than a diagnosis of depression. There are life stressors like divorce, loss of a job, death of a loved one, a bad breakup, etc. All of these can cause understandably sadness or loneliness which can be a normal reaction to life’s stressors depending on how long these feelings last.
What are the symptoms of depression?
There are a variety of symptoms of depression. The Mayo Clinic lists the following:4
- Feelings of sadness, tearfulness (check), emptiness or hopelessness
- Angry outbursts (double check), irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
If you are experiencing any of these symptoms it is worth getting help. However, if you are experiencing them for 2 or more weeks, it is even more imperative to seek help!
What can be done about depression?
First, it is very important to be honest and tell your medical team about how you are feeling. I am a patient with a large academic research institution, and during my first appointment, a member of my team went through a mental health questionnaire. This is probably not everyone’s experience. If they do not ask and you have been feeling some of these symptoms I encourage you to tell your team. Again, this issue not uncommon with heart failure.
What is hard about treatment for depression is there is no one treatment or plan that can help everyone. The causes of depression and how depression makes us feel are different for everyone.
From personal experience, medications took the edge off, and the right therapist has been essential! On the therapy front, I would encourage you to find someone who is a good fit. It might be personality and/or someone who specializes in chronic health care conditions or medical trauma. Your heart failure care team might have a referral.
Why should I get help?
You might be asking why should I get help? In my opinion, no one deserves to live their life bursting into tears or feeling hopeless. Depression also has a very negative impact on recovery and cardiovascular health. Can you honestly say that you will be fully adherent when you feel hopeless? That, among many other things, is why doctors will (by and large) take this issue seriously. You should too.
How many times have you been to the ER due to your heart failure?