Life After a Heart Attack: Caring for Your Mental Health

If you recently had a heart attack or have been diagnosed with heart disease, you’re probably already dealing with a host of changes in your life. You may be on a new diet, doing a different exercise routine or dealing with some side effects of new medications.

What may not be top of mind right now is your mental health. We’re all guilty of sometimes putting our emotional well-being on the back burner. But after a heart attack, making your mental health a priority can be as important as looking out for your physical well-being.

That’s because people living with heart conditions are at a higher risk of depression, which can complicate your heart health even more.

We talked with psychiatrist Leopoldo Pozuelo, MD, about the connection between heart disease and depression. Here’s what you need to know.

Life changes after a heart attack

It’s normal if you’re not feeling like your usual self after your heart attack. That’s OK and to be expected. You’ve been through a lot. You may feel afraid or uncertain about what’s to come. You may also be in the midst of making some changes to your lifestyle, which can feel disruptive and overwhelming. It can definitely be a challenging time, and it may take some time to adjust.

“A heart attack is a major life event,” Dr. Pozuelo says. “When your life gets disrupted in a major way, it’s understandable and even expected that you will experience some strong emotions.”

A certain amount of sadness, fatigue and worry are par for the course after a heart attack. But that funk should be temporary. As you get back into a routine, your mood should lift, too.

If it doesn’t, it’s important to talk to your doctor, Dr. Pozuelo says. Depression is intricately linked to heart disease and can put your recovery at risk.

Heart attacks: Effects on your mental health

Studies show that people who are living with heart disease ― including people who are recovering from a heart attack or heart failure ― are at a higher risk of developing depression. In turn, living with depression is detrimental to your heart health. It’s a vicious cycle.

“Depression and anxiety can significantly impair your quality of life,” Dr. Pozuelo notes. “And we also know that these conditions can have dangerous effects on your heart.”

There are several ways that living with depression can be detrimental to your heart.

Living with high levels of stress can increase your blood pressure and put you at risk for arrhythmia and a weakened immune system. Depression can also increase the risk of having another heart attack or developing blood clots.

People living with depression are less likely to stick to the physical therapy or exercise routines that are important to their heart health. Depression also is associated with poor eating habits, smoking, overuse of alcohol and other habits that can also be detrimental to your heart.

Symptoms to watch out for

Feeling “down” for a bit after your heart event is normal. Your feelings of sadness and worry should gradually go away within a few weeks as your health improves and you start getting back to your normal routine and activities.

But those symptoms don’t always ease up. Up to 15% of people with cardiovascular disease experience major depression. Symptoms of clinical depression that may emerge after heart surgery, a heart attack or another heart condition include:

• Increased negative thoughts.
• Tearfulness.
• Withdrawing from people and activities.
• Having difficulty carrying out daily routines, including participating in your recovery.
• Not finding pleasure in things that used to bring you joy.
• Having suicidal thoughts or feelings.

The importance of taking care of yourself

After a heart attack, your doctor might recommend a cardiac rehabilitation program to help you understand nutrition, develop sustainable healthy behavior changes, stick to safe levels of exercise and improve the quality of your everyday life.

Dr. Pozuelo says that in addition to these activities, there are a number of ways to ensure you make your mental health a priority during your recovery.

And both the physical changes and mental health changes you make will make a big difference in your heart health.

“Practicing self-care alongside your doctor-recommended lifestyle changes — like eating well and exercising — can improve your mood and protect your heart,” Dr. Pozuelo says.

Taking care of your mental health after a heart attack can mean:

• Getting dressed every day.
• Practicing stress management and relaxation techniques.
• Walking daily.
• Resuming hobbies and social activities you enjoy.
• Sharing your feelings with your family, friend or another person you trust.
• Joining support groups to find community.

Depression can prevent you from leading a full life and can increase your risk of complications after a heart attack. If your depressed mood is severe and accompanied by other symptoms that persist every day for two weeks or more, it’s time to ask for help.

Some reasons for concern include:

• Difficulty getting up the energy to participate in your recovery.
• Significant difficulty with your daily routine, social activities or work.
• Social withdrawal and isolation.
• Suicidal thoughts or feelings.

Treatment for depression includes antidepressant medication, psychotherapy (supportive counseling or “talk therapy”) or a combination of both.

A healthy lifestyle, including regular exercise, proper sleep and a well-balanced diet, as well as relaxation and stress management techniques, can also help you manage depression.

“Early detection and treatment of depression are important to improving your quality of life and possibly preventing a future heart attack,” Dr. Pozuelo states. “Help is available to help you cope with depression and help you manage your heart disease.”