Early Winter 2010
Depression After a Cardiac Event

Depression After a Cardiac Event

After surviving a heart attack or other cardiac event, life is bound to be different. Survivors may decide to make changes in what they eat or how much they exercise. Others may quit smoking or work on reducing stress.

What’s not expected is depression. According to leading experts, cardiac events seem to trigger depression in many people—often for the first time. Symptoms can crop up within days or weeks after the cardiac incident occurs.

For some, these symptoms will go away on their own in a few months. However, many people suffer from depression much longer than necessary after a cardiac event, and live each day waiting to feel like themselves again.

“It’s actually important for all adults who have survived a cardiac event to be evaluated by their physicians for depression,” says Bridgeport Hospital Chairman of Psychiatry Charles Morgan, MD. “Depression can get in the way of recovery and can also bring on new health concerns. Survivors can benefit greatly from early recognition and treatment, because treatment can improve quality of life and well-being.”

Facts about the cardiac-depression connection
About 1 in 3 adults in the United States who have survived a heart attack experience depression.

  • Depression in patients hospitalized for unstable angina, angioplasty, bypass surgery and valve surgery is similar those who have survived a heart attack.
  • Depression is slightly higher in those with congestive heart failure.
  • Depression is highest among young women who have survived a heart attack.
  • Depressed heart patients have a greater risk of suffering future cardiac events.

What is depression?
Depression is a medical illness that affects the mind and the body’s ability to function normally. Depression can lead to a variety of physical and emotional problems. It changes how you think, feel and behave and interferes with your ability to accomplish your day-to-day activities. It is more than “feeling sad” on occasion and therefore is not something that can be “shaken off.” When someone is suffering from depression, it is difficult for him or her to follow many of the lifestyle recommendations to improve their cardiac health.

Bridgeport Hospital

What causes depression?
Precisely what causes depression in one person and not another is not completely understood, but there are certain biological and behavioral connections between depression and coronary heart disease (CHD). What is known is that poor diet, exercise patterns, tobacco use, poor medication compliance, social isolation and chronic life stress are often seen in patients with depression and in patients suffering from CHD.

What are the treatments for depression?
The treatments for depression have improved greatly during the past few decades. Treatment options include medication, cognitive behavioral therapy and physical activity, such as aerobic exercise and cardiac rehabilitation.

Could You Be Depressed?

Your primary care physician is qualified to diagnose depression. In the meantime, try this simple self-assessment.

In the past two weeks, how often have you experienced the following? Please answer using this scale: 0=not at all, 1=about 5 days, 2=more than 7 days, 3=nearly 14 days.

  1. Little interest or pleasure in doing everyday activities.
  2. Feeling down, depressed or hopeless.

    Note: If you answer 1, 2 or 3 to either or both of these first two questions, please answer the rest of the questions. If not, then the depressed feelings you feel occasionally are probably within the normal range of human emotions.

  3. Trouble falling asleep, staying asleep or sleeping too much.
  4. Feeling tired or having little energy.
  5. Poor appetite or overeating.
  6. Feeling bad about yourself, feeling that you are a failure or feeling that you have let yourself or your family down.
  7. Trouble concentrating on things such as reading the newspaper or watching television.
  8. Moving or speaking so slowly that other people could have noticed, or being so fidgety or restless that you have been moving around a lot more than usual.
  9. Thinking that you would be better off dead or that you want to hurt yourself in some way.

Add together the item scores to get a total score. If you score higher than 9, please talk to your primary care physician to discuss your results and possible treatments that may be helpful. If you answered 1 or higher to question 9, please call your physician immediately or go to the nearest emergency department.

Which Came First?

When it comes to depression and heart disease, numerous studies acknowledge the association between the two, but the reason for the relationship remains inconclusive. In other words, which happens first—the heart disease or the depression? Researchers question whether people are depressed because they have heart disease or if depression—and related behaviors (poor diet, limited physical activity)—causes the heart disease.

Turkey Meatloaf

A low-fat version of a favorite cold-weather comfort food!

Serves 4
  • 1 lb. ground turkey, 94% lean
  • 1/2 cup unseasoned bread crumbs
  • 1 tablespoon Worcestershire sauce
  • 1 small onion, finely chopped
  • 1 egg, lightly beaten
  • 1/2 teaspoon salt
  • 1/4 teaspoon pepper
  • 1 tablespoon parsley
  • 1/2 teaspoon garlic powder
  • 1/4 cup ketchup

Preheat oven to 350 degrees. Spray baking dish or loaf pan with non-stick cooking spray. Combine all ingredients, except the ketchup, and mix together just until combined. Shape into meatloaf or put into a loaf pan and then spread ketchup over top. Bake for about 1 hour, or until internal temperature reaches 165 degrees.

Need a Physician?

For a referral to an expert cardiologist or cardiovascular surgeon affiliated with Bridgeport Hospital, please call us toll free, 24/7, at 1-888-357-2396 or visit www.bridgeporthospital.org/FindPhysician.
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